DHF

4 CLASSIFICATIONS 1. Dengue without warning signs - Signs and symptoms High grade fever Headache Retroorbital pain Muscle and joint pain Abdominal pain 2. Dengue with warning signs - Signs and symptoms Nausea and vomiting Petechiae Hermans sign Hematemesis Melena Hematochizia Epistaxis, gum bleeding 3. Severe DHF - Signs and symptoms Circulatory failure Cold clammy skin Cold extremities Decrease capillary refill Decrease BP Rapid waek pulse Increased RR 4. DSS ( Dengue Shock Syndrome) - Signs and symptoms Decrease VS Shock (hypovolemia)

5-10mins >20 petechiae in square inch. 2. Platelet count decreased - 150,000 400,000 mm3 3. Increased haematocrit - 0.37 0.54 MEDICAL MANAGEMENT - Symptomatic NURSING CARE - Prevention and control of bleeding - Avoid colored foods that can alter the result of guiac test ( occult blood test) - Increase body resistance - Increase fluid intake PREVENTION - Eradicate the mosquito

Hermans sign

Dx. Exam
1. Rumpel Leade Test ( tourniquet test) - For capillary fragility *3 Criteria to perform 1. age 6 months and older 2. fever more than or equal to 3 days 3. no other signs of DHF - presumptive test BP = S + D = mmHg 2