Nursing Care for Dengue Hemorrhagic Fever Patients in Critical Phase

Abstract

Dengue hemorrhagic fever (DHF) is found in all regions of the country. More than half of the leading causes of death are extreme bleeding and shock, especially gastrointestinal bleeding resulted from destroying endothelial cells. Blood clotting process is stimulated causing decreased platelets and clotting factors and plasma leaked to abdominal and pleural cavities resulting in low blood pressure and shock. The disease progresses into 3 stages. In the acute febrile stage, the temperature is usually high with petechiae. Some cases may present poor appetite and vomiting. In critical stage, which is the significant stage, there is plasma leakage that leads to circulatory failure in one third of the patients and has high risk for complications of many organs. With appropriate care, the patients will turn to convalescent stage in which having better symptoms accordingly and blood pressure, urine output, and appetite back to normal. Nurses play an important role in assessing and closely monitoring signs of bleeding and shock; administering blood or blood component as prescription; monitoring the balance of body fluid, urine output, and laboratory results to provide timely and appropriate care and treatment, so that the patients can go through critical to convalescent stage safely.