Dengue Hemorrhagic Fever (DHF) Nursing Review

High-yield practice flashcards covering pathophysiology, phases, DHF grading, diagnostic indicators, and essential nursing interventions for Dengue Hemorrhagic Fever.

What is Dengue Hemorrhagic Fever (DHF) characterized by?

Increased capillary permeability and plasma leakage.

What is the causative agent and virus family of Dengue?

Dengue virus (Flavivirus), which has four serotypes: DEN-1, DEN-2, DEN-3, and DEN-4.

What is the primary vector for Dengue virus transmission?

Aedes aegypti (can also be Albopictus, polynesiensis, and scultellaris).

What are the key characteristics and breeding habits of the primary Dengue mosquito vector?

Breeds in stagnant water, is a low-flying and day-biting mosquito, and has white bands on its legs and white markings on its wings.

What is the incubation period for Dengue?

3-10 days (or 3-14 days, with an average of 5-7 days).

What are the three main phases of Dengue Hemorrhagic Fever and their durations?

Phase 1: Febrile Phase (1-3 days), Phase 2: Critical Phase (4-7 days), and Phase 3: Recovery Phase (7-14 days).

What does a sudden drop in temperature indicate in a dengue patient?

It may indicate a worsening condition rather than recovery, signaling plasma leakage and impending shock.

What clinical manifestations occur during Phase 2 (Critical Phase) of Dengue Hemorrhagic Fever?

Fever subsides, plasma leakage begins, hemorrhagic manifestations appear, and hemoconcentration develops.

What are the classic clinical findings of Dengue?

Sudden high fever, severe headache with retro-orbital pain, abdominal pain, vomiting, bleeding gums, epistaxis (nosebleed), petechiae, and enlarged liver (hepatomegaly).

What are the warning signs suggesting progression to shock in a dengue patient?

Persistent vomiting, sudden and severe abdominal pain, restlessness, bleeding manifestations, narrowing pulse pressure, and cold clammy skin.

What findings characterize Grade I Dengue Hemorrhagic Fever (DHF)?

Fever, positive tourniquet test, easy bruising, anorexia, vomiting, and abdominal pain.

How is Grade II Dengue Hemorrhagic Fever (DHF) defined?

Grade I symptoms plus spontaneous bleeding.

What are the findings associated with Grade III Dengue Hemorrhagic Fever (Dengue Shock Syndrome)?

Weak rapid pulse, narrow pulse pressure, hypotension, cold clammy skin, and the onset of shock.

What defines Grade IV Dengue Hemorrhagic Fever (Severe DSS)?

Profound shock with no detectable blood pressure (BP) and no detectable pulse.

What is the hallmark laboratory finding in Dengue Hemorrhagic Fever?

Decreased platelet count (thrombocytopenia).

What lab finding serves as an indicator of plasma leakage in Dengue?

Increased Hematocrit (Hct).

What combination of CBC findings represents the classic DHF pattern?

Increased Hematocrit (↑ Hct) + decreased Platelets (↓ Platelets).

What is another name for the Tourniquet Test and how is a positive result defined?

Also called Rumpel-Leede Test or Hess Test; a positive finding is 20 or more petechiae appearing below the cuff area or antecubital fossa.

What is the most critical nursing assessment in a dengue patient and why?

Urine output, because it reflects tissue perfusion and fluid status.

What is the priority key treatment for Dengue Hemorrhagic Fever?

Fluid replacement (Oral Rehydration Solution for mild to moderate dehydration; IV fluids for severe dehydration).

Which medications are strictly contraindicated in dengue patients and why?

Aspirin, NSAIDs (Ibuprofen, Mefenamic Acid), and blood thinning meds (like warfarin or heparin) because they increase bleeding risk.

What is the antipyretic drug of choice for fever management in dengue?

Paracetamol (Acetaminophen).

What nursing interventions should be implemented for epistaxis in a dengue patient?

Elevate the head and apply an ice bag on the bridge of the nose and forehead.

What does the Department of Health (DOH) 4S Strategy stand for?

Search and destroy, Self-protection, Seek early consultation, and Say no to indiscriminate fogging.

Which types of foods should be recommended upon discharge to promote blood clotting?

Vitamin K-rich foods, including green leafy vegetables (kale, spinach, collard greens, mustard greens, turnip greens, Swiss chard), broccoli, Brussels sprouts, cabbage, asparagus, lettuce, soybeans/soybean oil, edamame, green peas, natto, egg yolk, liver, chicken, and cheese.

When prioritizing nursing actions for a dengue patient with warning signs, what should be evaluated first?

Think ABC + Circulation + Fluid Replacement: assess BP, pulse pressure, urine output, and hydration status first, as dengue deaths are primarily caused by plasma leakage and shock.