Hyper and Hypo Thermia Flashcards Preview

Geriatrics > Hyper and Hypo Thermia > Flashcards

Flashcards in Hyper and Hypo Thermia Deck (35):
1

past what age does thirst sensation decline?

50

2

a core temp over what is hyperthermia?

105 F

3

list some complications of heat stroke

Myocardial damage
renal failure
seizures
hepatocelullar necrosis

4

with early hyperthermia will you sweat?

Yes but not with late

5

Why do elderly have difficulty with temp regulation?

Loss of diurnal variation (rise)
Diminished sweating
Abnormal vasoconstrictor response

6

What is hypothermia?

Core temp < 35C or < 95F
increased heat loss with decreased heat production

7

Early signs of hypothermia

Fatigue, weakness, slowed gait, cool skin, shivering

8

Moderate signs of hypothermia

Cold skin, cyanotic, bradycardia, arrhythmia, hypotensive, hypo-reflexive, slowed pupillary rxn

9

Severe signs of hypothermia

Areflexia, fixed pupils, apneic, non-responsive, v. fib

10

What is a key finding of hypothermia?

J wave (Osborne wave) follows the QRS complex

11

Other labs that treat hypothermia

CMP, BUN, creatinine, clotting factors, CBC, urine/serum toxicity screens, thyroid, cardiac enzymes

12

Treatment of hypothermia

Warm IV fluids, warm core before limbs, anticipatory monitoring

13

What are anticipatory monitoring in hypothermia?

Metabolic acidosis
Cardiac decompensation/arrhythmias
Hyperkalemia, hypoglycemia
Renal failure

14

What is numb, swollen, erythematous area?

Frostnip (non-freezing)

15

Distal extremities & exposed skin
Cold, hard, white & numb; dry vs. wet gangrene

Frostbite

16

pale, edematous, clammy, cold, numb foot/feet

Immersion foot (non-freezing)

17

How do you treat frostnip, immersion foot, frostbite?

Rewarm
Wound care in frostbite

18

What is passive treatment for hypothermia and what temp should it be done at?

>32 C or 89.6 F, evidence shivering

Remove wet clothes and from cold env't
Warm fluids, heated blankets

19

What is active treatment for hypothermia and what temp should it be done at?

< 89.6F (also cardiac instability,toxin, trauma, or co-morbidity)

Heated and humidified O2
Warmed IV infusion (Lavage or ECR)

20

How to prevent hypothermia?

Warm layered clothing
Wind protection & moisture wicking
Foot wear allows for circulation
Head covering
Community outreach

21

What is hyperthermia?

Core temp > 40.6C or >105F
increased heat input with decreased heat output

22

Dizzy s/p exercise/exertion in hot weather
Pale & sweaty, moist & cool skin, HR increased, core temp normal

Heat syncope

23

Treatment for heat syncope and heat fatigue

rest, oral rehydration, cooler & less humid environment

24

Weakness, dizzy, HA, malaise, NAUSEA, syncope with prolonged standing in heat
PE: appear tired, sweaty, tachycardia, MS INTACT, NORMAL TEMP or < 40C or < 104F

Heat exhaustion

25

d/t exposure to elevated ambient temp or overexertion
Pale & sweaty, moist & cool skin, HR increased, core temp normal

Heat fatigue

26

Muscle cramps in legs due to exertion in hot weather, core temp normal

Heat cramps

27

How do you treat heat cramps?

Rx: cool environment, oral rehydration, IV NS, rest

28

How do you treat heat exhaustion?

Rx: Remove to cool environment, rest, supine, IV fluids/electrolyte replacement

29

hypoglycemia, coronary syndrome/MI, sepsis should be ruled out for what problem?

Heat exhaustion

30

Weakness, HA, malaise, CONFUSED, delirious
PE: skin hot & dry, supine tachycardia, tachypnea, ALTERED MENTAL STATUS, T > 40 C or > 104 F

Heat stroke

31

What are some causes of heat stroke?

Thermoregulatory dysfunction, heat wave exposure (2-3 days exposure)

32

CBC, clotting factors, electrolytes, BUN, creatinine, LFT, monitor urine output, core temp via rectal or esophageal probe

What are these labs for?

Heat stroke

33

What is treatment for heat stroke?

Admit & ID underlying cause

Ddx: sepsis, meningitis, CVA, meds/drugs, thyroid storm, malignant hyperthermia, neuroleptic malignant syndrome (from antipsychotics), serotonin syndrome (SSRIs)


Manage shivering/prevent seizures
Anticipatory monitoring

34

What is prescription for heat stroke?

Rapid cooling (continually wet & fan the skin; Add ice packs (groin & axilla))
IV hydration NS
PRN sedation to prevent agitation, seizures
Prevent aspiration if vomiting
DIC: platelets & fresh frozen plasma

35

Prevention of hyperthermia

Access to air conditioning in excessively hot weather
Avoid exertion
Maintain hydration
Loose fitting/ventilating clothing
Community outreach