Cherrielyn M.

Judan
BSN ll

Report about
Dengue

Introduction: Dengue fever is a viral illness transmitted to

humans through the bite of infected Aedes mosquitoes. It is a
significant public health concern worldwide, with an estimated
50 to 100 million infections occurring annually in over 100
countries. This report will provide an overview of dengue,
including its types, signs and symptoms, assessment, meaning,
nursing management for pediatric patients, pharmacologic and
medical management.

Types of Dengue: The four types of dengue are:

Dengue fever: Dengue fever is the most common type of

dengue. The symptoms include high fever, severe headache,
muscle and joint pain, nausea, vomiting, rash, and pain behind
the eyes. The symptoms usually appear within 4-7 days after
infection and can last up to 10 days.

Dengue hemorrhagic fever (DHF): Dengue hemorrhagic fever is

a more severe form of dengue that can lead to bleeding, shock,
and even death. It usually occurs in people who have already
been infected with dengue virus and have developed some level
of immunity. The symptoms of DHF include all the symptoms of
dengue fever, as well as bleeding from the nose, gums, or under
the skin, severe abdominal pain, and persistent vomiting.

Dengue shock syndrome (DSS): Dengue shock syndrome is the

most severe form of dengue and can be life-threatening. It
occurs when the body’s circulatory system fails and blood
pressure drops to dangerous levels. The symptoms of DSS
include all the symptoms of DHF, as well as severe abdominal
pain, rapid breathing, and cold, clammy skin.

Silent dengue infection: Some people may be infected with

dengue virus but not show any symptoms. This is known as
silent dengue infection or asymptomatic infection. These
individuals can still transmit the virus to others through
mosquito bites.

It's important to note that dengue fever, DHF, and DSS are all
caused by the same virus, but the severity of the disease
depends on a person's immune system and previous exposure
to the virus. Early diagnosis and treatment are crucial for
managing the symptoms and preventing complications.

Signs and Symptoms: The signs and symptoms of dengue

fever can range from mild to severe. The most common
symptoms include high fever, headache, muscle and joint pain,
nausea and vomiting, and a rash. In severe cases, dengue fever
can lead to a condition called dengue hemorrhagic fever, which
can be life-threatening. Symptoms of dengue hemorrhagic fever
include bleeding, low platelet count, and plasma leakage.

Assessment: The assessment of dengue fever includes a

physical examination and blood tests. The physical examination
may reveal a fever, rash, and signs of bleeding or plasma
leakage. Blood tests can confirm the diagnosis and determine
the type of dengue virus present. Diagnostic tests include
enzyme-linked immunosorbent assay (ELISA), reverse
transcription polymerase chain reaction (RT-PCR), and serology.

Meaning: Dengue fever is a viral illness that can cause

significant morbidity and mortality. The disease can be
prevented through measures to control mosquito populations
and protect against mosquito bites. There is currently no
specific treatment for dengue fever, and medical management
is focused on managing symptoms and preventing
complications.

Nursing Management for Pediatric Patients: Nurses play a

critical role in the management of pediatric patients with
dengue fever. The nursing management of pediatric patients
with dengue includes monitoring for signs of dehydration,
maintaining fluid and electrolyte balance, and managing fever
and pain. Patients with dengue fever are at risk of developing
dehydration due to high fever and vomiting. Therefore, it is
important to monitor fluid intake and urine output closely. The
use of oral rehydration solutions and intravenous fluids may be
necessary to prevent dehydration. Nurses should also educate
patients and their families on measures to prevent the spread
of dengue fever and protect against mosquito bites.

Pharmacologic Management: The pharmacologic management

of dengue fever includes the use of antipyretics to manage
fever and analgesics to manage pain. Nonsteroidal anti-
inflammatory drugs (NSAIDs) are not recommended due to the
risk of bleeding. In severe cases, patients may require blood
transfusions or intravenous fluids to manage fluid and
electrolyte imbalances. However, the use of platelet
transfusions is controversial and should be based on clinical
judgment.

