Nursing Diagnosis and Nursing Intervention

Hyperthermia and Acute Pain related to Dengue Fever Hemorrhagic (DHF)

Hyperthermia r/t Dengue Fever Hemorrhagic (DHF)
Nursing Diagnosis : Hyperthermia related to disease process (viremia)

Goal :
Patient 's body temperature can be reduced.

Outcome :
  • Comfortable body condition.
  • Temperature 36,80C-37,50C.
  • Blood pressure : 120/80 mmHg.
  • Respiration : 16-24 x / mnt.
  • Pulse : 60-100 x / mnt.

Intervention :
  • Assess the onset of fever.
  • Observation of vital signs (temperature, pulse, blood pressure, respiration) every 3 hours.
  • Instruct the patient to drink (2.5 liters / 24 hours).
  • Give warm compresses.
  • Suggest to not wear thick blankets and clothing.
  • Give intravenous fluid therapy and medications as ordered.

Rationale :
  • To identify patterns of fever.
  • Vital Signs is a reference to determine the patient's general condition.
  • The increase in body temperature results in increased evaporation body so it needs to be balanced with a high fluid intake.
  • With vasodilation can increase evaporation which accelerates the decline in body temperature.
  • Clothing thin body helps reduce evaporation.
  • Fluid administration is very important for patients with a high temperature.


Nursing Diagnosis : Acute Pain related to pathological disease process.

Goal :
Patient's pain can be reduced and disappeared.

Outcomes :
  • The patient said that the pain was reduced / lost.
  • The pain was on a scale of 0-3.
  • Blood pressure : 120/80 mmHg.
  • Temperature : 36,80C-37,50C.
  • Respiration : 16-24 x / mnt.
  • Pulse : 60-100 x / mnt.

Intervention :
  • Observation of the patient's level of pain (scale, frequency, duration).
  • Provide a quiet and comfortable environment and comfort measures.
  • Give proper entertainment activities.
  • Involve families in nursing care.
  • Teach the patient relaxation techniques.
  • Collaboration with physicians to analgesic drug delivery.

Rationale :
  • Indicates the need for intervention and also the signs of the development / resolution of complications.
  • A comfortable environment will help the process of relaxation.
  • Refocused attention ; improve the ability to cope with pain.
  • Family will help the healing process by training the patient relaxation.
  • Relaxation pain will move to other things.
  • Provide pain relief.
Copyright © Nursing Diagnosis Intervention. All rights reserved. Template by CB | Published By Kaizen Template | GWFL | KThemes