CHAPTER V

PATHOPHYSIOLOGY

Predisposing factors: Precipitating factors:

 Geographical area:  Stagnant water at
Malita, Davao neighboring area
Occidental, Philippines  Dengue carrier mosquitoes
 Outdoor activities

Bite from Aedes aegypti mosquito Redness & itchiness in the area
(Redness & itchiness in the area)

Allowing dengue virus to be inoculated towards the

circulation/blood (Incubation Period: 3-14 days)

Virus disseminated rapidly into the blood and stimulates

WBCs including B lymphocytes that produces and secretes
immunoglobulins (antibodies), and monocytes/macrophages,
neutrophils

Antibodies attach to the viral antigens, and

then monocytes/macrophages will perform
phagocytosis within the cells and dengue
virus replicates in the cells of
monocytes/macrophages

Entry to the Entry to the

spleen, and Recognition of dengue viral antigen on bone
liver infected monocyte by cytotoxic T cells marrow

Release of cytokines which consist of vasoactive

agents such as interleukins and platelet activating
factors which stimulates WBCs and pyrogen
release

S/Sx:
Febrile,
Diaphoresis, warm skin, Dengue Fever
flushed; headache , body
malaise
 Virus ultimately targets liver and Cellular direct destruction and infection of
spleen parenchymal cells where red bone marrow precursor cells as well as
infection produces apoptosis/cell immunological shortened platelet survival
death causing platelet lyses

Hepatosplenomegaly S/Sx:
Red sclera in
Thrombocytopenia both eyes
Petechiae

S/Sx:
>Abdominal pain
S/Sx:
Dengue Hemorrhagic Fever Bipedal edema;
weak bounding
pulse

Increase number and size of the pores

in the capillaries which leads to a
leakage of fluid from the blood to the
interstitial fluid (capillary leakage) of
the different organs and skin

S/Sx:
Profuse non-productive
cough with white sputum
with blood spots; shallow & Pleural effusion Ascites
rapid respirations of 35cpm; S/Sx:
crackles/rales Abdominal distention;
hypoactive bowel
sounds

Recovery Complications:
Intense bleeding
Pulmonary Edema
Shock
Very low blood pressure
Liver cirrhosis
Death
 Chapter XII
Health Teachings

Primary

• Advise patient to take medications on time and the right dosage to achieve the maximum
therapeutic effects of drugs.

• Advise not to take aspirin or other NSAID drugs as it may trigger gastritis and provoke
bleeding.

• Use insect repellents such as off lotion on skin and clothing.

• Wear full-covered clothing such as long sleeved shirts and long pants when outdoors.

• Use bednets if sleeping area is not screened nor airconditioned.

• Use mosquito coil to lessen or kill mosquitoes.

• Encourage to eat fruits and vegetables such as apples, banana, carrots, or broccoli for
nutrient intake.

• Encourage to increase OFI of at least 2.5L/day to prevent dehydration and replace fluid
loss.

• Encourage to sleep for at least 8hours/day to have adequate rest period.

• Maintain proper hygiene such as taking a bath everyday.

Secondary

 Remind SO to have follow up check up scheduled by the physician.

 Remind SO for the pt. to take rest upon his discharge and long exhausting travel going
back to Malita.
 Advise SO to seek medical help if warning signs appear such as sudden blurring of
vision, nausea and vomiting, skin rashes, or dry lips.
 Advise to assist patient in coping with illness.

Tertiary

 Encourage SO to keep the surroundings clean.

 Advise to report stagnant areas within the vicinity to the local authority so that necessary
action will be mandated.
 Prevent breeding sites of mosquitoes by draining stagnant water around the house and
clean water storage containers frequently.
 Dispose all unused bottles and jars that can collect and hold water.