DENGUE FEVER Flashcards
DENGUE FEVER also known as?
Breakbone fever
Causative Agents of Dengue
- Dengue virus 1, 2, 3, 4
- Chikungunya virus
- O’nyong’nyong virus
Source of infection (Mosquito) of DHF
Aedes Aegypti
CHARACTERISTICS OF THE FEMALE MOSQUITO in DHF
D- day biting (3pm-4pm)
L- low fling (common pedia pt.)
S- stagnant water
U- urban areas
Incubation period of DHF
6-7 DAYS (6 DAYS- 1WK)
MODE OF TRANSMISSION of DHF
Bite of Aedes Aegypti
Peak months of DHF
Sept- oct
Diagnostic test for DHF
- Tourniquet test/ Rumpel leede’s test/ capillary fragility test
- Platelet count
- Serologic test (IgM then IgG after 3-4 days)
Procedure: Tourniquet test/ rumpel leede’s test/ capillary fragility test
- Get BP
- Then deflate
- Inflate through midway
- Stay for 5 mins.
- Deflate
- Draw imaginary 1in square in antecubital fossa
- Count petechiae (at least 20)= +
Normal plt count
150,000- 450, 000 uL
Serologic test of DHF
IGM then IGG (after 4 days)
Stages of DHF
A. Febrile/invasive stage
B. Toxic/hemorrhagic stage
C. Convalescent/ recovery stage
Stages of DHF:
A. Febrile/invasive
- 1 to 3 days: high fever
- 3rd day: pruritic rash, n/v, abdominal pain, headache, myalgia, arthralgia, anorexia
Stages of DHF
B. Toxic/hemorrhagic stage
- 4 to 7 days
- epistaxis, gum bleeding, melena, hypotension, narrowed pulse pressure
Stages of DHF
C. Convalescent/recovery stage
- 8 to 10 days
- return to normal state, general flushing, BP returns to normal, regains appetite
GRADE LEVELS OF DHF
Level 1, 2, 3, 4
GRADE LEVELS OF DHF
Level 1
- (+) tourniquet test
- pruritic rash, n/v, headache, anorexia
GRADE LEVELS OF DHF
Level 2
- spontaneous bleeding
- epistaxis, gum bleeding, melena
GRADE LEVELS OF DHF
Level 3
- circulatory collapse
- hypo, tachy, tachy
- restlessness
- decreasing LOC
- oliguria
- weak and diminished pulses
GRADE LEVELS OF DHF
Level 4
- s/sx of sever and profound shock
- obliterated pulses
- hard to wake up
Nursing management DHF
- 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)
Medical management DHF
- 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
How to prepare ORESOL
homemade solution composed of 1 teaspoon of salt, 4 teaspoons of sugar mix to 1liter of water
PATHOGENESIS
- Bite of Aedes Aegypti
- Virus penetration to skin
- Replicates inside the Langerhans cells (immunity if the skin)
- Langerhans cell release interferon (limits spread of infection)
- Infected Langerhans cells go to the lymphatic (alert the immune system)
- Goes to the circulation
- Viremia (high level of virus in the bloodstream)
- Activation of immune response and blood vessels became fragile
- Increased capillary permeability
- Plasma leakage
- Increase lymphocytes; decrease WBC, platelets, and neutrophils
- Released of pyrogen, bleeding
- Fever
- Increase blood pressure in vessel
- Rash