Medical Management: Medical management of dengue fever is

focused on managing symptoms and preventing complications.
Patients with severe dengue fever may require hospitalization
and close monitoring for signs of hemorrhage, shock, and organ
failure. In severe cases, patients may require blood
transfusions, intravenous fluids, or other supportive measures.
Early recognition and prompt management of severe dengue
fever can improve outcomes and reduce mortality.

Nursing Diagnosis:Risk for Bleeding related to poor liver

function, increased hematocrit, thrombocytopenia, ruptured
blood vessels, and hypovolemic shock secondary to dengue
fever.

Goal: To minimize the risk of bleeding in the pediatric patient with

dengue fever.
Interventions:
● Monitor vital signs, including blood pressure, heart rate, and
respiratory rate, every 4 hours or as ordered.

Rationale: Frequent monitoring of vital signs will help detect

changes in the patient's condition that may indicate bleeding or
hypovolemia.

● Assess the patient's skin color, temperature, and turgor every 4

hours or as ordered.

Rationale: Assessment of skin color, temperature, and turgor can

help detect signs of poor perfusion or hypovolemia, which may
indicate bleeding.

● Assess the patient's level of consciousness every 4 hours or

as ordered.

Rationale: Changes in the patient's level of consciousness may

indicate hypoxia, hypovolemia, or cerebral bleeding.

● Administer prescribed medications, such as antipyretics and

analgesics, as ordered.

Rationale: Controlling fever and pain can help reduce the risk of
bleeding by preventing sudden changes in blood pressure.

● Administer blood products, such as packed red blood cells,

platelets, or fresh frozen plasma, as ordered.
Rationale: Blood products can help correct bleeding disorders and
increase blood volume in patients with hypovolemia.

● Monitor laboratory values, including hematocrit, platelet count,

and coagulation studies, as ordered.

Rationale: Laboratory values can help identify changes in the

patient's bleeding profile and guide interventions.

● Institute bleeding precautions, including the use of soft-

bristled toothbrushes, electric razors, and avoidance of rectal
temperatures and enemas.

Rationale: Bleeding precautions can help prevent trauma to the skin

and mucous membranes, which can increase the risk of bleeding.

● Encourage the patient to avoid activities that may cause

trauma or injury.

Rationale: Avoiding activities that can cause trauma or injury can

help prevent bleeding in patients with a high risk of bleeding.

Nursing Diagnosis: Risk for Shock related to severe plasma

leakage, bleeding, or sudden blood pressure drop secondary to
dengue fever.

Goal: To prevent shock in pediatric patients with dengue fever.

Interventions:
 ● Monitor vital signs, including blood pressure, heart rate, and
respiratory rate, every 4 hours or as ordered.

Rationale: Frequent monitoring of vital signs will help detect

changes in the patient's condition that may indicate shock.

● Assess the patient's skin color, temperature, and turgor every 4

hours or as ordered.

Rationale: Assessment of skin color, temperature, and turgor can

help detect signs of poor perfusion, which may indicate shock.

● Assess the patient's level of consciousness every 4 hours or

as ordered.

Rationale: Changes in the patient's level of consciousness may

indicate hypoxia or cerebral hypoperfusion, which can occur in
shock.

● Administer prescribed medications, such as IV fluids,

vasoactive medications, and antiemetics, as ordered.

Rationale: IV fluids and vasoactive medications can help increase

blood pressure and improve perfusion. Antiemetics can help
prevent vomiting, which can worsen shock.

● Provide oxygen therapy as ordered.

Rationale: Oxygen therapy can help improve tissue oxygenation and

prevent hypoxia, which can occur in shock.
 ● Institute strict bed rest and limit activity.

Rationale: Limiting activity can help decrease oxygen demand and

prevent further drops in blood pressure.

● Monitor laboratory values, including hematocrit, electrolyte

levels, and blood gas analysis, as ordered.

