DENGUE FEVER IN CHILDREN MANAGEMENT.pptx

DENGUE FEVER IN CHILDREN MANAGEMENT

1. DENGUE FEVER

2. Introduction Dengue fever is a viral illness transmitted primarily by Aedes mosquitoes, specifically Aedes aegypti and Aedes albopictus. It is a significant public health concern in tropical and subtropical regions, particularly in India, where cases surge during the monsoon season. The disease can range from mild to severe, with complications such as haemorrhagic fever and shock syndrome, making it a leading cause of hospitalization in pediatric populations. Definition Dengue fever is an acute viral infection caused by the dengue virus (DENV), which exists in four serotypes (DENV- 1, DENV- 2, DENV- 3, and DENV- 4). It is transmitted through the bite of an infected Aedes mosquito.

3. Incidence In India, dengue cases peak during the monsoon season (June- September) with significant regional variation. According to the National Vector Borne Disease Control Programme (NVBDCP), India reports hundreds of thousands of cases annually. Causes The disease is caused by the Dengue virus. Transmission occurs when a female Aedes mosquito bites an infected person and then transmits the virus to a healthy individual.

4. Classification Dengue Fever (DF): Mild illness with high fever, rash, and body aches. Dengue Haemorrhagic Fever (DHF): Severe form with bleeding, low platelet count, and plasma leakage. Critical form with Dengue Shock Syndrome (DSS): circulatory failure and shock. Pathophysiology Pathophysiology of dengue fever After the mosquito bite, the dengue virus enters the bloodstream and replicates in various organs, causing immune activation. The immune response leads to increased capillary permeability, fluid leakage, and plasma loss.

5. In DHF, there is activation of the coagulation system, leading to bleeding, and in DSS, fluid leakage leads to hypovolemic shock Clinical Manifestations Dengue Fever High fever (40°C or higher) Severe headache, retro- orbital pain Muscle and joint pain (muscular pain) Rashes (maculopapular) Nausea and vomiting Mild haemorrhagic manifestations (petechiae) Dengue fever cycle Fever 2- 3 days Critical period 4, 5, 6 day

6. Recovery 7th day onwards Dengue Haemorrhagic Fever Severe bleeding (epistaxis, gum bleeding, easy bruising) Decreased platelet count Plasma leakage (edema, pleural effusion, ascites) Shock Dengue Shock Syndrome Severe hypotension Cold extremities, tachycardia Rapid, weak pulse Decreased urine output

7. Diagnosis Clinical Examination: Identifying fever, rashes, bleeding, and symptoms of shock. Laboratory Tests NS1 Antigen Test: Detects the virus in early stages. Dengue IgM and IgG Antibody Tests: Help identify past or current infections. leukopenia Complete Blood Count (CBC): Detects thrombocytopenia, and haemoconcentration Management Mild Cases Antipyretics (paracetamol) for fever. Hydration with oral fluids. Rest and symptomatic treatment.

8. Severe Cases IV fluids to combat dehydration and plasma leakage. Platelet transfusion in case of bleeding or very low platelet count. Blood products in case of haemorrhage or shock. Nursing Management Nursing management focuses on symptomatic treatment, prevention of complications, and education on mosquito control. Assessment Subjective Data Complaints of headache, joint and muscle pain, nausea, or abdominal pain. History of fever, rash, or bleeding tendencies.

9. Objective Data High- grade fever (biphasic pattern). Presence of petechiae, rash, or bruising. Positive tourniquet test (capillary fragility). Laboratory findings Low platelet count (thrombocytopenia) Haematocrit elevation (haemoconcentration). Positive NSI antigen or dengue IgM/IgG, Nursing Diagnoses Hyperthermia related to the viral infection Risk for Bleeding related to thrombocytopenia and increased capillary fragility. Risk for Fluid Volume Deficit related to plasma leakage and high fever. Acute Pain related to myalgia, arthralgia, and headache

10. Deficient Knowledge related to the disease process, management, and prevention. Goals The child will maintain a normal body temperature. Bleeding episodes will be prevented, and platelet count will stabilize. Fluid volume will remain adequate as evidenced by normal hydration status. The child will experience relief from pain and discomfort. Caregivers will demonstrate understanding of dengue fever management and mosquito control measures. Nursing Interventions Manage Fever (Hyperthermia) Prevent and Monitor for Bleeding Maintain Fluid Balance

11. Pain Management Educate Caregivers Monitor for Complications Psychosocial Support Evaluation The child maintains a normal temperature without febrile seizures. Bleeding episodes are prevented, and platelet count remains stable. Hydration is adequate, with normal urine output and no signs of shock. Pain and discomfort are effectively managed. Caregivers understand dengue fever management and adopt preventive measures.

12. Prevention and Control Levels of Prevention Primordial: Improve sanitation grounds. and eliminate breeding Primary: Personal protection and community awareness. Secondary: Early symptom recognition and hydration monitoring. Tertiary: Hospitalize for complications; fluids and platelet support. Control Measures Vector control via fogging and larviciding. Outbreak tracking and community IEC drives. School health monitoring during monsoon.