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
https://greatnurses.com/
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.
Katies NCLEX
Concepts Covered:
- Test Taking Strategies
- Medication Administration
- Adult
- Emergency Care of the Cardiac Patient
- Microbiology
- Anxiety Disorders
- Depressive Disorders
- Nervous System
- Gastrointestinal Disorders
- Fundamentals of Emergency Nursing
- Dosage Calculations
- Understanding Society
- Circulatory System
- Concepts of Pharmacology
- Studying
- Newborn Care
- Adulthood Growth and Development
- Respiratory Disorders
- Pregnancy Risks
- Neurological
- Postpartum Complications
- Substance Abuse Disorders
- Bipolar Disorders
- Learning Pharmacology
- Psychotic Disorders
- Prenatal Concepts
- Tissues and Glands
- Factors Influencing Community Health
- Concepts of Population Health
- Community Health Overview
- Developmental Considerations
- Communication
- Legal and Ethical Issues
- Cardiovascular
- Emergency Care of the Neurological Patient
- Emergency Care of the Respiratory Patient
- Emergency Care of the Trauma Patient
- Delegation
- Multisystem
- Health & Stress
- Childhood Growth and Development
- Prenatal and Neonatal Growth and Development
- Trauma-Stress Disorders
- Developmental Theories
- Concepts of Mental Health
- Gastrointestinal
- Newborn Complications
- Labor Complications
- Fetal Development
- Terminology
- Labor and Delivery
- Postpartum Care
- Prefixes
- Suffixes
- Proteins
- Statistics
- Med Term Basic
- Med Term Whole
- Cardiac Disorders
- Preoperative Nursing
- Intraoperative Nursing
- Vascular Disorders
- Noninfectious Respiratory Disorder
- Upper GI Disorders
- Central Nervous System Disorders – Brain
- Shock
- Immunological Disorders
- Postoperative Nursing
- Perioperative Nursing Roles
- Hematologic Disorders
- Disorders of Pancreas
- Neurological Trauma
- Neurological Emergencies
- Musculoskeletal Trauma
- EENT Disorders
- Peripheral Nervous System Disorders
- Respiratory Emergencies
- Shock
- Disorders of the Posterior Pituitary Gland
- Endocrine
- Disorders of the Thyroid & Parathyroid Glands
- Liver & Gallbladder Disorders
- Lower GI Disorders
- Respiratory
- Acute & Chronic Renal Disorders
- Disorders of the Adrenal Gland
- Documentation and Communication
- Oncology Disorders
- Female Reproductive Disorders
- Cognitive Disorders
- Renal Disorders
- Male Reproductive Disorders
- Sexually Transmitted Infections
- Infectious Respiratory Disorder
- Integumentary Disorders
- Urinary Disorders
- Integumentary Disorders
- Musculoskeletal Disorders
- Disorders of Thermoregulation
- Basics of NCLEX
- Integumentary Important Points
- Urinary System
- Neurologic and Cognitive Disorders
- Central Nervous System Disorders – Spinal Cord
- Renal and Urinary Disorders
- Respiratory System
- Infectious Disease Disorders
- EENT Disorders
- Eating Disorders
- Personality Disorders
- Psychological Emergencies
- Somatoform Disorders
- Prioritization
- Hematologic Disorders
- Cardiovascular Disorders
- Musculoskeletal Disorders
- Endocrine and Metabolic Disorders
- Oncologic Disorders
- Behavior
- Emotions and Motivation
- Growth & Development
- Intelligence and Language
- Psychological Disorders
- State of Consciousness
- Basics of Sociology
- Note Taking
- Basics of Human Biology