INTRODUCTION

Dengue, the infamous "breakbone fever," is a silent threat

lurking in tropical and subtropical regions around the world. It's
a viral infection spread through the bite of infected Aedes
mosquitoes, leaving many unsuspecting victims with no
symptoms at all. But for those who do experience the virus, the
symptoms can be debilitating – high fever, headache, body
aches, nausea, and a telltale rash. Most people recover within a
couple of weeks, but for some, dengue takes a sinister turn.
This is where the danger of dengue truly lies. For some
individuals, the virus can escalate into a severe form,
known as dengue hemorrhagic fever (DHF) or dengue
shock syndrome (DSS). In these cases, the virus damages
blood vessels, causing them to leak and reducing the
number of platelets, the cells responsible for clotting.
This can lead to a cascade of complications – shock,
internal bleeding, organ failure, and even death.
The risk of severe dengue is highest in individuals who have
been infected with dengue before, but with a different type
of the virus. This is because prior infection provides long-
term immunity to the same type of dengue virus, but only
short-lived protection against other types. Therefore, areas
where multiple dengue virus types circulate are particularly
vulnerable to severe cases.
The impact of dengue is undeniable. Since the beginning of
2024, over 13 million cases and over 8500 dengue-related
deaths have been reported globally. It's a stark reminder of the
silent threat this virus poses. A study of 145 dengue fever
cases shed light on the preventive measures people are taking.
The majority wore full clothing to protect themselves from
mosquito bites, while approximately half used insecticide
spray or mosquito coils/mats. A third used repellent lotion,
but bed net use was the least frequent measure adopted.
The study also revealed potential risk factors associated with
dengue infection, including stagnant water around the house, the
presence of flower pots, and open containers of water. These
findings underscore the importance of eliminating mosquito
breeding grounds and utilizing various preventive measures to
reduce the risk of dengue infection.

Dengue remains a significant public health concern, but by

understanding the virus, its transmission, and the
importance of preventive measures, we can better protect
ourselves and our communities from its devastating
effects.
A. NUMBER OF CASES/STATISTIC DATA OF THE DISEASE
A.1 WORLD WIDE STATISTIC

Dengue, a silent threat that lurks in tropical and

subtropical regions, casts a long shadow across the
globe. While the exact number of cases is difficult to
pinpoint due to varying reporting systems and
underreporting, estimates suggest that around 390
million people are infected with dengue every year. This
staggering number paints a stark picture of the virus's
global reach.
Imagine a world where hundreds of millions
of people are potentially infected with a
disease, many without even knowing it. This is
the reality of dengue. While most cases are
mild, the potential for severe complications,
including death, hangs over these millions.
The impact of dengue is not confined to individual health. It stretches
across borders, impacting economies and straining healthcare systems.
Southeast Asia, in particular, bears a disproportionate burden, with
countries like Thailand, Philippines, and Indonesia consistently reporting
high numbers of cases. In Thailand, for example, an average of 100,000
dengue cases are reported annually, although the actual number is likely
much higher. Latin America is also experiencing a significant increase in
dengue cases, with countries like Brazil, Mexico, and Colombia reporting
a growing number of infections. In Brazil, over 1.5 million dengue cases
were reported in 2022, highlighting the significant impact of the disease
in this region.
While dengue has traditionally been less prevalent in
Africa, cases are on the rise, particularly in sub-
Saharan regions. In Nigeria, for example, over 100,000
dengue cases were reported in 2021.

The fight against dengue is a global one, requiring a

multifaceted approach. While exact numbers are
difficult to pinpoint, the global burden of dengue
remains significant, highlighting the need for
continued efforts to control and prevent this disease.
A.2 LOCAL STATISTIC

