Dengue Nursing Care Plan: Deficient Fluid Volume

           Dengue fever is brought about by the Dengue virus transmitted by a vector known as the Aedes aegypti mosquito. Such sickness is very common in the tropics and subtropics due to the climate that favours the breeding of the mosquitoes that harbour the virus. At present, there are still no available vaccines to prevent such disease, however, there is a simple way to stop dengue and that is to prevent mosquitoes from biting you. Furthermore, the DOH has relaunched the 4 o’clock habit which is a program geared towards the elimination of breeding sites of mosquitoes a possible way that can lessen the risk for dengue infection

           If a person is infected with dengue he or she may manifest the following signs and symptoms: headache, sudden-onset fever, rashes and the muscle and join t pains to which we can attribute the other name of dengue which is “breakbone fever”.

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Here is a nursing care plan for a patient with dengue fever:

CUES/EVIDENCES:

Verbalized feeling very warm and thirsty
Objective data:
-V/S: Temp= 41 deg. C, Respi= 29 cpm, Pulse= 97 bpm, BP= 130/80 mmHg
-Diaphoresis
-Dry skin; mucous membranes; poor skin turgor
-Concentrated urine

NURSING DIAGNOSIS:

  • Deficient fluid volume related to an elevated body temperature and increased insensible loss secondary to Dengue
  • Deficient fluid volume r/t  increased metabolic state and insensible loss secondary to Dengue fever

OBJECTIVE:

At the end of the nursing care, the client will have restored normal fluid volume as evidenced by:
-Good skin turgor
-Moist mucous membranes
-Vital signs within normal limits
-Decreased perspiration
-Urine specific gravity within normal range

INTERVENTIONS:

Independent:
  1. Assess, document and monitor vital signs
  2. Assess skin turgor and mucous membranes
  3. Assess the color and amount of urine and specific gravity
  4. Assess fluid intake and output
  5. Assess the fluid status in relation to dietary intake
  6. Encourage to drink prescribed amount of fluid
  7. Monitor electrolyte results
  8. Provide oral hygiene

  Dependent:

  1. Administer IV fluids per doctor’s order
  2. Administer antipyretics (Paracetamol) per doctor’s order

RATIONALE:

Independent:
  1. Getting the baseline vital signs will allow you to compare and note the progress in rehydration or decline to dehydration.
  2. Poor skin turgor and dry mucous membranes signal decreased fluid volume
  3. Dark scant and dark-colored urine with decreased specific gravity denotes fluid deficit
  4. To note if patient is in need of taking in more fluids.
  5. This is to determine if there is equal intake and output of fluids.
  6. To help restore a normal fluid volume in the body.
  7. A deficient fluid volume may alter electrolyte levels
  8. Dry mucous membranes, especially on oral cavity, may cause peeling and oral hygiene may also promote interest in drinking.
Dependent:
  1. To help restore a normal fluid volume in the body.
  2. Paracetamol is the only drug allowed to lower down the temperature since NSAIDs may increase the risk for bleeding.

EVALUATION:

At the end of the nursing care the objectives were met and the client achieved normal fluid volume as evidenced by:
-Good skin turgor
-Moist mucous membranes
-Vital signs within normal limits
-Decreased perspiration
-Urine specific gravity within normal range

Jenny Margallo

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