Professional Documents
Culture Documents
PAPERS ABOUT
BY GROUP 07:
DEWITA MAHARANI
2018
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Foreword
Praise and thankfulness we always offer to the presence of Allah SWT Because It is for
blessings and His will that we can compile and complete this paper. In completing this paper,
we faced many Difficulties. But thanks to group collaboration, this English paper on "
Nursery Care Dengue Heamorrhagic Fever" can be completed on time.
We Realize, as a student Whose knowledge is insufficient and still needs a lot of
learning in writing papers, this paper still has many shortcomings and is far from perfect.
Therefore, we really hope for positive criticism and suggestions so that this paper will be
better and useful in the future. We hope that this paper can be useful simple and useful for
readers in the future.
Bukittinggi, 24 Februari2019
Author
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TABLE OF CONTENTS
Cover page
Preface .............................................................................................................................
2
Table of contents ............................................................................................................. 3
CHAPTER I INTRODUCTION
A. Background ................................................................................................................ 4
B. Problem formulation .................................................................................................. 4
C. Purpose of writing ...................................................................................................... 4
D. Benefits of Writing .....................................................................................................5
CHAPTER II DISCUSSION
REFERENCES .............................................................................................................. 21
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CHAPTER I
INTRODUCTION
A. Background
Dengue spread by the virus is spread by the Aedes mosquito (Stegomyia).
Over the past two decades, the frequency of cases and epidemics of dengue fever
(dengue fever, DF), dengue fever (dengue hemorragic fever, DHF), and dengue shock
syndrome (dengue shock syndrome, DSS) have shown dramatic improvements
throughout the world.The World Health Report 1996,states that "the reappearance of
infectious diseases is a warning that the progress made so far on world security in
terms of health and prosperity is futile". The report further states that "these infectious
diseases range from diseases that occur in the tropics (such as malaria and DHF that
often occur in developing countries) to diseases found throughout the world (such as
hepatitis and sexually transmitted diseases [STDs], including HIV / AIDS) and food-
borne diseases that affect large numbers of the world's population both in poor and
rich countries.In May 1993, the 46th World Health Meeting submitted a resolution on
dengue control and prevention which emphasized that strengthening DF and DHF
prevention and control at both local and national levels should be one of the priorities
of WHO Member States where the disease is endemic. The resolution also calls for:
(1) strategies developed to address the spread and increase of dengue incidents must
be carried out by relevant countries, (2) increase public health education, (3) promote
health promotion, (4) strengthen research, (5) expand dengue surveillance, (6) guide
delivery in terms of vector control, and (7) mobilization of external resources for
disease prevention must be a priority.
To respond to WHA's resolution in the prevention and control of dengue, a
global strategy for the operation of vector control activities was developed based on
key components such as selective, integrated mosquito control measures with
community participation and cooperation between sectors, emergency preparation,
etc. One of the main pillars in the global strategy is an increase in active surveillance
and is based on accurate laboratory examinations of DF / DHF and its vectors. In
order to run smoothly, every endemic country must enter DHF disease into one type
of disease that must be reported.
This disease is commonly found in tropical areas such as Southeast Asia, India,
Brazil, America, including in all corners of Indonesia, except in places of altitude
more than 1000 meters above sea level. Doctors and other health workers, such as
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midwives and medical staff Often wrong in the diagnosis, because of the tendency of
early symptoms that resemble other diseases such as flu and typhoid (typhoid).
D. Benefit
Can add knowledge Knowing DHF nursing care As a reference for nursing students
CHAPTER II
DISCUSSION
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b. Appetite improved.
c. Clinical improvement appears.
d. Hematocrine stable.
e. Three days after shock is solved.
f. Platelet counts 200.000-300.000 / mm3
g. No respiratory distress.
h. Emergency room for dengue Haemorragic Fever (DHF)
The precise principle in the prevention of DHF (Dit.Jen.P3M., Dep. Case R.I., 1976)
is as follows.
a. Utilize the change of mosquito state as a result of natural influences by
implementing vector eradication when there is a small DHF / DSS case.
b. Decide the transmission circle by holding the vector density at very low levels to
give the patient the opportunity to heal spontaneously.
c. Introduce vector eradication at the center of the deployment area, ie schools and
hospitals, including the surrounding buffer areas.
d. Attempt vector eradication in all potential high-risk areas.
DBD Prevention includes:
1. Eradication of adult mosquitoes
Attempt to clean the places that mosquitoes prefer (eg hang clothes), install
mosquito nets on ventilation and house windows, spraying with chemicals,
fogging fumes, penetrating the life cycle by using fishfish in the water
reservoir.
2. Eradicate mosquito larvae
By doing 3M (draining, closing, and burying) means the tubing curves once a
week, closing the water storages together, the used cannabis cisterns in the
pool or hard-water storage areas can be transmitted by Abate powder.
