Nursing Care for Patients with Dengue Shock Syndrome Receiving Hemodialysis: Hemodialysis nurse’s Roles

Abstract

In adults, dengue fever can become severe, particularly when plasma leakage leads to dengue hemorrhagic fever (DHF) or advances to dengue shock syndrome (DSS), marked by critically low blood pressure. This syndrome involves plasma leaking from capillaries, abnormal clotting, thrombocytopenia, and an immune response that can result in fluid accumulation in the pleural cavity and abdomen, as well as potential organ failure. Acute kidney injury (AKI) is a serious complication, affecting approximately 10% of dengue cases and contributing to increased hospitalization and mortality rates. Circulatory failure leads to reduced renal perfusion, resulting in hemolysis, muscle breakdown, and acute tubular necrosis. Patients may present with decreased urine output, uremia, fluid overload, and metabolic acidosis, often necessitating dialysis. The role of hemodialysis nurses is therefore critical. They must possess specialized knowledge and skills in sustained low-efficiency dialysis (SLED) and continuous renal replacement therapy (CRRT). Additionally, they need experience managing AKI patients with complications during dialysis and addressing complex issues promptly. This includes preparing dialysis machines, configuring blood filters, and organizing dialysis solutions according to the physician’s plan to ensure safe, effective, and timely patient care.