- by Aegis Medicare
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- Feb 05 2018
Nursing Management of Dengue Haemorrhagic Fever
Some patients with dengue fever on to develop dengue haemorrhagic fever which is a severe and sometimes fatal form of the disease. Dengue is a mosquito-borne disease caused by genus Aedes.
Nursing management of patients with DHF is necessary and important to achieve complete recovery.
Assessment of a patient with DHF should include:
- Evaluation of the patient’s heart rate, temperature, and blood pressure.
- Evaluation of capillary refill, skin color, and pulse pressure.
- Assessment of evidence of bleeding in the skin and other sites.
- Assessment of increased capillary permeability.
- Measurement and assessment of the urine output.
The major nursing diagnoses for a patient with DHF are:
- The risk for bleeding related to possible impaired liver function.
- Deficient fluid volume related to vascular leakage.
- Pain related to abdominal pain and severe headaches.
- The risk for ineffective tissue perfusion related to the failure of the circulatory system.
- The risk for shock related to dysfunction in the circulatory system.
Nursing Care Planning and Goals
The goals in a patient with DHF are:
- Be free of signs of bleeding.
- Display laboratory results within the normal range for individuals.
- Maintain fluid volume at a functional level.
- Report pain is relieved or controlled.
- Follow prescribed pharmacologic regimen.
- Demonstrate adequate tissue perfusion.
- Display hemodynamic stability.
- Be afebrile and free from other signs of infection.
- Measure blood pressure as indicated.
- Note client report of pain in specific areas, whether pain in increasing, diffused, or localized.
- Maintain patency of vascular access for fluid administration or blood replacement as indicated.
- Periodic review of the medication regimen of the client.
- Establish 24-hour fluid replacement needs.
- Elevate position of the patient and apply an ice bag to the bridge of the nose and to the forehead.
- Place the patient in Trendelenburg position to restore blood volume to the head.
Home Care Guidelines
A patient with DHF discharged from the healthcare facility should be instructed to:
- Avoid caffeine and alcohol as indicated to reduce effects of diuresis.
- Comply with the recommended medical and laboratory follow-ups.
- Recommend use of soft toothbrush to reduce the risk of injury to the oral mucosa.
- Foods rich in vitamin K should be recommended to promote blood clotting.
- Educate patients on the use of mosquito nets and insecticides.
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