Nursing Management of Dengue Hemorrhagic Fever

Dengue Hemorrhagic Fever

Dengue hemorrhagic fever is an acute febrile disease caused by four serotypes of dengue virus and is characterized by four main clinical symptoms are high fever, hemorrhagic manifestations, hepatomegaly, and signs of circulatory failure and the onset of shock (dengue shock syndrome) as a result of leakage of plasma which can lead to death. (Rohim et al, 2002; 45).

Signs and Symptoms

1. Fever.
Fever occurs suddenly lasts for 2-7 days, then go down to the normal temperature or lower. Along with ongoing fever, clinical symptoms are not specific example anorexia. Back pain, bone pain and supplies, headache and weakness may accompany it.

2. Bleeding.
Bleeding usually occurs on days 2 and 3 of fever and usually occur on the skin and can be torniguet test positive, easy bleeding at the site of venous function, petechiae and purpura. Mild to moderate bleeding can be seen in the upper gastrointestinal tract, causing haematemesis (Nelson, 1993; 296).
Gastrointestinal bleeding is usually preceded by severe abdominal pain. (Ngastiyah, 1995; 349).

3. Hepatomegaly.
At the onset of fever is usually the liver was palpable, although the liver of malnourished children also. If there is an increase of hepatomegaly and liver palpable springy to note the possibility to take place seizures in patients.

4. Shock.
The onset of shock usually occurs on day 3 since the pain sufferer, starting with signs of circulatory failure, namely the skin moist, cool the tip of the nose, fingers, toes and cyanosis around the mouth. When shock occurs during the fever usually indicate a poor prognosis.


Management of Patients with DHF are as follows:

1. Bed rest.
2. Diet soft meal.
3. Drink plenty of (2-2.5 liters / 24 hours) can be: milk, sweet tea, syrup and give people a bit of ORS, fluid administration is the most important for patients with DHF.
4. Intravenous fluids.
5. Monitor vital signs every 3 hours (temperature, pulse, blood pressure, respiration) if the patient's condition worsens, the strict observation of each hour.
6. Check hemoglobin, hematocrit and platelets every day.
7. Antipyretic drug delivery.
8. Monitor signs of further bleeding.
9. Giving antibiotics if there is a concern of secondary infection.
10. Monitor signs and shock covers; general condition, changes in vital signs, laboratory results deteriorate.