The Philippines is facing a surge in dengue cases, with

the Department of Health (DOH) sounding the alarm
and urging the public to ramp up mosquito control
efforts. As of September 6th, 2024, the number of
dengue cases in the country had reached a staggering
208,965, representing a concerning 68% increase
compared to the same period last year.
While the death toll from dengue has reached 546, a somber
reminder of the disease's severity, the fatality rate has
thankfully decreased compared to the previous year. The
DOH is particularly concerned about the rapid rise in cases.
Between July 21st and August 3rd, 2024, dengue cases
increased by 25%, with 29,021 cases reported. This trend
continued to escalate, with a further jump to 36,335 cases
between August 4th and August 17th. This surge was
observed in all regions except Mimaropa, Bicol, Zamboanga
Peninsula, and the Bangsamoro.
The DOH is calling on the public to take action. Eliminating
mosquito breeding grounds, using insect repellent and
protective clothing, and seeking early medical consultation
for any symptoms are crucial steps to take. The DOH also
encourages communities to support fogging or spraying
efforts in areas with high dengue activity. The fight against
dengue requires a collective effort, and the DOH is urging
everyone to take responsibility and contribute to the
prevention and control of this potentially deadly disease.
(www.DOH.com)
B. CURRENT TRENDS ABOUT DENGUE

The fight against dengue fever intensifies in 2024, marked by a surge in cases,
particularly in Latin America, where over 3.5 million cases were reported in the
first quarter, exceeding the total number of cases in 2023. This outbreak, linked
to climate change, underscores the urgent need for effective prevention and
treatment strategies. While the exact global figures for 2024 are not yet
available, the overall trend of increasing dengue cases continues, with over
100-400 million cases estimated annually. New vaccine developments include
Butantan-DV, a single-dose vaccine showing promising results in clinical trials,
and Takeda's TAK-003, a live-attenuated vaccine that received prequalification
from the WHO in May 2024.
Research continues into antiviral drugs and monoclonal
antibodies as potential treatment options, while efforts
are underway to develop more rapid and accurate
diagnostic tools. However, challenges remain in ensuring
equitable access to vaccines, evaluating long-term
effectiveness, developing effective treatments, and
maintaining robust vector control measures. Continued
research, global collaboration, and a commitment to
public health are essential to effectively address this
growing global health challenge.
Student nurses might choose to study a dengue case for a
variety of reasons. It allows them to gain practical
knowledge about a prevalent and significant public health
concern, develop essential clinical skills like patient
assessment and symptom management, and sharpen
their critical thinking abilities. Dengue cases also highlight
the importance of disease prevention and control,
prompting students to learn about mosquito control
measures, vaccination programs, and community
education initiatives.
Furthermore, these cases expose students to the
complexities of managing a multi-faceted disease,
emphasizing the importance of a holistic approach to
patient care and fostering empathy and
communication skills. Ultimately, studying dengue
cases equips student nurses with the knowledge and
skills they need to provide effective care for patients
with this disease in their future nursing careers.
B. OBJECTIVES
Student Nurse-centered:

At the end of the rotation, the student murses shall be able to:

•Understand and gain knowledge about the condition of the

patient
•Gain knowledge about the causes or signs and symptoms of
Dengue.
•Provide relevant information on the health condition of the
patient
Psychomotor
•Establish rapport or effective communication skills to the
patient.
•Assess the patient's condition.
•Provide appropriate nursing interventions and treatment
plan for patient with Dengue.

Affective

•Improve their confidence in handling a

patient with a same condition.
Client Centered:

at the end of the rotation the patient shall be able to:

• Gain knowledge about her condition.
• Understand the sign and symptoms.
• Follow the nursing intervention given by the student.