Guidelines for the use of Abate powder (abatization): 1 tablespoon perch (10
g) for 100 liters of water. Walls should not be brushed after sprinkling abate à
abate powder will stick to the wall of the tub or crockery. The abate powder
remains effective for up to 3 months.
3. Counseling for the community
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Because DBDs have no drugs that can kill dengue virus or DBD vaccine, the
efforts to prevent dengue are very important. Fighting of mosquito nest (PSN)
is very important for the prevention of DBD. PSN movements should be done
jointly by all levels of society at home , in schools, in hospitals, and public
places such as places of worship, tombs. Thus society can change the behavior
of healthy living, especially improving environmental hygiene.
G. Complications of Dengue Heamorrhagic Fever (DHF)
1. Encephalitis such as seizures and coma may appear so complications in the case of
a long enough shock accompanied by severe bleeding.
2. Water toxicity, a relatively common introgenic complication that can cause an
orthopathy.
3. Unusual manifestations that are rarely seen in DF / DHF infections include acute
renal failure and hemolytic urinary syndrome.
A. Assessment
Entry date: June 10, 2001 Entrance: 09.00 WIB
Space: Transmitted Children No. Reg. Med: 1005905
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1. Patient Identity
Name, age (in DHF most often affects children less than 15 years of age), gender,
address, education, parents' names, parents' education, and parents' work.
2. Main complaints
Reasons / prominent complaints in DHF patients to come to the hospital are high
heat and weak children.
3. History of Current Disease
Obtained sudden hot complaints accompanied by shivering and when the fever is
aware of mentis compost. The decline in heat occurs between the 3rd and 7th day,
and the child becomes weaker. Sometimes accompanied by complaints of coughs,
colds, swallowing pain, nausea , anorexia vomiting, diarrhea / constipation,
headache, muscle and joint pain, heartburn and sore eyeball movements, and the
presence of bleeding manifestations on the skin, gums (grade III, IV), melena or
hematemesis.
4. History of Disease that Has Been Suffered Any
illness that has been suffered. In DHF, children can experience repeated attacks of
DHF with other types of viruses.
5. Immunization History
If the child has good immunity, then the possibility of complications can be
avoided.
6. Nutritional History The nutritional
status of children who suffer from DHF can vary. All children with good or bad
nutritional status can be at risk, if there are predatory factors. Children who suffer
from DHF often experience complaints of nausea, vomiting, and decreased
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a. The presence of petechiae on the skin, skin turgor decreases, and cold sweat
appears and is moist.
b. Cyanosis nails / no.
c. Head and neck. The head feels painful, the face looks reddish because of
fever (flusy), the eyes are anemic, the nose sometimes experiences bleeding
(epistaxis) in grade II, III, IV. In the mouth it is found that the dry mouth
mucosa, gum gums occur, and painful pain. While the throat has pharyngeal
hyperemia and ear bleeding occurs (in grade II, III, IV).
d. Chest. The shape is symmetrical and sometimes feels tight. In the chest X-ray
there is fluid that is buried in the right lung (pleural effusion), rales (+),
ronchi (+) which are usually found in grades III and IV.
e. Abdomen. Having tenderness, enlarged liver (hepatomegaly), and ascites.
f. Extremity. Akral cold, and there is pain in muscles, joints and bones.
11. Laboratory Examination
On blood tests a DHF patient will be found:
a. Hb and PCV increase (more than equal to 20%).
b. Trobositopenia is less than 100,000 / ml).
c. Leukopenia (may be normal or leukocytosis).
d. Ig. Dengue positive.
e. Blood chemistry examination results showed: hypoproteinemia,
hypochloremia, and hyponatremia.
f. Urium and blood pH may increase.
g. Metabolic acidosis: pCO2 <35-40 mmHg and HCO3 are low.
h. SGOT / SGPT may increase.
B. Problems / Diagnosis
1. Medical diagnosis: suspected (suspect) DHF.
2. The nursing diagnoses that are often found in DHF patients:
a. Increased body temperature (hyperthermia) is associated with dengue virus
infection.
b. Deficit of body fluid volume is related to imbalance of input and output fluids.
c. Nutrition is less than needed related to nausea, vomiting, anorexia.
d. The high risk of hypovolemic shock is associated with severe bleeding, decreased
osmotic pressure.
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C. Planning
To overcome the problem, the planning needed is:
a. Increased body temperature (hyperthermia) is associated with dengue virus
infection.
Nursing goals:
Increased body temperature can be overcome, with criteria:
- Normal body temperature (35 ° C - 37.5 ° C).
- The patient is free from fever.
Intervention plan:
INTERVENTION RATIONAL
1. Assess for the onset of fever. 1. To identify the patient's fever
pattern.
2. Observation of vital signs
every 3 hours. 2. Vital signs are a reference for
knowing the general condition
3. Give a warm compress to the
forehead. of the patient.
3. Warm compresses can restore
4. Give plenty to drink (± 1-1.5
liters / day) a little but often. normal temperatures to
facilitate circulation.