Rationale: Laboratory values can help identify changes in the

patient's condition and guide interventions.

● Educate the patient and family about the importance of rest,

hydration, and medication compliance.

Rationale: Patient and family education can improve understanding

of the disease process and encourage compliance with treatment
recommendations.

The nursing management of dengue in pediatric patients includes the following:

Assessing for signs and symptoms of dengue fever, such as high fever, headache,
rash, muscle and joint pain, vomiting, and bleeding.
Monitoring fluid and electrolyte balance to prevent dehydration and maintain
adequate hydration. This includes monitoring the patient's intake and output, vital
signs, skin turgor, and mucous membrane moisture.

Administering oral rehydration solutions and intravenous fluids as ordered to

prevent dehydration.

Assessing for signs of bleeding, such as petechiae, ecchymosis, and bleeding from
the gums or nose. Administering platelet transfusions as ordered to maintain
adequate platelet levels and implementing bleeding precautions.

Implementing isolation precautions to prevent the spread of infection, maintaining

strict hand hygiene, and monitoring for signs of infection.

Providing emotional support and reassurance to the patient and family, encouraging
the patient to express feelings, and involving the patient in their care by explaining
procedures and encouraging questions.

Educating the patient and family on measures to prevent the spread of dengue fever
and protect against mosquito bites, including wearing protective clothing, using
mosquito repellent, and removing standing water.

Administering antipyretics and analgesics as ordered to manage fever and pain.

Providing skin care, including frequent bathing and application of topical creams to
reduce itching.

Encouraging the patient to rest and limit physical activity to conserve energy.

Overall, the nursing management of dengue in pediatric patients focuses on

preventing complications, maintaining fluid and electrolyte balance, managing
symptoms, and providing emotional support and education to the patient and family.
Dengue is a viral infection that is transmitted by the Aedes mosquito. It is a
significant health problem in many parts of the world, particularly in tropical and
subtropical areas. Although most cases of dengue are mild and self-limiting, severe
cases can occur, particularly in children. There is no specific antiviral treatment for
dengue, and the management of the disease is mainly supportive.
In pediatric patients with dengue, the pharmacologic management aims to alleviate
symptoms and prevent complications. Some of the medications commonly used
include:

Acetaminophen: Fever and pain are common symptoms of dengue. Acetaminophen

is the recommended medication for relieving these symptoms in children with
dengue. It is important to note that nonsteroidal anti-inflammatory drugs (NSAIDs),
such as aspirin and ibuprofen, should be avoided in dengue patients, as they can
increase the risk of bleeding.

Intravenous fluids: Dehydration is a common complication of dengue, particularly in

children. Intravenous fluids are the mainstay of treatment for dengue-related
dehydration. The type and amount of fluids administered will depend on the severity
of dehydration.

Antiemetics: Nausea and vomiting are common symptoms of dengue, particularly in

children. Antiemetics, such as ondansetron, can be used to alleviate these
symptoms and prevent dehydration.

Platelet transfusions: Severe cases of dengue can lead to thrombocytopenia (low

platelet count), which can increase the risk of bleeding. Platelet transfusions may be
necessary in children with severe thrombocytopenia and bleeding.

Antipyretics: In addition to acetaminophen, other antipyretics, such as ibuprofen or

diclofenac, may be used to reduce fever. However, it is important to note that these
drugs should be avoided in children with dengue.

It is important to note that the use of medications in children with dengue should be
closely monitored by a healthcare provider, particularly in cases of severe dengue.
Children with severe dengue may require hospitalization and intensive care.
1. Synthesis: the ability to put parts together to form a coherent
or unique new whole. While 2. Eavaluating: making
judgements based on criteria and standards through checking
and critiquing. Critiques recommendations and reports are
some of the products that can be created to demonstrate the
processes of evaluation. In the newer taxonomy, evaluating
comes before creating as it is often a necessary part of the
precursory behavior before one creates something