Affective

• Develop a good working relationship to the student nurses to

meet the goal of improving health.
PERSONAL DATA
Name: Aliman, Raifa Banding
Age: 12 years old Date of birth: 08/07/2012 Sex: Female
Address: Tumahubung, Sumisip Basilan
Mother: Rahma Banding
Father: Sapwan Aliman
Religion: Islam Nationality: Filipino
Cheif complain: on and off fever, LMB
Admitting diagnosis: To be considered dengue fever
Date and time of admission: 10/22/24 9:00AM
BRIEF HISTORY:
3 days prior to admission onset of loose bowel movement watery, non-
blood streaked. Occuring 3 times a day associated with on and off fever,
no consultation done. Given paracetamol which provided temporary
relief. Persistence of condition prompted admission.
FAMILY HISTORY: No heredofamilial disease
PHYSICAL EXAMINATION
VS: BP: 90/60 RR: PR: O2:
Height: Weight: 36kg
HEENT: Sunken eyeballs, dry mucosa, poor skin turgor
CHEST/LUNGS: Clear breath sound
ABDOMEN: Round shape, Flabby soft, Hyperactive bowel sound, Rebound
Tenderness
SKIN EXTREMITIES: Essentially normal
The circulatory system, also known as the
cardiovascular system, is a complex network
responsible for transporting blood
throughout the body. This vital system
delivers oxygen and nutrients to cells while
removing waste products, ensuring proper
function of all organs and tissues.
Anatomy of the Circulatory System:
The circulatory system is composed of three main components:
1. Heart: This muscular organ acts as the central pump, propelling
blood through the blood vessels. It is located in the chest, slightly to
the left of the midline, and is about the size of a clenched fist. [1]
The heart has four chambers:

- Atria: The two upper chambers, the right atrium and left atrium,
receive blood returning to the heart.
- Ventricles: The two lower chambers, the right ventricle and left
ventricle, pump blood out of the heart.
- Valves: The heart contains four valves that prevent backflow of
blood:
- Tricuspid valve: Separates the right atrium and right ventricle.
- Pulmonary valve: Separates the right ventricle and pulmonary
artery.
- Mitral valve: Separates the left atrium and left ventricle.
- Aortic valve: Separates the left ventricle and aorta.
2. Blood Vessels: These tubes form a vast network that carries
blood throughout the body. There are three main types:

- Arteries: These thick-walled vessels carry oxygenated blood away from the
heart. The largest artery is the aorta, which branches into smaller arteries
called arterioles. [1]
- Veins: These thinner-walled vessels carry deoxygenated blood back to the
heart. They begin as small venules and converge into larger veins. [1]

Capillaries: These microscopic vessels connect arterioles and

venules, forming a vast network that allows for the exchange of
gases, nutrients, and waste products between blood and tissues. [1]
3. Blood: This fluid tissue is composed of plasma (the liquid
portion) and formed elements (cells and cell fragments):

- Plasma: This yellowish fluid makes up about 55% of

blood volume and contains water, proteins, electrolytes,
nutrients, and waste products. [2]
- Red Blood Cells: These cells contain hemoglobin, an
iron-containing protein that binds to oxygen, giving blood
its red color. They are responsible for transporting oxygen
to the tissues. [2]
- White Blood Cells: These cells are part of the
immune system and defend the body against
infection. [2]
- Platelets: These cell fragments are essential for
blood clotting. [2]

Physiology of the Circulatory System

The circulatory system functions to transport blood
throughout the body, delivering oxygen and nutrients
to cells and removing waste products. This process
occurs through two main circuits:
1. Pulmonary Circulation: This circuit involves the
heart and lungs. Deoxygenated blood from the body
enters the right atrium, is pumped to the right
ventricle, and then sent to the lungs through the
pulmonary arteries. In the lungs, blood picks up
oxygen and releases carbon dioxide. Oxygenated
blood then returns to the heart through the
pulmonary veins. [1]
2. Systemic Circulation: This circuit involves the heart
and the rest of the body. Oxygenated blood from the
lungs enters the left atrium, is pumped to the left
ventricle, and then sent to the rest of the body
through the aorta. As blood circulates through the
body, it delivers oxygen and nutrients to tissues and
picks up waste products. Deoxygenated blood then
returns to the heart through the veins. [1]
Regulation of the Circulatory System
The circulatory system is tightly regulated by the
nervous and endocrine systems to maintain blood
pressure, blood flow, and oxygen delivery. The
autonomic nervous system controls heart rate and
blood vessel diameter, while hormones like
epinephrine and norepinephrine can increase heart
rate and blood pressure.
Importance of the Circulatory System
The circulatory system is essential for life. It
provides the body with oxygen, nutrients,
and hormones, and removes waste products.
Proper function of the circulatory system is
crucial for maintaining overall health and
well-being.