Fever Flashcards

(54 cards)

1
Q

fevers are more commonly reported in

A

children than adults

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2
Q

populations with greater risk for fever

A

children, elderly, immunocompromised

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3
Q

principle reason to treat a fever

A

to relieve discomfort

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4
Q

risk in treating a fever

A

may have benefit on the host defense mechanism; treating fever may delay identification of underlying pathology

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5
Q

benefit in treating fever

A

improved patient comfort

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6
Q

normal body temperature

A

between 97.5-98.9

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7
Q

core body temp is regulate by

A

the hypothalamus

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8
Q

core body temp =

A

temp of blood that surrounds the hypothalamus and is NOT subject to much variation

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9
Q

core body temp rising:

information is transmitted between

A

the anterior hypothalamus and thermo-sensitive neurons in the skin and CNS

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10
Q

physiologic and behavioral mechanism will regulate

A

body temp to the normal range

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11
Q

skin temp may fluctuate greatly due to

A

environmental conditions

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12
Q

fever occurs when

A

there is a regulated rise in the core body thermoregulatory set point

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13
Q

fever occurs in response to

A

circulating pyrogens that active that host defenses

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14
Q

prostaglandins

A

elevate the core temp

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15
Q

during the upward temp readjustment

A

the person experiences chills cause by peripheral vasoconstriction and muscle rigidity to maintain homeostasis

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16
Q

fever is a body temp higher than

A

100 degrees

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17
Q

most febrile episodes are caused by

A

microbial infections

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18
Q

hyperthermia

A

malfunction of the hypothalamus that leads to a lack of control of the thermoregulatory set point

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19
Q

malignant hyperthermia consists of

A

temp greater than 104, muscle rigidity, metabolic acidosis

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20
Q

hyperpyrexia

A

temp > 106; leads to harmful and mental consequences

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21
Q

hyperpyrexia typically occurs in patients with

A

underlying medical conditions that prevent the body from regulating the core temp

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22
Q

non-specific symptoms of fever

A

chills, diaphoresis, tachycardia, headache, malaise, arthralgia, irritability and anorexia

23
Q

rectal

  1. normal range
  2. fever
A

1) 97.9-100.4

2) greater than or equal to 100.4

24
Q

oral

  1. normal
  2. fever
A

1) 95.9-99.5

2) greater than or equal to 99.5

25
temporal 1. normal 2. fever for 0-2 months 3. fever for 3-47 months 4. fever for greater than 4 years
1) 92.9-100.1 2) greater or equal to 100.7 3) greater or equal to 100.3 4) greater or equal to 100.1
26
accuracy of temp measurement
rectal > oral/temporal/tympanic > axillary
27
converting oral to rectal
add one degree
28
converting axillary to rectal
add 2 degrees
29
converting temporal/tympanic to rectal
same
30
electronic probe
- readings provided in 10-60 seconds
31
oral electronic probe
- wait 20/30 min after eating or drinking | - not appropriate for under 3
32
how long for pacifier shaped thermometer
2-6 min
33
preferred method in less than 3 months
rectal
34
risks of rectal measurement
retention of thermometer, rectal or intestinal perforation, peritonitis
35
infrared readings
- provided in 5 secs or less | - do not use in less than 6 months
36
infrared for children younger than one year
pull ear backwards
37
infrared for children older than one year
pull ear up and back
38
complications of fever
dehydrations, mental status changes, and seizures
39
complications of fever typically occur in
infants, elderly or patients with brain tumors/hemorrhage, CNS infections, pre-existing neurologic damage, and neuropathy
40
febrile seizure
seizure accompanied by fever in infants and children due to rapidly rising temp
41
signs and symptoms of dehydration
1. feeling thirsty 2. urinating less often, dark yellow or brown urine 3. dry mouth or cracked lips 4. decrease skin turgor 5. no tears when child cries 6. feeling tired or confused 7. eyes that look sunken 8. feeling dizzy or light headed 9. babies than have "sunken fontanel"
42
exclusions for self treatment
1. pts > 3 mos w rectal temp > 100.4 2. pts < 3 mos w rectal temp > 100.1 3. severe symptoms of infection 4. risk of hyperthermia 5. impaired oxygen utilization 6. impaired immune function 7. CNS damage 8. children w history of febrile seizures or seizures 8. child w spot or rash 9. child who wont drink fluids 10. child who is sleepy, irritable or hard to wake up 11. child who is vomiting and cant keep fluids down 12. child w repeated diarrhea 13. child w stiff neck 14. pts > 2 with fevers > 3 days 15. pts <2 with fever > 24 hrs 16. fever repeated rising > 104
43
non pharm treatment
- increase fluid intake - wear lightweight clothing, remove blankets, and maintain room temps of 68 - body sponging w tepid water ( not recommended for fever < 104 )
44
antipyretics moa
inhibit prostaglandin E2 which decreases feedback between thermoregulatory neurons and hypothalamus which reduces hypothalamic set point
45
APAP ped dose
10-15 mg/kg q4-6hr *max 5 dose in 24 hrs*
46
APAP adult dose
325-1000 mg q4-6hr *max 4000mg/day and elderly 3000mg.day*
47
ibuprofen ped dose
ONLY IF OLDER THAN 6 mos | 5-10mg/kg q6-8hrs *max 40mg/kg/day*
48
ibuprofen adult dose
200-400mg q4-6hr *max 1200mg/day*
49
naproxen ped dose
not for children < 12
50
naproxen adult dose
220 mg q8-12hr *max 660mg, elderly 440mg*
51
aspirin ped dose
not for children
52
aspirin adult dose
325-650 mg q4-6hr
53
how long to treat w antipyretics
around the clock for at least 24 hrs | may take 6-24 hrs to bring fever down
54
antipyretics should not be used longer than
3 days