Superior College of Nursing
Session: September 2018-2019
Discipline: Medical nursing
Assignment
Subject: Malaria, Dengue Fever
Submitted To: Respected Ma’am Safoora
Shaukat
Submitted By: Kanwal Sohail
Submission Date: 27/11/2018
Fever:
AN ABNORMALLY HIGH BODY
TEMPERAGURE, USUALLY ACCOMPAINED BY
SHIVERING AND HEADACHE.
MALARIA
Malaria is a life threatening disease its typically
transmitted through the bite of an inflected
Anopheles mosquito.
Infected mosquitoes carry the plasmodium
parasite.
When this mosquito bites you, the parasite is
released into your blood stream.
Etiology
Malaria is caused by protozoa from the genus plasmodium and is
transmitted go human through a bite from one if 40 species of
female Anopheles mosquito.
Infection MAY also occur through exposure to infected blood or
blood products
Five plasmodium species cause human disease.
P falciparum
P vivax
P ovals
P malariae
P knowlesi
Pathophysiology
During a blood meal, an infected female
Anopheles mosquito infected 8 to 15 malarial
sporozoites, which rapidly enter hepatocytes
reproduction by asexual fission (tissue
schizogony) takes place to form a pre
erythtocytic schizont.
The majority of infections are caused by p
falciparum and p vivax and p falciparum is
responsible for the most severe disease. The
distribution of these species is dependent on
ecological and behavioural parameters
affecting the ability of mosquitoes go transmit
them.
Malarial cycle diagram
Clinical Manifestation
Common symptoms of malaria includes
Shaking Chills that can rang from moderate to severe
High fever
Profuse sweating
Headache
Nausea
Vomiting
Abdominal pain
Diarrhoea
Clinical Diagnosis
Clinical diagnosis is based on the patients symptoms and on
physical findings at examination.
The first symptom of malaria (most often Fever, chills, sweats,
headache, muscles pain, nausea and vomiting)are often not
specific and are also found in other diseases ( such as the FLU and
common viral infections) likewise the physical findings are often
not specific (elevated temperature, perspiration, tiredness)
In severe malaria (caused by plasmodium falciparum) clinical
findings (confusion, coma, neurologic focal signs, severe anaemia,
respiratory difficulties) are more striking and may increase the index
of suspicion for malaria.
If possible clinical finding should always be confirmed by a
laboratory test for malaria.
Management of Malaria
Patient who have severe [Link] malaria or who
cannot take oral medications should be given the
treatment by continuous intravenous infusions.
Most drugs used in treatment are active against the
parasite form in the blood and includes chloroquine.
Complications of Malaria
Life threatening situation because of malaria infection
with p falciparum may includes
Severe infection of brain (cerebral malaria), with
seizures, confusion, and increasing tiredness leading to
coma and death.
Fluid in the lungs (pulmonary edema)
Kidney failure.
Dengue
1. Dengue fever is a mosquito-born tropical
disease caused by the Dengue virus,
symptoms typically begin three to fourteen
days after infection. This may include a high
fever, headache, vomiting, muscles and
joint pain and a characteristic skin rash.
Etiology of dengue Fever
Dengue fever is caused by any one of four types of
dengue viruses spread by mosquitoes that thrive in and
near human lodgings. When a mosquito bites a person
infected with a dengue virus The virus enters the
mosquito. When the infected mosquito then bites
another person the virus enters that person’s blood
stream.
Pathophysiology
The transmission cycle of dengue virus by the mosquito Aedes aegypgi
begin with a dengue infected person.
This Person will have virus circulating in the blood.
A viremia that lasts for about five days.
During the viremic period an uninfected female Aedes aegypgi
mosquito bites the person and ingested blood that contains dengue
virus.
Then within the mosquito, the virus replicates during an extrinsic
incubation period of 8 to 12 days.
The mosquito then bites a susceptible person and transmits the virus.
The virus then replicates in the second person and produces
symptoms. The symptoms begin go to appear an average of four to
seven days after the mosquito bite, this is the intrinsic incubation period
within humans.
It can range from 3 to 14 days. (Average 4 to 7 days)
Clinical Manifestation
High fever
Severe headache
Pain behind the eyes
Severe joint and muscles pain
Fatigue
Nausea
Vomiting
Skin rash, which appears two to five days after the onset of fever
Bleeding manifestations. Petechiac, epistaxis, gum bleeding,
hematemesis, Helena or positive tourniquet test.
Diagnosis
Diagnosing dengue fever can be difficult because it’s
signs and symptoms can be easily confused with those
of other disease, such as malaria, typhoid fever.
Your doctor will likely ask about your medical and travel
history.
As well as any contact you may have had with
mosquitoes.
Diagnostic test Direct detection of viral components
RT-PCR
NS-1AG detection by Elisa or lateral flow rapid test.
Life cycle of Aedes mosquito
Management
No specific treatment for dengue fever exists. Your doctor may
recommend that you drink plenty of fluids to avoid dehydration
from vomiting and high fever.
While recovering from dengue fever watch for signs and symptoms
of dehydration.
Call your doctor right away if you develop any of the following
Decrease urination
Few or no tears
Dry mouth or lips
Lethargy or clammy extremities.
If
you have severe dengue fever you may
need.
Supportive care in a hospital
Intravenous
fluids and electrolyte
replacement
Blood pressure monitoring
Transfusion to replace blood loss
Complications
Denguefever can result in the following
complications
Dengue haemorrhagic fever
Dengue shock syndrome.
Nursing care plan for hyperthermia:
Thank you.
