Nursing Care Plans | 12/22/2011, 1:07 am

2 Dengue Hemorrhagic Fever Nursing Care Plans


Dengue NCPDengue is transmitted by the bite of an Aedesmosquito infected with any one of the four dengue viruses. It occurs in tropical and sub-tropical areas of the world. Symptoms appear 3—14 days after the infective bite. Dengue fever is a febrile illness that affects infants, young children and adults.

Symptoms range from a mild fever, to incapacitating high fever, with severe headache, pain behind the eyes, muscle and joint pain, and rash. There are no specific antiviral medicines for dengue. It is important to maintain hydration. Use of acetylsalicylic acid (e.g. aspirin) and non steroidal anti-inflammatory drugs (e.g. Ibuprofen) is not recommended.

Dengue hemorrhagic fever (fever, abdominal pain, vomiting, bleeding) is a potentially lethal complication, affecting mainly children. Early clinical diagnosis and careful clinical management by experienced physicians and nurses increase survival of patients.

Read the two Dengue Hemorrhagic Fever Nursing Care Plans below

1. Ineffective Tissue Perfusion - Dengue Hemorrhagic Fever Nursing Care Plans

NDx: Ineffective tissue perfusion related to decreased HgB concentration in the blood secondary to DHF 1

A mosquito which carries the dengue virus is called Aedes aegypti. The said mosquito comes in contact with a person and bites the person. The dengue virus will flow through the blood stream and destroys blood components. Patients with dengue often has decreased WBC, platelet & haemoglobin count. Hemoglobin count is used to measure oxygen carrying capacity of the blood. Hemoglobin carries oxygen. Therefore, if there is decreased haemoglobin, there is also decreased oxygen that reaches the different tissues of the body.

AssessmentObjectivesNursing InterventionsRationaleExpected Outcome
Subjective: (none)Objective:

  • Decreased WBC
  • Decreased platelet
  • Decreased HgB
  • Decreased capillary refill time
  • Dysrhythmias
  • Altered LOC
  • Fever
  • Chills
  • Diaphoresis
Short Term:After 4 hours of NI, the pt will demonstrate behaviours to improve circulation.

Long Term:

After 4 days of NI, the pt will demonstrate increased perfusion as appropriate

  1. Establish Rapport
  2. Monitor Vital Signs
  3. Assess patient’s condition
  4. Note customary baseline data
  5. Determine presence of dysrhythmias
  6. Perform blanch test
  7. Check for Homan’s sign
  8. Note presence of bleeding
  9. Elevate HOB
  10. Encourage quiet & restful atmosphere
  11. Instruct to avoid tiring activities
  12. Encourage light ambulation
  13. Encourage use of relaxation techniques
  14. Administer medications
  1. To gain pt’s trust
  2. To obtain baseline data
  3. To assess contributing factors
  4. For comparison with current findings
  5. To identify alterations from normal
  6. To identify / determine adequate perfusion
  7. To determine presence of thrombus formation
  8. To determine risk of anemia
  9. To promote circulation
  10. To promote comfort & decrease tissue O2 demand
  11. To decrease cardiac workload
  12. To enhance venous return
  13. To decrease tension and anxiety level
  14. To treat underlying cause
The pt shall have demonstrated behaviours to improve circulationThe pt shall have demonstrated increased perfusion as appropriate

2. Hyperthermia - Dengue Hemorrhagic Fever Nursing Care Plans

NDx: Hyperthermia

When a person comes in contact with a mosquito, Aedes aegypti, the dengue virus flows through the blood stream. As the compensatory mechanism of the body, it will raise its temperature to allow the immune system to work better and to deteriorate the condition of the invaders thus causing hyperthermia.

AssessmentObjectivesNursing InterventionsRationaleExpected Outcome
S> (none)O>

  • Temp of 39.8 or higher
  • Flushed skin
  • Skin warm to touch
  • Chills
  • Increased RR
  • Tachycardia
  • Convulsions
  • Sweating
Short Term:After 4 hours of NI, pt’s temperature will decrease from 39.8 to 37.

Long Term:

After 3 days of NI, the pt will identify underlying factors & importance of treatment as well as s/sx requiring further evaluation or intervention

  1. Establish Rapport
  2. Monitor Vital Signs
  3. Assess neurologic response, note LOC & orientation, reaction to stimuli, papillary reactions & presence of seizures
  4. Note presence / absence of sweating
  5. Wrap extremities with bath towels
  6. Provide TSB q 15 minutes
  7. Apply local ice packs in axilla
  8. Instruct client to have bed rest
  9. Instruct client to increase OFI
  10. Administer replacement fluids
  11. Administer antipyretics
  12. Reassess temperature q 15 minutes
  1. To gain pt’s trust
  2. To obtain baseline data
  3. To evaluate effects & extent of hyperthermia
  4. To monitor heat & fluid loss
  5. To minimize shivering
  6. To reduce body temperature
  7. To reduce body temperature in areas of high blood flow
  8. To reduce metabolic demands / oxygen consumption
  9. To prevent dehydration
  10. To support circulating blood volume and tissue perfusion
  11. To restore normal body temperature
  12. To determine effectiveness of interventions done
The pt shall have a decreased body temperature from 39.8 to 37The pt shall have identified underlying factors and importance of treatment as well as s/sx requiring further evaluation or intervention

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4 Comments

  • md. abdul jabbar 09/23/2010 5:36 am

    32 years lady came to hospital with history of 2 days watery diarrhoea but physical condition is eyes sunken,thirst,lose of skin tregore,but pulse is normal and lathergic .my question is what is the dehydration score and what sign is false and how i will manage?

    Reply
    • ellen 10/31/2010 7:54 am

      i guess for me, the condition of the patient is in severe dehydration because lethargy is presence.adequate hydration is very much needed.laboratory examination should be done to rule out cause of diarrhea..pulse rate should i think that is confusing.

      Reply
  • rasana 08/21/2010 9:08 pm

    Nursing care in febrile phase:

    Problem: – High fever, headache, nausea and vomiting

    Aims: -Reduction the high of fever

    Ngs, Tepid sponge

    give paracetamol if fever > 39.0C

    Force oral fluid – ORS

    Chcek temperature every 4 hrs.

    Follow lab test CBC: Hct normol range,

    WBC >5,000 and Plt. > 100,000

    Reply
  • rasana 08/21/2010 8:48 pm

    Dengue infection in Thailand. There are 3 phase in natural course of Dengue.

    1. Febrile phase – High fever

    2 Leakage phase – plams leakage 24 -48 hrs.

    3. Convalescent phase – Normal clinical

    Reply

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