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    Case-Presentation 2

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    Ugalde Alyssakyle
    The patient, an 11-year old girl, presented with fever, abdominal pain, and vomiting and was diagnosed with dengue fever. Her vital signs and laboratory results on admission showed signs of infection such as elevated temperature and low platelet count. She was given IV fluids, antipyretics, and antibiotics and closely monitored. Her symptoms improved over time as evidenced by normalization of vital signs and increasing platelet count. Nursing care focused on reducing fever through tepid sponging and monitoring for worsening of condition.

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    Case-Presentation 2

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    Ugalde Alyssakyle
    32 views28 pages
    The patient, an 11-year old girl, presented with fever, abdominal pain, and vomiting and was diagnosed with dengue fever. Her vital signs and laboratory results on admission showed signs of infection such as elevated temperature and low platelet count. She was given IV fluids, antipyretics, and antibiotics and closely monitored. Her symptoms improved over time as evidenced by normalization of vital signs and increasing platelet count. Nursing care focused on reducing fever through tepid sponging and monitoring for worsening of condition.

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    CASE-PRESENTATION 2

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    The patient, an 11-year old girl, presented with fever, abdominal pain, and vomiting and was diagnosed with dengue fever. Her vital signs and laboratory results on admission showed signs of infection such as elevated temperature and low platelet count. She was given IV fluids, antipyretics, and antibiotics and closely monitored. Her symptoms improved over time as evidenced by normalization of vital signs and increasing platelet count. Nursing care focused on reducing fever through tepid sponging and monitoring for worsening of condition.

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    32 views28 pages

    Case-Presentation 2

    Uploaded by

    Ugalde Alyssakyle
    The patient, an 11-year old girl, presented with fever, abdominal pain, and vomiting and was diagnosed with dengue fever. Her vital signs and laboratory results on admission showed signs of infection such as elevated temperature and low platelet count. She was given IV fluids, antipyretics, and antibiotics and closely monitored. Her symptoms improved over time as evidenced by normalization of vital signs and increasing platelet count. Nursing care focused on reducing fever through tepid sponging and monitoring for worsening of condition.

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    of 28

    CASE

    PRESENTATI
    ON
    Pediatric Ward
    Exposure

    March 06-15,
    2023
    TABLE OF CONTENT
    Introduction
    Demographic Data
    Physical examination
    Laboratory result
    Doctor’s Order
    Prevention
    Conclusion
    DENGUE
    Dengue

    Is a mosquito-borne illness that


    occurs in tropical and subtropical
    areas of the world. Mild dengue
    fever causes a high fever and flu-
    like symptoms.
    What causes dengue?

    Dengue is a viral infection transmitted to humans through the


    bite of infected mosquitoes. The primary vectors that transmit
    the disease are "Aedes aegypti" mosquitoes and, to a lesser
    extent, albopictus. The virus responsible for causing dengue,
    is called dengue virus (DENV).

    Severe dengue can result in shock, internal bleeding,


    and even death. If you have had dengue in the past,
    you are more likely to develop severe dengue. Infants
    and pregnant women are at higher risk for developing
    severe dengue.
    The most common symptom of dengue is
    fever with any of the following:

    • Nausea
    • Vomiting
    • Rash
    • Aches and pains (eye pain,
    typically behind the eyes,
    muscle, joint, or bone pain)
    Case # 4173774
    Demographic Data
    Bressel Ken Blanco Bancale
    Age: 11 years old
    Lived: Purok 2, Talisay,
    Malaubang Ozamiz City.