5. Change client's clothes with
thin material to absorb 4. Reduce heat by convection
sweat.
(heat is wasted with urine and
6. Give an explanation to the sweat while replacing body
client's family about the
fluids due to evaporation).
cause of increasing body
temperature. 5. Thin clothing absorbs sweat and
helps reduce body evaporation
7. Collaboration in providing
anti-pyretic drugs. due to increased temperature
and conduction can occur.
6. Explanations given to the
client's family can be
understood and cooperative in
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b. The fluid and electrolyte volume deficit associated with (fluid volume deficit) of
the body is related to the imbalance of input and output fluids.
Purpose of intervention:
Volume of body fluids balanced, with criteria:
- Good skin turgor
- Vital signs within normal limits
Intervention plan:
INTERVENTION RATIONAL
1. Assess the client's general state 1. Know quickly the deviation
and vital signs. from the normal state.
2. Assess fluid input and output. 2. Knowing the balance of fluids
3. Observation of signs of shock. and electrolytes in the body or
4. Encourage clients to drink a homeostasis.
lot. 3. In order to take immediate
5. Collaboration with doctors in action in the event of shock.
administering IV fluids 4. Fluid intake is needed to
increase body fluid volume.
5. Giving IV fluids is very
important for clients who
experience a fluid volume
deficit to meet the client's fluid
needs.
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d. The high risk of hypovolemic shock is associated with severe bleeding, decreased
osmotic pressure.
Objective:
There is no hypovolemic shock, with criteria:
- General condition improves.
- Vital signs within normal limits.
Plan for intervention:
INTERVENTION RATIONAL
1. Monitor the client's general 1. Monitor the condition of the client
condition during the treatment period,
2. Observe vital signs. especially when there is bleeding so
3. Monitor signs of bleeding that a sign of prereok, shock can be
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Objective:
Family anxiety is overcome, with criteria:
- Parents do not ask questions about their child's illness.
- Cheerful facial expressions.
Intervention plan:
INTERVENTION RATIONAL
1. Assess parents' anxiety level. 1. Knowing parents' anxiety and
2. Explain the treatment procedure for making it easier to determine the
her child care. next intervention.
3. Give an opportunity for parents to 2. To increase knowledge and
ask about their child's condition. information to clients that can reduce
4. Give an explanation of each parental anxiety.
procedure or action that will be 3. To get more information and increase
performed on the patient and its knowledge and reduce stress.
benefits to the patient. 4. Provide an explanation of the disease
5. Give spiritual encouragement. process, explain about the possibility
of intensive care if it is really needed
by patients to get more optimal care.
5. Giving peace to the client by
surrendering to God Almighty.
CHAPTER III
COVER
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A. Conclusion
There are many ways to reduce the incidence of DHF. Because the vector of DHF is
Aedes a mosquito, then there are some things that should be done to break the chain
of diseases:
1. Without insecticide:
a) Drain bath tubs, jars, drums, etc. at least once a week.
b) Close the reservoir of water tightly.
c) Clean the yard from used cans, used bottles that allow mosquitoes to nest.
2. With insecticide:
a) Malathion to kill adult mosquitoes: usually by fogging.
b) Abate to kill mosquito larvae by way of sowing on vessels holding clean water
with a dose of 1 gram of Abate SG 1% per 10 liters of water.
B. Suggestion
The author hopes that the preparation of papers on Askep in children / infants with
DHF can provide knowledge and knowledge in the fields of education and nursing
practice. And also with this paper can be a reference for the actions of the nursing
process.
REFERENCES
Behrman, R.E., Kliegman, R.M. & Arvin, A.M. 1999.Ilmu Kesehatan Anak Nelson Volume
2Edisi 15. Jakarta: EGC.
Behrman, R.E.,& Vaughan, V.C. 1992. Ilmu Kesehatan Anak. Jakarta: EGC.
Chin Ling, W.Y. & Sin Hock, J.T 1993.Kedaruratan pada Anak.Jakarta: Binarupa Aksara.
Indrawati, E. Februari, 2012.Demam Berdarah Dengue.Warta RSUD, hlm 7.
Nursalam, Susilaningrum, R. & Utami, S. 2005. Asuhan Keperawatan Bayi dan Anak
(untuk Perawat dan Bidan). Jakarta: Salemba Medika.
Rampengan, T. H. 1993. Penyakit Infeksi Tropik pada Anak. Jakarta: EGC.
Soedarmo, S. S. P. 1988. Demam Berdarah (Dengue) pada Anak. Jakarta: Penerbit
Universitas Indonesia.
Soegijanto, S. 2002. Ilmu Penyakit Anak, Diagnosa & Penatalaksanaan. Jakarta: Salemba
Medika.
WHO. 2004. Pencegahan dan Pengendalian Dengue dan Demam Berdarah Dengue.
Jakarta: EGC.