Eka Fatmawati (P1337420316007)

Yolanda Eka Putri (P1337420316013)

Syervina Kurrun P. (P1337420316015)
Syifani Wulan Sari (P1337420316017)
Putri Sekar Khasanah (P1337420316025)
Ratna Dwi Budiarti (P1337420316030)

GROUP 3
REGULAR A

DENGUE HEMORHAGIC FEVER (DHF)

 DHF

DEFINITION SIGNS AND SYMPTOMS

Dengue Hemorhagic 1. Incubation Period
Fever (DHF) is a 2. Fever
disease characterized 4. Shock
by the presence of a 5. Other clinical symptoms
mark – signs and
symptoms of fever
and bleeding.
 COMPLEMENTARY EXAMINATIONS.

1. HB, Hematokrit/PVC increases equal to or

more than 20%
Normal: PVC/Hm = 3 x Hb.
Normal values:
Male: 12.0 – 16.8 g/dl.
Female : 11.0 – 15.5 g/dl. THERAPY
-PVC/Hm: L: 35 – 48%. • Injection Amoxan
P: 34 – 45%.
2. Decreased Platelets (100,000/mm3. • Injection Kalmetson
Normal values: L: 150,000 – • Sanmol
400,000/mm3.
P: 150,000 – 430,000/mm3
3. Leucopenia, sometimes Leucositosis lightness.
Normal values: L/P: 4,600 –
11.400/mm3.
4. Bleeding Time lengthwise.
Normal values: 1 – 5 minutes.
5. Time of protombin compounds.
Normal values: 0 – 14 seconds.
As for the physical examination in children with dengue fever
were obtained the following results:
The general circumstances:
By grade (grade) DHF circumstances are as follows:
1. Grade I: compost mentis, Awareness generally weak, signs
– vital signs and pulse weak.
2. Grade II: compost mentis, awareness of the circumstances is
weak, there is spontaneous bleeding, bleeding gums and
petekia ear, as well as the pulse is weak, small, and
irregular.
3. Grade III: the State of public awareness is weak, apathetic,
somnolen, pulse weak, small, and not regular as well as
decreasing tensi.
4. Grade IV: the consciousness of coma, mark – vital signs:
the pulse not palpable, tensi no measurable, irregular
breathing, cold sweaty skin and extremities look cyanosis.
INTERVENSI
1. Increased body temperature (hipertermi) is associated with increased
metabolic rate.

Purpose Planning Rational

Maintain normal body •Measure the vital signs • Temperature 38-41,

temperature. (temperature) are 10 c
with the expected result: •Give a warm compress. • shows the process of
•body temperature •Increase the intake of acute infectious diseases.
between 36 – 370C. fluids. • warm compress heat
•Mucous membrane moist •Provide health transfer conduction will
•Muscle pain is gone the education How to handle occur.
Families understand the a child with high • to replace body fluids
action that should be temperature that are lost due to
performed evaporation
2. Fluid volume deficit related to loss of active
liquids.
Purpose Planning Rational
Fluid needs are • observations of the • decrease in blood circulation can
met. vital signs at least occur from increased loss of fluid
with the expected every three hours. resulting in hypotension and
results: • observation and catas tachycardia.
• The eye is not intake and output. • shows the status of the volume of
concave. • Weigh weight. circulation, the occurrence of fluid
• Mucous • Monitor the granting displacement/improvements, and
membrane of intravenous fluid response to therapy.
moist Good skin through each hour. • measure the appropriate fluid
turgor. replacement keadekuatan kidney
function.
• Maintain fluid balance/electrolyte.
 3. The nutrition changes less than body requirements related to
inability to digest food.
Purpose Planning Rational
Adekuat • Provide food that is • Replace lost vitamins due to
nutrition needs. accompanied with nutritional malnutrition or anaemia
with the supplements to improve the • smaller Portions can increase
criteria of the quality of the intake of nutrients. input.
expected • Recommend to parents to • Oversees weight loss.
results: provide meals with small portion • a clean Mouth enhances
Weight stable of engineering but often appetite and oral intake.
or increased gradually. • Explain the importance of
• Weigh weight every day at the intake of nutrients that are
same time and with the same adekuat for healing disease.
scale. • to motivate patients
• Maintain oral hygiene. increased appetite
• Explain the importance of intake
of nutrients that are adekuat for
healing disease.
• Explain the knowledge to their
families about nutrition so the
motivation so that increases
appetite
4. Capillary tissue perfusion changes associated with
bleeding
Purpose Planning Rational
peripheral tissue • Review and record the vital • decrease in blood
Perfusion adekuat. signs. circulation can occur
The criteria of the • the value of the probability from increased loss of
expected results: fluid resulting in
of the death of a network in
TTV stable hypotension.
the extremities such as cold,
• the condition of the skin
pain, swelling of the feet. are affected by
circulation, nutrition, and
immobilisasi
5. Lack of knowledge is not familiar with the related
sources of information
Purpose Planning Rational
clients understand and • determine the ability a. the existence of a desire to
understand the disease learn to facilitate the
process and treatment. and willingness to learn.
receipt of information.
• explain the rationale of
b. can increase cooperation
treatment, dosage, side
with drug therapy and
effects and the
prevent termination on the
importance of drug and the adverse drug
appropriate medication called or.
prescription. c. can increase knowledge of
• Give health education patients and may reduce

