Malaria is a life-threatening parasitic disease transmitted through the bite of infected Anopheles mosquitoes. This nursing diagnosis focuses on identifying and treating malaria symptoms, preventing complications, and providing comprehensive patient care.
Causes (Related to)
Malaria affects patients in various ways, with several factors contributing to its severity and progression:
- Infection by Plasmodium parasites (P. falciparum, P. vivax, P. ovale, P. malariae)
- Travel to or residence in endemic areas
- Compromised immune system due to chronic conditions or medications
- Risk factors such as:
- Pregnancy
- Young age
- HIV/AIDS
- Lack of antimalarial prophylaxis
- Genetic factors (sickle cell trait)
- Environmental factors including:
- Living in or traveling to endemic areas
- Poor mosquito control measures
- Inadequate housing conditions
- Limited access to healthcare
Signs and Symptoms (As evidenced by)
Malaria presents with characteristic signs and symptoms that nurses must recognize for proper diagnosis and treatment.
Subjective: (Patient reports)
- Cyclic fever and chills
- Severe headache
- Muscle and joint pain
- Extreme fatigue
- Nausea and vomiting
- Abdominal pain
- Profuse sweating
- Loss of appetite
Objective: (Nurse assesses)
- Cyclical temperature spikes (typically >101°F/38.3°C)
- Tachycardia
- Hepatosplenomegaly
- Pallor
- Jaundice
- Mental status changes
- Decreased hemoglobin levels
- Dark urine
Expected Outcomes
The following outcomes indicate the successful management of malaria:
- The patient will maintain normal temperature within 48-72 hours of treatment
- The patient will demonstrate improved hemodynamic stability
- The patient will maintain adequate hydration status
- The patient will show no signs of complications
- Patient will demonstrate an understanding of prevention measures
- Patient will complete the full course of antimalarial medication
- The patient will return to normal daily activities within 2-3 weeks
Nursing Assessment
Monitor Vital Signs
- Check temperature patterns every 4 hours
- Monitor blood pressure and heart rate
- Assess respiratory rate and effort
- Document fever cycles
Assess Neurological Status
- Monitor consciousness level
- Check orientation
- Assess for signs of cerebral malaria
- Document any seizure activity
- Evaluate pupillary response
Evaluate Hydration Status
- Monitor fluid intake and output
- Assess skin turgor
- Check mucous membranes
- Monitor urine output and color
- Document any bleeding
Check for Complications
- Monitor for signs of severe malaria
- Assess for respiratory distress
- Watch for signs of kidney failure
- Check for severe anemia
- Monitor for hypoglycemia
Review Risk Factors
- Document travel history
- Assess prophylaxis status
- Note previous malaria episodes
- Review pregnancy status
- Check immune system status
Nursing Care Plans
Nursing Care Plan 1: Hyperthermia
Nursing Diagnosis Statement:
Hyperthermia related to malarial parasitic infection as evidenced by cyclic fever patterns, chills, and diaphoresis.
Related Factors:
- Plasmodium parasite infection
- Inflammatory response
- Altered thermoregulation
- Metabolic changes
Nursing Interventions and Rationales:
- Monitor temperature patterns q4h
Rationale: Identifies characteristic malaria fever cycles - Administer antipyretics as ordered
Rationale: Reduces fever and associated discomfort - Provide cooling measures during fever spikes
Rationale: Helps maintain safe body temperature - Monitor for signs of dehydration
Rationale: Prevents fluid volume deficit from fever
Desired Outcomes:
- Temperature will stabilize within the normal range
- The patient will report improved comfort
- The patient will maintain adequate hydration
Nursing Care Plan 2: Risk for Decreased Cardiac Output
Nursing Diagnosis Statement:
Risk for decreased cardiac output related to severe malaria infection as evidenced by tachycardia, hypotension, and poor tissue perfusion.
Related Factors:
- Severe anemia
- Parasitemia
- Fluid shifts
- Systemic inflammatory response
Nursing Interventions and Rationales:
- Monitor vital signs and hemodynamic status
Rationale: Detects early signs of cardiovascular compromise - Administer prescribed fluids and medications
Rationale: Maintains adequate circulation and tissue perfusion - Position patient to optimize cardiac function
Rationale: Improves venous return and cardiac output
Desired Outcomes:
- The patient will maintain stable vital signs
- The patient will demonstrate adequate tissue perfusion
- The patient will show improved energy levels
Nursing Care Plan 3: Acute Confusion
Nursing Diagnosis Statement:
Acute confusion related to cerebral malaria as evidenced by altered consciousness, disorientation, and behavioral changes.
Related Factors:
- Cerebral malaria
- Hypoxia
- Metabolic changes
- Fever
Nursing Interventions and Rationales:
- Assess neurological status frequently
Rationale: Monitors progression of cerebral involvement - Maintain safe environment
Rationale: Prevents injury during confusion episodes - Implement orientation strategies
Rationale: Helps maintain patient awareness
Desired Outcomes:
- The patient will demonstrate improved mental status
- The patient will maintain safety
- The patient will show no signs of neurological deterioration
Nursing Care Plan 4: Risk for Deficient Fluid Volume
Nursing Diagnosis Statement:
Risk for deficient fluid volume related to excessive sweating, vomiting, and decreased oral intake as evidenced by poor skin turgor and decreased urine output.
Related Factors:
- Fever and diaphoresis
- Gastrointestinal symptoms
- Decreased oral intake
- Increased metabolic demands
Nursing Interventions and Rationales:
- Monitor intake and output strictly
Rationale: Ensures early detection of fluid imbalance - Administer IV fluids as ordered
Rationale: Maintains adequate hydration status - Assess for signs of dehydration
Rationale: Enables prompt intervention
Desired Outcomes:
- The patient will maintain adequate hydration
- The patient will demonstrate stable vital signs
- The patient will show improved skin turgor and urine output
Nursing Care Plan 5: Impaired Gas Exchange
Nursing Diagnosis Statement:
Impaired gas exchange related to severe malaria complications as evidenced by dyspnea, tachypnea, and decreased oxygen saturation.
Related Factors:
- Severe anemia
- Pulmonary edema
- Respiratory distress
- Tissue hypoxia
Nursing Interventions and Rationales:
- Monitor respiratory status and oxygen saturation
Rationale: Detects respiratory compromise early - Position patient to optimize breathing
Rationale: Improves ventilation and oxygenation - Administer oxygen therapy as ordered
Rationale: Maintains adequate tissue oxygenation
Desired Outcomes:
- The patient will maintain oxygen saturation >95%
- The patient will demonstrate an improved breathing pattern
- The patient will show no signs of respiratory distress
References
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