Nursing Care Plan for Dengue Hemorrhagic Fever

NCP for Dengue Hemorrhagic Fever

Dengue Hemorrhagic Fever

Dengue hemorrhagic fever is a severe, potentially deadly infection spread by certain species of mosquitoes (Aedes aegypti).


Four different dengue viruses are known to cause dengue hemorrhagic fever. Dengue hemorrhagic fever occurs when a person catches a different type dengue virus after being infected by another one sometime before. Prior immunity to a different dengue virus type plays an important role in this severe disease.

Worldwide, more than 100 million cases of dengue fever occur every year. A small number of these develop into dengue hemorrhagic fever. Most infections in the United States are brought in from other countries. It is possible for a traveler who has returned to the United States to pass the infection to someone who has not traveled.

Risk factors for dengue hemorrhagic fever include having antibodies to dengue virus from prior infection and being younger than 12, female, or Caucasian.


Early symptoms of dengue hemorrhagic fever are similar to those of dengue fever, but after several days the patient becomes irritable, restless, and sweaty. These symptoms are followed by a shock -like state.

Bleeding may appear as tiny spots of blood on the skin (petechiae) and larger patches of blood under the skin (ecchymoses). Minor injuries may cause bleeding.

Shock may cause death. If the patient survives, recovery begins after a one-day crisis period.

Early symptoms include:
  • Decreased appetite
  • Fever
  • Headache
  • Joint aches
  • Malaise
  • Muscle aches
  • Vomiting

Acute phase symptoms include:
  • Restlessness followed by:
    • Ecchymosis
    • Generalized rash
    • Petechiae
    • Worsening of earlier symptoms
  • Shock-like state
    • Cold, clammy extremities
    • Sweatiness (diaphoretic)
Source :

Nursing Care Plan for Dengue Hemorrhagic Fever

Nursing Assessment for Dengue Hemorrhagic Fever
  1. Identity
    Dengue Hemorrhagic Fever is a tropical disease that often causes the death of children, adolescents and adults (Effendi, 1995)
  2. Main Complaint
    Patients complain of fever, headache, weakness, heartburn, nausea and decreased appetite.
  3. History of Disease Now
    Medical history showed headache, muscle pain, aches throughout the body, pain when swallowing, weakness, fever, nausea, and decreased appetite.
  4. Previous Disease History
    No illness is specific.
  5. Family Health History
    History of Dengue Hemorrhagic Fever disease in other family members is crucial, because the disease Dengue Hemorrhagic Fever is a disease that can be transmitted through the bite of mosquito Aedes aegipty.
  6. Environmental Health History
    Normally less clean environment, lots of clean water puddles like tin cans, old tires, a dirty bathtub.
  7. Historical Growth
  8. Assessment Per System
    • Respiratory System
      Shortness of breath, bleeding through the nose, shallow breathing, epistaxis, symmetrical chest movements, resonant percussion, auscultation sounds ronchi.
    • Neural System
      In grade III patients with anxiety and a decline in awareness and in grade IV can occur Dengue shock syndrome.
    • Cardiovascular System
      In grde I Hemo concentrations can occur, positive tourniquet test, thrombocytopenia, grade III to circulatory failure, rapid pulse, weakness, hypotension, cyanosis around the mouth, nose and fingers, in grade IV no palpable pulse and blood pressure can not be measured .
    • Digestive System
      Dry mucous membranes, difficulty swallowing, pain when the press in the epigastric, enlarged spleen, enlarged liver, abdominal stretch, decreased appetite, nausea, vomiting, pain on swallowing, can hematemesis, melena.
    • Urinary System
      Urine production declines, sometimes less than 30 cc / hour, will reveal pain when urinating, the colour of urine is red.
    • Integumentary System
      An increasing body temperature, dry skin, the grade I have a positive tourniquet test, occurred pethike, in grade III bleeding can occur spontaneously in the skin.
Nursing Diagnosis and Nursing Interventions for Dengue Hemorrhagic Fever (DHF)

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