Nursing Diagnosis for Rabies

Rabies is a zoonotic disease (a disease that is transmitted from animals to humans) that is caused by a virus. It is known to be present on all continents except Antarctica and infects domestic and wild animals.

For a human, rabies is almost invariably fatal if postexposure prophylaxis is not administered prior to the onset of severe symptoms. The rabies virus infects the central nervous system, ultimately causing disease in the brain and death.

The rabies virus travels to the brain by following the peripheral nerves. The incubation period of the disease is usually a few months in humans, depending on the distance the virus must travel to reach the central nervous system. Once the rabies virus reaches the central nervous system and symptoms begin to show, the infection is virtually untreatable and usually fatal within days.

The initial symptoms of rabies are often vague, and it can be easy to mistake them for other less serious types of infection. They include:

• a high temperature of 38ºC (100.4ºF) or above
• chills
• fatigue (extreme tiredness)
• problems sleeping
• lack of appetite
• headache
• irritability
• anxiety
• sore throat
• vomiting

Around half of people will also experience pain and a tingling sensation at the site of the infection.

Initial symptoms of rabies last for two to 10 days before more severe symptoms start to develop. There are two types of advanced rabies:

furious rabies, which accounts for four out of five cases
dumb or paralytic rabies, which accounts for the remainder of cases

Nursing Diagnosis for Rabies

1. Ineffective breathing pattern related to asphyxia
2. Imbalanced Nutrition: less than body requirements related to decreased swallowing reflexes
3. Hyperthermia related to viremia
4. Anxiety (family) related to exposure to information
5. Risk for injury related to seizures and weakness
6. Risk for infection associated with open wounds

Fluid Volume Deficit related to Dengue Fever

Fluid Volume Deficit

Decreased intravascular, interstitial, and/or intracellular fluid (refers to dehydration, water loss alone without change in sodium level)

Defining Characteristics:

• Decreased urine output;
• increased urine concentration;
• weakness;
• sudden weight loss (except in third-spacing);
• decreased venous filling;
• increased body temperature;
• decreased pulse volume/pressure;
• change in mental state;
• elevated hematocrit;
• decreased skin/tongue turgor;
• dry skin/mucous membranes;
• thirst;
• increased pulse rate;
• decreased blood pressure

Dengue Fever

Dengue fever is a disease caused by a family of viruses that are transmitted by mosquitoes.

Dengue hemorrhagic fever (DHF) is a specific syndrome that tends to affect children under 10 years of age. It causes abdominal pain, hemorrhage (bleeding), and circulatory collapse (shock).

Signs and symptoms of dengue fever most commonly include:

• Fever, up to 106 F (41 C)
• Headaches
• Muscle, bone and joint pain
• Pain behind your eyes

You might also experience:

• Widespread rash
• Nausea and vomiting
• Minor bleeding from your gums or nose

Nursing Diagnosis for Dengue Fever

Fluid Volume Deficit related to active fluid loss

Goal:

• Fluid requirements are met, with the result criteria: no sunken eyes, mucous membranes moist, good skin turgor

Outcomes:

• Good skin turgor, dry skin, mucous membranes moist

Interventions:

1) Observation vital signs at least every three hours.
Rationale: Decrease in blood circulation may occur from increased fluid loss resulting in hypotension and tachycardia.

2) Observation and cata intake and output.
Rationale: Shows the status of the circulating volume, the / repair fluid displacement, and response to therapy.

3) Measure the weight.
Rationale: Measuring the adequacy of fluid replacement according kidney function.

4) Monitor intravenous fluids every hour.
Rationale: Maintaining the balance of fluid / electrolyte.

Hyperthermia related to Dengue Fever

Hyperthermia is defined as a temperature greater than 37.5–38.3 °C (100–101 °F), depending on the reference used, that occurs without a change in the body's temperature set point.

The normal human body temperature in health can be as high as 37.7 °C (99.9 °F) in the late afternoon. Hyperthermia requires an elevation from the temperature that would otherwise be expected. Such elevations range from mild to extreme; body temperatures above 40 °C (104 °F) can be life threatening.

Dengue hemorrhagic fever is a severe, potentially deadly infection spread by mosquitos, mainly the species Aedes aegypti.

