Nursing Diagnoses of Yellow Fever

5 Key Nursing Diagnoses:

Deficient fluid volume related to inadequate fluid intake and vomiting

Impaired skin integrity related to hyperbilirubinemia from jaundice

Imbalanced nutrition; less than body requirements related to loss of appetite and vomiting

Activity intolerance related to muscle and joint aches, headache, and fever

Risk of delirium and altered mental status related to organ ischemia

Problem	Related To	Plan	Outcome	Nursing Intervention
Activity intolerance	Fever Headache Nausea and vomiting Muscle and joint aches	Assess nutritional status Monitor patient’s sleep pattern and amount of sleep achieved over past few days Assess potential for physical injury with activity Assess emotional response to change in physical status	Patient maintains activity level within capabilities, as evidenced by normal heart rate and blood pressure during activity, as well as absence of shortness of breath, weakness, and fatigue Patient verbalizes and uses energy-conservation techniques	Encourage adequate rest periods Refrain from performing nonessential procedures to promote rest Progress activity gradually Encourage verbalization of feelings regarding limitations Provide emotional support

References:

Gulanick, M. (2012). Activity intolerance – Weakness; deconditioned; sedentary. Elsevier. Retrieved from http://www1.us.elsevierhealth.com/MERLIN/Gulanick/archive/Constructor/gulanick01.html

Nursing Care of Individuals with Yellow Fever

The primary nursing care of individuals with yellow fever is supportive care. The goal is to provide symptomatic relief or life-saving interventions.

According to UpToDate, “supportive care should include maintenance of nutrition, prevention of hypoglycemia, nasogastric suction to prevent gastric distention and aspiration, treatment of hypotension by fluid replacement and vasoactive drugs if necessary, administration of oxygen, management of metabolic acidosis, treatment of bleeding with fresh-frozen plasma, dialysis if indicated by renal failure, and treatment of secondary infections.” 

Other important parts of supportive care include:

• Monitoring for fever, dehydration, pain, bleeding, restlessness, and other infections such as malaria or a bacterial infection
• Administering fluids, analgesics, and antipyretics
• Encouraging rest
• Treating the patient’s clinical signs with available drugs and therapies

Recommended drugs or therapies for treating yellow fever and concurrent infections
For fever	Give paracetamol
For dehydration	Give oral rehydration salts
For restlessness	Give diazepam
For malaria	Give an antimalarial recommended for your area
For bacterial infections	Give anti-bacterials recommended for your area

During this time, it would also be important for the nurse to:

• Question patients with suspicious symptoms about recent travel 
• Report yellow fever to the Public Health Department

Resources

Gershman, M. D., Staples, J. E. (2013). CDC health information for International travel – yellow fever. Retrieved from

http://wwwnc.cdc.gov/travel/yellowbook/2014/chapter-3-infectious-diseases-related-to-travel/yellow-fever

Monath, T. P. (2015). Yellow fever. UpToDate. Retrieved from http://www.uptodate.com/contents/yellow-fever

Sheff, B. (2005). Microbe of the month: Yellow fever. Nursing, 35(7), 75.

World Health Organization. (n.d.). District guidelines for yellow fever surveillance. Retrieved from: http://www.who.int/csr/resources/publications/yellowfev/whoepigen9809.pdf