    Family background: Diagnosed with Dengue fever and has been


    • Ginalyn Bancale (mother) admitted at March 4, 2023 (09:30 AM) in
    • Vincente Bancale( father)
    MHARSMC at Pediatric Ward.
    • Jovinc Bacale (brother)
    • Nathaniel Bancale (brother)
    History of 5 days continuous fever and no
    consult done, given Paracetamol which
    provided mild relief. Condition persisted,
    now associated with fair appetite and not
    tolerating oral medication hence admitted.
    She became more unwell on the day of
    admission with recurrent bouts of
    vomiting, abdominal pain, and reduced
    urine output. Further discussion showed
    that her neighbor had a similar illness
    requiring admission to the hospital a week
    ago.
    Day on admission: March 4, 2023
    Bp: 90/60 mmHg
    PR: 139 BPM March 06, 2023
    Complaint: RR: 19 CPM Bp: 100/60 mmHg

    On and off fever X 3 day’s O2SAT: 98% PR: 72 BPM


    abdominal pain, dizziness T: 38.4 ◦C RR: 22 CPM
    Admission Diagnosis: O2SAT: 96%

    Dengue fever with warning T: 39 ◦C


    signs March 07, 2023
    Bp: 100/60 mmHg
    Symptoms:
    PR: 96 BPM
    Abdominal cramp/pain, Body
    RR: 23 CPM
    pain, Fever, Anorexia, Vomiting
    O2SAT: 97% Height: 152 cm

    T: 36◦C Weight: 52 kg
    Physical Examination
    • (Head, Eyes, Ears, Nose, Throat)
    HEENT: Dry mucous membranes
    • Chest/Lungs: Essentially Normal
    • CVS: Essentially Normal
    • Abdomen: Abdomen Tenderness
    • GU (IE): Essentially Normal
    • Skin: Essentially Normal
    • Neuro: Essentially Normal
    11
    Doctor’s Oder

    IVF: PLR 1c @ 20 gtts/min


    Paracetamol 300 mg IV Q4hrs PRN
    Omeprazole 40 mg W now then Q24hrs
    Zinc sulfate syrup, 10 ml OD
    PARACETAMO
    L
    Drug Classification: Analgesic, Antipyretic Drugs

    Generic Name: Paracetamol

    Indication:
    Paracetamol injection is indicated for the management of mild to
    moderate pain, the management of moderate to severe pain with
    adjunctive opioid analgesics, and the reduction of fever.
    MOA:
    The mechanism of its analgesic effect has not been fully determined but may be associated with the
    inhibition of prostaglandin synthesis in the CNS and to a lesser extent, through peripheral blockage of
    pain-impulse generation. It produces antipyresis by inhibiting the hypothalamic heat-regulating centre.
    ADR’s:
    Inj site reactions (e.g. pain, burning sensation), fatigue,
    peripheral oedema. Tachycardia, Nausea, vomiting
    OMEPRAZOLE
    Drug Classification: Proton-pump inhibitors

    Generic Name: Prilosec


    Indication:
    Omeprazole is indicated for the short-term treatment of peptic ulcer disease in adults,
    where most patients heal within four weeks.

    MOA : Side Effects : Headaches, Stomach pain, Constipation


    Omeprazole is selective and irreversible
    proton pump inhibitor. It suppresses stomach ADR's : Nausea, Vomiting, or Diarrhea
    acid secretion by specific inhibition of the
    H+/K+-ATPase system found at the secretory CI : Lithium
    surface of gastric parietal cells.
    DI : Therapy significantly improved blood glucose
    levels, as evidenced by the improvement in HbA1c
    levels.
    ZINC SULFATE
    Drug Classification: Minerals and Electrolytes

    Indication:
    This medication is a mineral used to treat or prevent low levels of zinc alone and
    together with oral rehydration therapy (ORT).
    MOA:
    Zinc inhibits cAMP-induced, chloride- CI: Copper deficiency
    dependent fluid secretion by inhibiting
    basolateral potassium (K) channels, in in-vitro DI: Reduce Zn absorption with Ca and oral Fe
    studies with rat ileum. Zinc also improves the supplements
    absorption of water and electrolytes,
    improves regeneration of the intestinal Side effects: nausea; or upset stomach
    epithelium, increases the levels of brush
    border enzymes, and enhances the immune ADR’s: nausea, severe vomiting, dehydration,
    response, allowing for a better clearance of and restlessness.
    the pathogens.
    Cues/Evidences

    • “Gipanugnaw medyo sakit ako ulo pero makaya ra tapos kapoy ako lawas” as verbalized by
    the client.

