Malaria is an acute illness and can become chronic, caused by protozoa that live intra cells, the genus plasmodium which is characterized by fever, anemia, and splenomegaly.
Plasmodium malaria as a cause consists of four species, namely Plasmodium vivax, Plasmodium falciparum, Plasmodium malariae, and Plasmodium ovale. Malaria also involves the intermediate host, the human and the other vertebrae, and hospes definitive, the Anopheles mosquito.
3. Clinical manifestations
In anamnesis asked symptoms and a history of travel to malaria endemic areas. Symptoms and signs that can be found are:
Periodic fever associated with the outbreak skizon mature (sporulation). In tertiana malaria (Plasmodium vivax and Plasmodium ovale), maturation skizon every 48 hours then the periodicity of the fever every third day, while kuartana malaria (Plasmodium malariae) every 72 hours maturation and periodicity of fever every 4 days. Each attack is characterized by periodic fever attacks. Typical malaria fever consists of three stages, namely chills (15 minutes-1 hour), the peak fever (2-6 hours), and sweating (2-4 hours). Fever will subside gradually as the body can adapt to the parasite in the body and there is an immune response.
Splenomegaly is a typical symptom of chronic malaria. Spleen experiencing congestion, blackened, and being loud as erythrocyte parasite pigment accumulation and connective tissue is increased.
The degree of anemia depends on the cause of the species, which is the most severe anemia due to Plasmodium falciparum.
Anemia is caused by:
1) excessive destruction of erythrocytes.
2) normal erythrocytes can not live long (reduced survival time).
3) Impaired formation of erythrocytes due eritropoesis depression in the bone marrow (diseritropoesis).
Jaundice caused by hemolysis and liver disorders.
Malaria is a latent period of patients outside during bouts of fever. This period occurs when the parasite can not be found in the peripheral blood, but the stadium eksoeritrosit still persist in the liver tissue.
Relapse is the onset of symptoms of infection after the first attack. Relapses can be:
1. Relapse short term, may present 8 weeks after the first attack is gone, because the parasites multiply within red cells.
2. Relapse long term, may appear 24 weeks or more after the first attack lost due to parasite exo-erythrocyte liver into the blood and multiply.
Nursing Diagnosis and Nursing Interventions for Malaria
Nursing Diagnosis for Malaria
Risk for infection related to decreased immune system.
Objective: Demonstrate the healing over time, free of any signs of infection.
Nursing Interventions for Malaria
1) Provide isolation / monitor visitors as indicated.
R / Reduce the risk of possible infection.
2) Wash your hands before and after activity despite using sterile gloves.
R / Reduce cross contamination.
3) Monitor the temperature trend.
R / Fever is caused by the effects of endotoxin in the hypothalamus and releases endorphins that pyrogen. Hypothermia is critical signs that reflect the development status of shock / decrease in tissue perfusion.
4) Observe the chills and diaphoresis.
R / Shivering often precedes the height of the temperature on the infection.
5) Monitor signs of irregularities conditions / failure to improve during therapy.
R / Can demonstrate the inappropriateness / ketidakadekuatan antibiotic therapy or excessive growth of resistant organisms / opportunistic.
6) Collaboration of anti-infective drugs as indicated.
R / Can eradicate / provide temporary immunity to infection.