Hemorrhagic Fevers for Certified Emergency Nursing (CEN)
Included In This Lesson
Outline
Hemorrhagic Fevers
Definition/Etiology:
Viral hemorrhagic fevers (VHFs) are a group of illnesses caused by four families of viruses. These include the Ebola and Marburg, Lassa fever, and yellow fever viruses. VHFs have common features: they affect many organs, they damage the blood vessels, and they affect the body’s ability to regulate itself. Some VHFs cause mild disease, but some, like Ebola or Marburg, cause severe disease and death.
Pathophysiology:
Ebola virus infects at a mucosal surface and infects macrophages and dendritic cells which migrate to lymph nodes. The infection suppresses innate and adaptive immune responses, allowing the virus to disseminate systemically. This systemic spread leads to damage in a variety of tissues, excessive cytokine responses, vascular leakage and disseminated intravascular coagulation. So basically, these are bad bugs that turn your blood to sludge.
Clinical Presentation:
Primary signs and symptoms of Ebola often include some or several of the following:
- Fever
- Aches and pains, such as severe headache and muscle and joint pain
- Weakness and fatigue
- Sore throat
- Loss of appetite
- Gastrointestinal symptoms including abdominal pain, diarrhea, and vomiting
- Unexplained hemorrhaging, bleeding or bruising
Other symptoms may include red eyes, skin rash, and hiccups (late-stage). If patients present in respiratory distress with suspicion of a HF, chances of survival are very low.
Collaborative Management:
the most important factor here is your personal safety. This is a full Haz-mat, space suit PPE situation. For those that were nurses during the Ebola outbreak in 2016, you may remember the drills we did. That being said, we are going to test. Basic labs, cultures, lactate. These patients may present similarly to a flu or septic patient, and we will treat accordingly. Unfortunately for HF, the primary treatment at this time is supportive care.
Evaluation | Patient Monitoring | Education:
Honestly, if this is a true hemorrhagic fever, the best evaluation is whether they are alive or not. If the progression is not that bad, then our evaluations are as always… our ABCs.
Cardiac monitoring, O2, ventilator management if we have gotten to that point. If there is a confirmed HF, the most important factor is isolation and the safety of the staff and the patient.
Linchpins: (Key Points)
- Safety first
- Supportive care
- Identification
Transcript
For more great CEN prep, got to the link below to purchase the “Emergency Nursing Examination Review” book by Dr. Laura Gasparis Vonfrolio RN, PHD
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References:
- Centers for Disease Control and Prevention. (2021, May 4). Ebola (Ebola Virus Disease). Retrieved from CDC 24/7: https://www.cdc.gov/vhf/ebola/symptoms/index.html
- Emergency Nurses Association. (2022). Emergency Nursing Orientation 3.0. Cambridge, MA: Elsevier, Inc.
- Sheehy, S. B., Hammond, B. B., & Zimmerman, P. G. (2013). Sheehy’s manual of emergency care (Vol. 7th Edition). St. Louis, MO: Elsevier/Mosby.
NCLEX
Concepts Covered:
- Circulatory System
- Emergency Care of the Cardiac Patient
- Cardiac Disorders
- Cardiovascular
- Shock
- Shock
- Disorders of the Posterior Pituitary Gland
- Endocrine
- Disorders of Pancreas
- Disorders of the Thyroid & Parathyroid Glands
- Hematology
- Gastrointestinal
- Upper GI Disorders
- Liver & Gallbladder Disorders
- Newborn Complications
- Lower GI Disorders
- Multisystem
- Neurological
- Nervous System
- Central Nervous System Disorders – Brain
- Renal
- Respiratory
- Urinary System
- Respiratory System
- Noninfectious Respiratory Disorder
- Test Taking Strategies
- Note Taking
- Basics of NCLEX
- Prefixes
- Suffixes
- Medication Administration
- Gastrointestinal Disorders
- Respiratory Disorders
- Pregnancy Risks
- Labor Complications
- Hematologic Disorders
- Fundamentals of Emergency Nursing
- Factors Influencing Community Health
- Delegation
- Perioperative Nursing Roles
- EENT Disorders
- Basics of Chemistry
- Adult
- Emergency Care of the Neurological Patient
- Acute & Chronic Renal Disorders
- Emergency Care of the Respiratory Patient
- Respiratory Emergencies
- Studying
- Substance Abuse Disorders
- Disorders of the Adrenal Gland
- Behavior
- Documentation and Communication
- Preoperative Nursing
- Endocrine System
- Legal and Ethical Issues
- Communication
- Understanding Society
- Immunological Disorders
- Infectious Disease Disorders
- Oncology Disorders
- Female Reproductive Disorders
- Fetal Development
- Terminology
- Anxiety Disorders
- Cognitive Disorders
- Musculoskeletal Trauma
- Intraoperative Nursing
- Tissues and Glands
- Vascular Disorders
- Renal Disorders
- Eating Disorders
- Prenatal Concepts
- Microbiology
- Male Reproductive Disorders
- Sexually Transmitted Infections
- Infectious Respiratory Disorder
- Depressive Disorders
- Personality Disorders
- Psychotic Disorders
- Trauma-Stress Disorders
- Peripheral Nervous System Disorders
- Integumentary Disorders
- Neurologic and Cognitive Disorders
- Integumentary Disorders
- Newborn Care
- Basics of Mathematics
- Statistics
- Labor and Delivery
- Proteins
- Emergency Care of the Trauma Patient
- Hematologic System
- Hematologic Disorders
- Developmental Considerations
- Skeletal System
- Digestive System
- Urinary Disorders
- Postpartum Care
- Basic
- Musculoskeletal Disorders
- Bipolar Disorders
- Metabolism
- Cardiovascular Disorders
- Concepts of Population Health
- Musculoskeletal Disorders
- EENT Disorders
- Postpartum Complications
- Basics of Human Biology
- Postoperative Nursing
- Neurological Emergencies
- Prioritization
- Disorders of Thermoregulation
- Writing
- Community Health Overview
- Dosage Calculations
- Neurological Trauma
- Concepts of Mental Health
- Health & Stress
- Endocrine and Metabolic Disorders
- Childhood Growth and Development
- Prenatal and Neonatal Growth and Development
- Concepts of Pharmacology
- Integumentary Important Points
- Emotions and Motivation
- Renal and Urinary Disorders
- Developmental Theories
- Reproductive System
- Adulthood Growth and Development
- Psychological Emergencies
- Growth & Development
- Basics of Sociology
- Somatoform Disorders
- Reading
- Intelligence and Language
- Oncologic Disorders
- Med Term Basic
- Med Term Whole
- Central Nervous System Disorders – Spinal Cord
- Muscular System
- Neonatal
- Learning Pharmacology
- Pediatric
- Psychological Disorders
- State of Consciousness
- Sensory System