DENGUE FEVER

Question 1

DENGUE FEVER also known as?

Answer 1

Breakbone fever

Question 2

Causative Agents of Dengue

Answer 2

1. Dengue virus 1, 2, 3, 4
2. Chikungunya virus
3. O’nyong’nyong virus

Question 3

Source of infection (Mosquito) of DHF

Answer 3

Aedes Aegypti

Question 4

CHARACTERISTICS OF THE FEMALE MOSQUITO in DHF

Answer 4

D- day biting (3pm-4pm)
L- low fling (common pedia pt.)
S- stagnant water
U- urban areas

Question 5

Incubation period of DHF

Answer 5

6-7 DAYS (6 DAYS- 1WK)

Question 6

MODE OF TRANSMISSION of DHF

Answer 6

Bite of Aedes Aegypti

Question 7

Peak months of DHF

Answer 7

Sept- oct

Question 8

Diagnostic test for DHF

Answer 8

1. Tourniquet test/ Rumpel leede’s test/ capillary fragility test
2. Platelet count
3. Serologic test (IgM then IgG after 3-4 days)

Question 9

Procedure: Tourniquet test/ rumpel leede’s test/ capillary fragility test

Answer 9

1. Get BP
2. Then deflate
3. Inflate through midway
4. Stay for 5 mins.
5. Deflate
6. Draw imaginary 1in square in antecubital fossa
7. Count petechiae (at least 20)= +

Question 10

Normal plt count

Answer 10

150,000- 450, 000 uL

Question 11

Serologic test of DHF

Answer 11

IGM then IGG (after 4 days)

Question 12

Stages of DHF

Answer 12

A. Febrile/invasive stage
B. Toxic/hemorrhagic stage
C. Convalescent/ recovery stage

Question 13

Stages of DHF:
A. Febrile/invasive

Answer 13

• 1 to 3 days: high fever
• 3rd day: pruritic rash, n/v, abdominal pain, headache, myalgia, arthralgia, anorexia

Question 14

Stages of DHF
B. Toxic/hemorrhagic stage

Answer 14

• 4 to 7 days
• epistaxis, gum bleeding, melena, hypotension, narrowed pulse pressure

Question 15

Stages of DHF
C. Convalescent/recovery stage

Answer 15

• 8 to 10 days
• return to normal state, general flushing, BP returns to normal, regains appetite

Question 16

GRADE LEVELS OF DHF

Answer 16

Level 1, 2, 3, 4

Question 17

GRADE LEVELS OF DHF
Level 1

Answer 17

• (+) tourniquet test
• pruritic rash, n/v, headache, anorexia

Question 18

GRADE LEVELS OF DHF
Level 2

Answer 18

• spontaneous bleeding
• epistaxis, gum bleeding, melena

Question 19

GRADE LEVELS OF DHF
Level 3

Answer 19

• circulatory collapse
• hypo, tachy, tachy
• restlessness
• decreasing LOC
• oliguria
• weak and diminished pulses

Question 20

GRADE LEVELS OF DHF
Level 4

Answer 20

• s/sx of sever and profound shock
• obliterated pulses
• hard to wake up

Question 21

Nursing management DHF

Answer 21

• ASSESS FOR S/S OF BLEEDING
• ICE PACKS (place on forehead to relieve epistaxis)
• TSB AND INCREASE FLUID INTAKE (replace blood loss= increasing circulatory vol.= prevent hypovolemia)
• Monitor vital signs
• DIET: avoid dark colored foods and beverages, No ASA, Increase (Vit. C, protein, fiber), Decrease (fat)
• CALAMINE LOTION (pruritus)
• BORIC ACID/SALINE COMPRESS (pruritus- small amount only)

Question 22

Medical management DHF

Answer 22

• IV Fluids (Isotonic= neg. Dehy and hypovolemia) (hypotonic= + dehy)
• ORESOL (electrolyte loss
• Antipyretics (Paracetamol): FOR FEVER
• Codeine: severe headaches and for
  myalgia
  -No Aspirin (promote bleeding)
• Blood transfusion (common: fresh frozen plasma) for thrombocytopenia and anemia

Question 23

How to prepare ORESOL

Answer 23

homemade solution composed of 1 teaspoon of salt, 4 teaspoons of sugar mix to 1liter of water

Question 24

PATHOGENESIS

Answer 24

1. Bite of Aedes Aegypti
2. Virus penetration to skin
3. Replicates inside the Langerhans cells (immunity if the skin)
4. Langerhans cell release interferon (limits spread of infection)
5. Infected Langerhans cells go to the lymphatic (alert the immune system)
6. Goes to the circulation
7. Viremia (high level of virus in the bloodstream)
8. Activation of immune response and blood vessels became fragile
9. Increased capillary permeability
10. Plasma leakage
11. Increase lymphocytes; decrease WBC, platelets, and neutrophils
12. Released of pyrogen, bleeding
13. Fever
14. Increase blood pressure in vessel
15. Rash