Which is not a finding in a dengue patient?

Appeared in: RUHS, Jaipur, PB B.Sc Nursing Entrance-2021

Explanation

Hypertension, or high blood pressure, is not a characteristic feature of dengue fever.
The core pathophysiology of severe dengue involves increased capillary permeability and plasma leakage.
This loss of fluid from the vascular compartment leads to hypovolemia (decreased blood volume).
Hypovolemia results in hypotension (low blood pressure), which is a key sign of dengue shock syndrome, the opposite of hypertension.

Option A: Haemodilution is a finding in dengue patients, specifically during the recovery phase.
Option B: Thrombocytopenia, a platelet count below 100,000 cells/mm3, is a hallmark and a diagnostic criterion for dengue hemorrhagic fever.
Option C: Increased capillary permeability is the fundamental pathophysiological change in severe dengue.

Clinical Relevance

Nursing practice connection: Use the key finding related to Clinical manifestations and pathophysiology of Dengue Fever to guide bedside assessment, documentation, and the next nursing action.
Nurses must vigilantly monitor for signs of hypotension, such as a narrowing pulse pressure (systolic and diastolic pressures getting closer), tachycardia, and cool extremities, as these are warning signs of impending shock.
Accurate fluid management is critical. Over-infusion of IV fluids during the recovery phase, when haemodilution occurs, can lead to fluid overload, pulmonary edema, and congestive heart failure.
Patient education should include recognizing warning signs like severe abdominal pain, persistent vomiting, and any bleeding, and seeking immediate medical care.

How to Approach the Question

First, identify the core of the question. It asks to identify the option that is NOT a finding in dengue. This is a negative question, so you are looking for the incorrect statement.
Recall the pathophysiology of dengue. The key event is increased capillary permeability leading to plasma leakage.
Think about the consequences of plasma leakage: loss of blood volume (hypovolemia), concentration of remaining blood cells (hemoconcentration), and a drop in blood pressure (hypotension).
Evaluate each option against this knowledge:
Does dengue cause haemodilution? Yes, in the recovery phase.
Does dengue cause thrombocytopenia? Yes, it's a hallmark.

Concept Tested & Keywords

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E6 Parks TextBook of Preventive & Social Medicine part 1 — Subpart B (pp 202-403 of 604) p. 106-108

E6 Ghai Essential Pediatrics(pp 26-904 of 913) p. 242-244

Practise the full RUHS, Jaipur, PB B.Sc Nursing Entrance-2021

Attempt every question from this paper in a timed mock, then review the full solution for each one.