about the disease dengue anxiety

fever
 QUESTIONS

1. Patients aged 1 year in outpatient hospital with

complaints of fever and temperature 39 ºC Fever
occurs suddenly runs for 2 – 7 days later the fever
down to normal temperature or lower, no appetite, eat
depleted 3 spoons and there petekie. the results of
laboratory examination Trambositopenia (≤
100,000/ml). What is the proper medical diagnosis
for the child?
a. Diarrhea
b. Typoid
c. Anemia
d. DHF
Rational :
D : Patient with DHF after biting the sufferer and the
dengue virus into the skin then have a latency of 4-
5 days, followed by fever, malaise,nausea,vomiting.
2. Patients aged 7 years, address Manojaya came with her
mother to the clinic with a complaint of 3 days ago fever
accompanied there are red spots on face parts and
ekstermitas. The son also complained of a cough and would
not eat. When do physical examinations obtained on
temperature 39,2°C, 116x/min pulse, respiration 28
x/minute, the client's eyes look red, appetite diminishes and
clients complained he had a limp.
Whether the main nursing issues that appear on the child?
a. Hipertermi
b. activity Intolerance
c. damage to the integrity of the skin
d. Ineffectiveness way breath
Rational :
A : in answer number 2 i.e. hypertension because the
patient has a fever of 39, in cases of dengue fever
have signs symptoms fever, and nursing diagnosis
obtained will increase body
temperature/hipertermi
3. Intervention what should the nurse do in case
number 2?
a. Explain the rationale of treatment, dosage,
side effects and the importance of
appropriate medication prescription.
b. Recommend to parents to provide meals with