Early symptoms include:

• Decreased appetite
• Fever
• Headache
• Joint or muscle aches
• Malaise
• Vomiting

Nursing Diagnosis for Dengue Fever : Hyperthermia related to increase the rate of metabolism

Defining characteristics :

• Convulsions
• Skin redness
• Increased body temperature above the normal range
• Seizures
• Tachycardia
• Tachypnea
• Skin feels warm

Goals:

• Maintain normal body temperature with the expected outcomes: body temperature from 35.50 to 37.00 c

Outcomes:

• Body temperature between 36-370 c,
• mucous membranes moist,
• muscle pain disappeared

Interventions:
1) Measure vital signs (temperature)
Rationale: Temperature 38.90 C-41, 10c, shows an acute infectious disease process

2) Give warm compresses
Rational: Warm compresses will happen conduction heat transfer

3) Increase fluid intake
Rational: To replace fluids lost due to evaporation

List of Antioxidant Fruits Content

Antioxidants are substances that can slow or prevent the oxidation process.

Antioxidants are defined as substances that protect cells from the harmful effects of reactive oxygen free radicals, when it comes to disease, free radicals can be derived from the body's metabolism as well as other external factors.

Free radicals are unstable species because it has an unpaired electron and the electron pairs in the search for biological macromolecules.

Antioxidants are found in many foods, such as vitamin E, vitamin C, and carotenoids.

Antioxidants are expected to secure the use or non-toxic, effective at low concentrations (0,01-0,02%), available at quite affordable prices, and resistant to the product processing. Antioxidants are important in the fight against free radicals, but the excess capacity causing cell damage.

Based on origin, antioxidants consists of: anti-oxygen that comes from within the body (endogenous) and from outside the body (exogenous). Sometimes endogenous antioxidant systems are not sufficiently able to cope with the excessive oxidative stress. Oxidative stress is a condition when antioxidant mechanisms are not enough to break down reactive oxygen species. Therefore, the necessary antioxidants from outside (exogenous) to overcome.

Your diet can be a rich source of beneficial antioxidants, anticarcinogens, and anti-aging ingredients including vitamin E, beta-carotene, selenium, glutathione, ascorbic acid (vitamin C), and phenol. [Ames1983] One well-known example is the resveratrol in grapes which indicates cancer preventive antioxidant, anti-inflammatory, and anti-mutagenic properties of these. [Jang1997]

Here is a list of different antioxidant power of fruits classified with AEAC analytical method as described by Leong and Shui. Category AEAC fruit is relatively specific antioxidant power is based on laboratory test methods.

Extremely High antioxidant: Sapodilla (Manilkara zapota), Strawberry (Fragaria virginiana), Plum (Prunus Domestics)

High antioxidant: Starfruit (Averrhoa carambola L.), Guava (Psidium guajava), Grape 'Flame seedless (Vitis vinifera), Salak (Salacca edulis), Mangosteen (Garcinia mangostana L.), Avocado (Persea Americana), Orange (Citrus aurantium), Mangoes (Mangifera indica L.), Solo varieties of papaya (Carica papaya L.), kiwi fruit (Actinidia chinensis)

Medium antioxidant: Cempedak (Artocarpus integer Merr.), Grapefruit (Citrus grandis), Lemon (Citrus lemon), Pineapple (Ananas comosus Merr.), Apple (Malus pumila), papaya, long legs (Carica papaya L.), Rambutan (Nephelium lappaceum L.), king of Rambutan (Nephelium mutabile), Banana (Musa paridasiaca), pulp Coconut (Cocos nucifera), Tomato (Lycopersicon esculentum)

Low antioxidant: Rockmelon (Cucumis melo var cantalupensis.), Melon / honeydew (Cucumis melo var inodorus.), Watermelon (Citrullus vulgaris), coconut water (Cocos nucifera).


References:

[Jang1997] Meishang Jang, Lining Cai, George O. Udeani, Karla V. Slowing, Cathy F. Thomas, Christopher W.W. Beecher, Harry H. S. Fong, Norman R, Farnsworth, A. Douglas Kinghorn, Rajendra G. Mehta, Richard C. Moon, John M. Pezzuto, “Cancer Chemopreventive Activity of Resveratrol, a Natural Product Derived from Grapes”, Science V275 pp218-220 1997.

[Leong2002] L.P. Leong, G. Shui, “An investigation of antioxidant capacity of fruits in Singapore markets”, Food Chemistry 76 (2002) 69–75.

[Ames1983] Bruce N. Ames, “Dietary Carcinogens and Anticarcinogens, Oxygen radicals and degenerative diseases”, Science V221 N4617 pp1256-1264 1983.


[Melov2000] Simon Melov, Joanne Ravenscroft, Sarwatt Malik, Matt S. Gill, David W. Walker, Peter E. Clayton, Douglas C. Wallace, Bernard MaLfroy, Susan R. Doctrow, Gordon J. Lithgow, “Extension of Life-Span with Superoxide Dismutase/Catalase Mimetics”, Science V289 N5484 pp1567-1569 2000.

http://www.health-nutrition-facts.com/fruit-nutrition-facts.html