    • Objective cues:

    • Vital signs:
    • T- 39°C
    • P-72 bpm
    • R- 20 cpm
    • BP- 100/60 mmHg
    • Warm to touch
    ADD A FOOTER 16
    Nursing Diagnosis:

    Hyperthermia related to dengue fever


    as evidenced by temperature 39 ⁰C.
    GOAL:

    • To reduce chills, fever, body pains.


     
    • To increase platelet count.
     
    • To provide symptomatic relief.

    • To improve quality of life.


    Goal/ Outcome criteria:

    After 4 hours of nursing interventions the client will


    be able to:

    • Maintain core temperature within normal range as


    evidenced by body temperature is lowered to 39
    degree celcius.

    ADD A FOOTER 19
    Nursing Intervention
    • Provide tepid sponge bath
    • Promote surface cooling by means of undressing
    • Provide cool environment
    • Maintain bedrest or minimize movement
    • Discuss importance of adequate fluid intake
    particularly to the parents.
    • Strictly monitor temperature
    Rationale
    1. 2. 3.
    Heat loss by Heat loss by Heat loss by
    means of means of means of
    evaporation and radiation and convection
    conduction. conduction.

    4. 5. 6.
    To reduce To prevent To know if the
    metabolic dehydration patient’s
    demands of temperature
    oxygen went down to
    consumption the normal
    21
     Take plenty of rest.
     Drink plenty of fluids.
     Avoid spicy, oily, canned food.
     Eat fruits and fresh vegetables.
     Walk in fresh environment for about 5-10 minutes.
     Eat papaya leaf extract.
     Always be happy and avoid stress.

    Health teaching :
    Monitor vital signs, weight of a patient and
    symptoms of the patient, decreased of
    platelet count must be monitored.

    Monitor parameter:
    LABORATORY RESULT:

    March 04,2023 March 05,2023 March 08, 2023


    • WBC : 4.0 • WBC : 2.2 • WBC : 4.9 WBC : 4.50-13.50
    • Hematocrit: 46.1 • Hematocrit: 43.9 • Hematocrit: 43.7 Hematocrit: 35-45
    • MCV : 86 • MCV : 87 • MCV : 86 MCV : 77-95
    • MCH: 28.0 • MCH: 28.3 • MCH: 28.3 MCH: 26.10-33.30
    • Hmglb : 15 • Hmglb : 14.3 • Hmglb : 14.5 Hmglb : 11.50-15.50
    • MCHC: 32.6 • MCHC: 32.5 • MCHC: 33.1 MCHC: 31-37
    • Platelet: 35 • Platelet: 51 • Platelet: 45 Platelet: 150-390
      • •  
       
    • Differential count: Differential count:
    • Differential count: • Differential count: Neutrophils:43.5-73.5
    • Neutrophils: 22 • Neutrophils: 55 • Neutrophils: 34 Monocytes: 5.5-13.7
    • Monocytes: 36 • Monocytes: 15 • Monocytes: 21 Basophils:
    • Basophils: 2 • Basophils: 1 • Basophils: 1 Lymphocytes: 15.2-43.3
    • Lymphocytes: 38 • Lymphocytes: 28 • Lymphocytes: 41 Eosinophils: 0.8-8.10
    • Eosinophils: 2 • Eosinophils: 0 • Eosinophils: 3 RDW: 11.50-14.50
    • RDW: 13.3 • RDW: 13.6 • RDW: 13.4
    Evaluation :

    The goal was met.

    • After 4 hours of nursing intervention goals and


    objectives was met as evidenced by body
    temperature lowered to 39 degree celcius, upon
    monitoring it is 36 degree celcius .

    ADD A FOOTER 25
    Conclusion

    Dengue is a serious and potentially fatal virus that


    can affect children, so it is important to take steps
    to prevent it. This includes using insect repellent,
    wearing long-sleeved clothing, and avoiding
    standing water. It is also important to seek
    medical attention if your child is exhibiting any
    symptoms of dengue.
    MEMBERS:
    Jerimhe Tolentino, Ishii Dianne Tanudra, Eldexmae Tumatao,
    Alyssa Kyle Ugalde, Mild Angelica Tabog
    THANK YOU!

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