Dengue

Cause of Dengue

Flavi Virus

4 strains of Flavi Virus

DENV 1

DENV 2

DENV 3

DENV 4

Is dengue contagious?

No

Vector of Dengue?

Flavi Virus Infected Female Aedes Aegypti

2 viruses spread by Female Aedes Aegypti

Flavi Virus, Arbovirus

Dengue Prevention (pt education) = 4

Wear long sleeves, spray insect repellent, clean surrounding area, and search and destroy dirty stagnant water

DOC for dengue

none

Mainstay Mgt for Dengue

Fluids

incubation period of flavi virus after the female aedes aegypti mosquito bite

4 to 10 days

DOC for dengue

none

Female Aedes Aegypti Mosquito Characteristic: High Flying or Low Flying?

Low Flying

Female Aedes Aegypti Mosquito Characteristic: Day Biter or Nighttime Biter

Day Biter

Female Aedes Aegypti Mosquito Characteristic: Clean Flowing Water or Dirty Stagnant Water

Likes Dirty Stagnant Water

Normal APC level

150,000 to 450,000

WOF: bleeding signs

Epistaxis, Gingival Bleeding, Melena, Abdominal Pain

3 symptoms of DHN on Dengue, caused by fever

Dry Skin, Dry Mouth, Sunken Eyes

What does severe DHN cause to a pt?

Hypovolemic Shock

Nursing Diagnosis for someone who is DHN

Fluid Volume Deficit

Presumptive diagnostic tool that test capillary integrity

Tourniquet Test

What is the name for the presumptive dx tool for dengue where you’ll inflate the BP cuff for 1 min or put on the tourniquet

Rummpel Leads Test

Confirmatory Dx tool for dengue that detects the effects of dengue such as hemoconcentration

APC

This laboratory test can detect presence of dengue viral antigen in the blood in the acute phase of the disease

Dengue NS1 antigen

normal hematocrit level

35 to 45

HCT > 45 indicates what?

hemoconcentration

COmplications of dengue

Hypovolemic Shock

Mgt for Hypovolemic Shock

Plain LRS

what to prepare in cases such as hypovolemic shock to monitor hemodynamic status of the patient

CVP Tray

Symptomatic relief for Dengue, since there is no drug that can treat dengue

Antipyretic

General choice of Antipyretic for pt that has fever on top of dengue

Paracetamol

General choice of management for pt that has fever on top of dengue but allergic to paracetamol, can be also done if pt is taking paracetamol

TSB

Drug class contraindicated for Dengue since they are antiplatelet

NSAIDS

2 examples of NSAIDS that are contraindicated for pt that has dengue

Mefenamic Acid, Ibuprofen

Mainstay Treatment for Dengue, the fluid of choice?

IVF (Plain LRS)

Drug of choice for shock to increase Cardiac output as well as blood pressure

Dobutamine (B1 specific agonist), Dopamine (more beta than alpha)

Drug of choice for shock to vasoconstrict the blood vessels in order to increase venous return, and hence increase C.O as well as Blood pressure

Norepinephrine (levophed) = more alpha than beta

side effect of Dobutamine, Dopamine, and Levophed

Tachycardia (WOF)