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.
Rina’s NCLEX Study Plan 2026
Concepts Covered:
- Endocrine System
- Studying
- Urinary System
- Tissues and Glands
- Nervous System
- Circulatory System
- Medication Administration
- Hematologic System
- Skeletal System
- Digestive System
- Respiratory System
- Emergency Care of the Cardiac Patient
- Reproductive System
- Endocrine and Metabolic Disorders
- Basics of Human Biology
- Muscular System
- Sensory System
- Communication
- Legal and Ethical Issues
- Basics of NCLEX
- Prenatal Concepts
- Prioritization
- Fundamentals of Emergency Nursing
- Documentation and Communication
- Delegation
- Community Health Overview
- Factors Influencing Community Health
- Concepts of Mental Health
- Test Taking Strategies
- Note Taking
- Substance Abuse Disorders
- Behavior
- Concepts of Population Health
- Concepts of Pharmacology
- Health & Stress
- Labor and Delivery
- Gastrointestinal Disorders
- Microbiology
- Depressive Disorders
- Postpartum Care
- Emergency Care of the Trauma Patient
- Emotions and Motivation
- Growth & Development
- Intelligence and Language
- Psychological Disorders
- State of Consciousness
- Respiratory Disorders
- EENT Disorders
- Infectious Disease Disorders
- Integumentary Disorders
- Neurologic and Cognitive Disorders
- Hematologic Disorders
- Cardiovascular Disorders
- Musculoskeletal Disorders
- Renal and Urinary Disorders
- Oncologic Disorders
- Anxiety Disorders
- Cognitive Disorders
- Eating Disorders
- Personality Disorders
- Psychotic Disorders
- Trauma-Stress Disorders
- Bipolar Disorders
- Developmental Considerations
- Psychological Emergencies
- Somatoform Disorders
- Perioperative Nursing Roles
- Preoperative Nursing
- Central Nervous System Disorders – Brain
- Lower GI Disorders
- Peripheral Nervous System Disorders
- Cardiac Disorders
- Integumentary Disorders
- Musculoskeletal Disorders
- Noninfectious Respiratory Disorder
- Postoperative Nursing
- Respiratory Emergencies
- Intraoperative Nursing
- Disorders of Pancreas
- Urinary Disorders
- Neurological Emergencies
- Central Nervous System Disorders – Spinal Cord
- Renal Disorders
- Infectious Respiratory Disorder
- Sexually Transmitted Infections
- EENT Disorders
- Shock
- Cardiovascular
- Shock
- Disorders of the Posterior Pituitary Gland
- Endocrine
- Disorders of the Thyroid & Parathyroid Glands
- Gastrointestinal
- Upper GI Disorders
- Liver & Gallbladder Disorders
- Neurological
- Respiratory
- Hematologic Disorders
- Acute & Chronic Renal Disorders
- Disorders of the Adrenal Gland
- Immunological Disorders
- Oncology Disorders
- Female Reproductive Disorders
- Musculoskeletal Trauma
- Vascular Disorders
- Male Reproductive Disorders
- Newborn Complications
- Disorders of Thermoregulation
- Neurological Trauma
- Integumentary Important Points
- Multisystem
- Emergency Care of the Neurological Patient
- Emergency Care of the Respiratory Patient
- Prefixes
- Suffixes
- Fetal Development
- Terminology
- Proteins
- Statistics
- Med Term Basic
- Med Term Whole
- Basics of Mathematics
- Basics of Sociology
- Pregnancy Risks
- Labor Complications
- Newborn Care
- Postpartum Complications
- Understanding Society
- Adult
- Dosage Calculations
- Adulthood Growth and Development
- Learning Pharmacology