Which among the following is one of the laboratory findings of dengue shock syndrome (DSS)?

WCL Staff Nurse - 2022

Medical & Surgical Nursing

Medium

Appeared in: WCL Staff Nurse - 2022

Explanation

A rising haematocrit is a direct laboratory sign of haemoconcentration.
Haemoconcentration is caused by severe plasma leakage from the blood vessels, which is the primary pathophysiological event in Dengue Shock Syndrome (DSS).
This loss of plasma volume from the circulatory system leads to hypovolemic shock.
Even a 5-10% rise in haematocrit during the critical phase is a significant warning sign, although a rise of 20% or more is a formal diagnostic criterion for severe plasma leakage.

Option A: Thrombocytopenia (platelet count < 100,000/mm³) is a diagnostic criterion for Dengue Haemorrhagic Fever (DHF), but it does not directly cause the shock. The shock in DSS is due to hypovolemia from plasma leakage, not bleeding from low platelets.
Option B: This statement is the opposite of what occurs in DSS. The syndrome is defined by severe plasma loss, which leads to shock.
Option C: Leukopenia (decreased white blood cell count) is a common finding in the early, febrile phase of dengue fever. It is not a specific indicator of the progression to the critical phase or shock.

Clinical Relevance

Nursing practice connection: Prioritize focused assessment, early escalation, and real-time monitoring when managing Laboratory findings in Dengue Shock Syndrome (DSS) in acute care settings.
For nurses, monitoring for a rising haematocrit is a critical intervention. Serial haematocrit levels, along with vital signs (especially narrowing pulse pressure ≤ 20 mmHg), are key to detecting the onset of the critical phase of dengue.
A rising haematocrit signals the need for judicious intravenous fluid resuscitation to prevent shock, while a falling haematocrit after fluid therapy indicates improvement. Overhydration is a major risk and must be avoided.
What if? - If a patient in shock has a falling haematocrit without clinical improvement, it is an extremely ominous sign. It suggests major internal haemorrhage, as the blood is being diluted by bleeding. This is a medical emergency requiring immediate blood transfusion, not just crystalloid fluids.

How to Approach the Question

First, identify the core subject of the question: the specific laboratory findings for Dengue Shock Syndrome (DSS).
Recall the fundamental pathophysiology of DSS. The 'shock' is hypovolemic, caused by massive leakage of plasma from the blood vessels.
Think about how this plasma leakage would affect blood tests. If the liquid part (plasma) leaves, the remaining components (red blood cells) become more concentrated.
Evaluate each option based on this core concept:
Does low platelet count cause this type of shock? No, volume loss does.
Is there 'no plasma loss'? No, that's the opposite of what happens.

Concept Tested & Keywords

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