small portion of engineering but often

gradually.
c. Provide a warm compress.
d. Monitor the granting of intravenous fluid
through each hour.
Rational :
C : Patient who has the above normal temperature or
hipertermi can give a warm commpress to lower
body temperature (36,5 – 37,5 ºc)
4. Patients age 3 years brought to the hospital with
complaints of fever and Pekalongan in the evening
chills, then a nurse performing actions with measure
body temperature of the patient and give the medicine
paracetamol. Then the nurse asked his family "what if
my child's fever later that night what should I do?
How health education that should be said by the nurse
in that case?
a. The drug should be used until depleted
b. Explain how to give a warm compress
c. Explain the importance of tirah baring
d. Provide food that is easy on the thrash
Rational :
B. Because educating hot compressesis a
simpleway to reduce the temperature that a
mother can do at home when her child has a
highfever. The compresseswarmisthe main
problemthatmomcomplain.
A.3-year-olds are still difficult to take medication until
they run out.
C.Bed rest in DHF patientsis not appropriate because
patients will feel less comfortable if bed rest is too
long
D. nausea and vomiting reduce the child's appetite
5. Patients Age 4 years was taken to the hospital that his son's
nausea, vomiting, do not want to eat, after measuring in her
weight, her weight has decreased, after doctors in check that
the patient has the disease dengue fever
How the Extension should be said to the nurse to the patient's
family about the case?
a. increase the knowledge of the patient's family and patients
about nutrition so the motivation to eat increases
b. Assist the patient and family to reduce anxiety
c. Administering fluids is especially important for patients with
high temperatures
d. Explain the importance of administering drugs
Rational :
A. Toin crease the child's weight by improving
nutrition.
B. On the main problem thereis a lack off ulfilled
patient nutrition, so to reduce in sight can by
providing knowledge about nutrition improvement.
C. Fluid administration is very necessary, but weight
gain is not only in fluids but also in nutrition.
D.Child's fear of drugs make sit difficult for children
too bey taking medication, without good nutrition,
the body is difficult to receive drugs that enter
6. Patients Y the age of 4 years, brought to the hospital
with complaints of fever that lasted for 3 days
accompanied by cough colds, patients experience
nausea vomiting, do not want to eat and drink, bad skin
turgor. after a nurse did a study of the existence of the
red spots S: 38 º C Rr: 30 x/minute n: 95 x/minute
The Nursing problems?
a. damage to the integrity of the skin
b. Activity Intolerance
c. The risk of Fluid Deficit
d. Tissue Perfusion
Rasional :
C : nursing problems that occur An Y is the risk of fluid
devisit, because the patient has a fever, nausea
vomiting, not eating and drinking for 3 days, and bad
skin turgor. These signs and symptoms refer to
someone who has a fluid devisit.
7. Based on case number 6 patients experience a
fever of 38 ° C, therapy is right for a given
patient?
a. Amoxan
b. Sanmid
c. Kalmetson
d. Nacl
Rational :
B : Because sanmid is a medicine to reduce heat or
fever. In addition, this drug can actually be used for
all ages and not only for children. However, sanmid
should be used if a fever patient already has a body
temperature above 38,5 C. That Drugs contain
paracetamol can also be a drug to relieve pain
caused by mind arthritis, but it can also be used to
treat colds and colds.
8. A patient aged 5 years comes to the installation of
emergency HOSPITALS stem with complaints of fever and
then the nurse doing the assessments there are spontaneous
bleeding, red spots, bleeding gums and ears, composmetis,
the State of public awareness is weak and irregular. The
doctor said that the patient has dengue fever
In that case included in the patients of dengue on the grade
to what?
a. Grade 2
b. Grade 1
c. Grade 3
d. Grade 4
Rational :
A : because the fever can cause sufferes to
experience severe pain as if their bones were broken.
A number of symtoms of dengue fever are fever
headaches, reddish skin that looks like measles, and
pain in the muscles and joints so that they experience
bleeding.
9. Patients age 3 years, patients in the outpatient in the
hospital already 3 days, on day three of the patient's
family said the patient did not want to eat then nurses
provide health education regarding the needs for
nutrients.
How to evaluation in that case?
a. patient nutrition Requirements are met, the patient is
capable of menghabiiskan foods in accordance with a
given portion of
b. fluid balance undisturbed
c. the daily activities of the patient are met
d. the patient's normal body temperature
Rational :
A : in answer number 9, namely the patient’s
nutritional needs are met , the patient is able to
spend food according to the portion given ,
because the patient has been hospitalized for 3
days, on day 3, the family said that the patient did
not want to eat, then the nurse provided health
education regarding nutritional needs.
10. Female patients aged 2 years and came to the hospital
with complaints of fever, vomiting, cough, then check the
results of the laboratory the laboratory officer, Hb: 11 g/dl,
Lekosit: 3500/mm ³ 90,000 Platelets/mm3 Hematokrit
36%. Then the doctor said that the patient has dengue
fever.
How much is the result of normal platelet in General?
a. 1000/mm ³
b. 150.000-430,000/mm ³
c. < 100,000/mm ³
d. > 500,000/mm ³
Rational :
B : in answer number 10, which is 150.000-
430.000/mm3, because at dhf , for girls the normal
platelet result is 150.000-430.000/mm3
THANK YOU ~