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Malaria: Nursing Care Plan, Nursing Diagnoses and

Interventions
How does Malaria affect our body?
First, the parasites grow and multiply in the liver cells and then infect red blood cells. After
infecting red blood cells, they grow and multiply and later destroy them. The death of the red blood
cell causes the release of malaria parasites to neighboring red blood cells, perpetuating further
infection.

Clinical manifestations of Malaria:


Early Symptoms: fever, headache, chills, GI symptoms (e.g. diarrhea and vomiting)
Severe manifestations of complicated malaria: anemia, abnormal bleeding, circulatory collapse,
jaundice, hemoglobinuria, respiratory distress, pulmonary edema, altered mental status, cerebral
malaria (CNS infections), renal failure (rare complication),

Nursing Care for patients with Malaria:


a. Physical Examination:
1. Assess level of consciousness using Glasgow Coma Scale during assessment and/or hourly if
severely ill.
2. Monitor vital signs and urine output. Look for evidence of shock
(e.g. low BP, high RR, high HR).

3. Look for enlarged spleen (Splenomegaly), which may indicate previous infection of malaria.
4. Assess for signs of anemia and bleeding. Be equipped to provide blood transfusion if needed.
5. Monitor for hypoglycemia, especially for populations at increased risk, such as pregnant women.
b. Complicated Severe Malaria Laboratory Tests:
- Severe anemia
- Hypoglycemia
- Acidosis
- Renal impairment
- Hyperlactatemia

Visit Nursing Care of Malaria Patients for more detailed information about nursing plan of care for
patients with uncomplicated and complicated (severe) malaria during physical examination, pre-
referral, transfer, and post-referral care.

Nursing Diagnoses for Nursing Assessments: Nursing Interventions:


Malaria:
1. Impaired Circulation - Assess pt’s airway, - Pt may need supplemental
related to anemia and breathing, and respiratory oxygen if condition is severe.
destruction of RBC needed condition (e.g. respiratory - Maintain a well-ventilated
for delivery of oxygen and distress, shortness of breath, room.
nutrients in the body. shallow fast-paced breathing) - Head of the bed at 30º.
- Monitor vital signs, - Lessen activities that
especially body temperature. require moderate to high
- Assess skin color, pulse, exertion.
and capillary refill.
2. Hyperthermia related to - Monitor vital signs and - Warm water compress on
increased metabolism, keep an eye on increase and forehead and both axilla (not
dehydration, direct effects of changes in body temperature. more than 15 minutes each
parasites on the hypothalamic time).
circulation. - Maintain warm
environment by using warm
blankets, adequate clothing).
Pt may sweat excessively.
Make sure to avoid exposing
pt to wet clothes and linens.
- Administration of
antipyretic drugs as ordered.
3. Fluid Volume deficit - Monitor I&O of pt. - Expect loss of fluid through
- Assess for dehydration (e.g. sweat. Provide information
skin turgor) about fluid balance and
guideline for fluid
replacement.
- Administer parenteral fluids
as ordered.
4. Imbalanced Nutrition, less - Assess for GI symptoms - Provide food in a well
than body requirements (e.g. nausea, passing gas, ventilated, pleasant
abdominal distention) environment as tolerated.
- Provide oral hygiene
- Encourage bed rest/lessened
activity for the time being.
- Administer PRN anti-
emetic medications as
appropriate.
5. Risk for Knowledge - Assess what the patient - Review the disease process
Deficit about disease knows and concerns about and therapy, focusing on pt’s
the disease concerns.
- Discuss importance of
adhering to therapy. Go over
medication, purpose,
frequency, dosage, and side
effects.
- Have a family member or
trusted individual listen to
and understand guideline of
treatment as the patient
chooses.
NCP NANDA: Nursing Intervention of Malaria is a site that briefly goes over nursing interventions for
malaria and related signs and symptoms for each diagnosis. There are 4 main diagnoses presented
on the page, but is really helpful because it elaborates on important nursing diagnoses, assessments,
and interventions for malaria. Most information above are directly quoted from NCP NANDA.

Bibliography:
NCP NANDA. (n.d.). Retrieved May 13, 2015, from http://ncpnanda.blogspot.com/2013/03/nursing-
intervention-of-malaria.html

NANDA Nursing. (n.d.). Retrieved May 13, 2015, from http://nanda-nursing.blogspot.com/2011/02/


nursing-care-plan-for-malaria.html

Retrieved May 18, 2015 from http://www.tm.mahidol.ac.th/eng/tropical-medicine-knowledge/book-


pocket-guilines/i-book-nurse02-pocket-guilines-part2.pdf

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