Superior College of Nursing

 Session: September 2018-2019

 Discipline: Medical nursing
 Assignment
 Subject: Malaria, Dengue Fever
 SubmittedToSubmitted By: 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 p.falciparum 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.