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Nursing Fundamentals > Thermoregulation > Flashcards

Thermoregulation Flashcards

1
Q

Normal Thermoregulation–Heat Production

A
  • basal metabolism
  • muscular activity (shivering)
  • Thyroxine and epinephrine (stimulating effects on metabolic rate)
  • temperature effect on cells
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2
Q

Normal Thermoregulation–Heat loss

A
  • radiation
  • conduction/convection
  • evaporation (vaporization)
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3
Q

Factors affecting heat production

A
  • basal metabolic rate
  • muscle activity
  • thyroxine output
  • fever increase
  • epinephrine, norepinephrine, stress response
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4
Q

Radiation

A

through electromagnetic waves (sunlight)

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5
Q

Conduction

A

through direct touch

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6
Q

Convection

A

through gas or liquid (heat rising/hot air balloon)

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7
Q

Evaporation

A

liquid changes to gas (boiling water)

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8
Q

Core Temp is controlled by

A

hypothalmus

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9
Q

3 processes that regulate temperature

A
  • shivering (increase temp)
  • sweating (decrease temp)
  • vasoconstriction (increase temp)
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10
Q

Newborns Thermoregulation Considerations

A
  • decreased subQ fat
  • blood vessels are closer to surface (loose heat easily)
  • brown adipose fat
  • nonshivering themogenesis (a way to generate heat)
  • preemies have less brown adipose fat
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11
Q

Children Thermoregulation Considerations

A

handle high temps well if healthy

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12
Q

Elderly Thermoregulation Considerations

A
  • decreased subQ fat
  • less active
  • sensitive to extremes in environment temp
  • Thermoregulation not as efficient
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13
Q

Normal Oral Body Temp

A

96.8 degrees F- 98.6 degrees F

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14
Q

Hypothermia

A
  • excessive heat loss
  • inadequate heat production
  • impaired hypothalamic thermoregulation (brain damage)
  • vasoconstriction and tissue ischemia
  • vasoconstriction too long can cause gangrene (tissue death)
  • 95.0 degrees F – 93.2 degrees F
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15
Q

Hyperthermia (not fever)

A
  • body temp rises uncontrollably
  • brain damage and death can occur
  • delirium, convulsions, coma
  • heat stroke/heat exhaustion
  • may be due to neurological impairment/brain injury
  • malignant hyperthermia (rare response to anesthesia, can be deadly, inherited, can be screened for genetic risk)
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16
Q

Fever

A
  • adaptive response to pyrogen entering body (example: virus)
  • controlled response by hypothalamus
  • brain damage and death very rarely occur
  • thermoregulation is not altered-fever can adversely affect critically ill patients
  • raises BMR which will increase the demand for oxygen
17
Q

Febrile Response: Chill phase

A
  • body warms itself to raise core temp to new set point

- peripheral vasoconstriction, shivering, warmth-seeking behavior (start by feeling very cold)

18
Q

Febrile Response: Flush Phase

A
  • set point lowered to normal

- body cools itself-peripheral vasodilation, sweating, cool-seeking behavior

19
Q

Benefits of fever

A
  • fever is a protective mechanism (bacteria)
  • enhances neutrophils and T-lymphocytes (viruses)
  • slows growth of bacteria and viruses (they don’t replicate well at high fevers)
  • may slow growth of certain tumors-may work better with penicillin
  • early exposure to fevers caused by infections may protect children from asthma, allergies and cancer in adulthood
20
Q

Culture and fever

A
  • ethnic differences in parental management of fever-fever phobia in many cultures
  • hispanics: more likely to believe fever can cause brain damage and death
  • African Americans: more likely to over treat with ibuprofen and more concerned about febrile seizures
21
Q

Nursing Care: Fever

A
  • monitor temp every 2 hours as needed-promote adequate fluid intake
  • monitor intake and output
  • cover with sheet only-administer antipyretics as needed
  • cool washcloth or ice bag to groin, axilla, forehead-cooling blanket
22
Q

Clinical Manifestations: Fever

A
  • cool skin when temp rising
  • warm and flushed skin when temp decreasing
  • increased heart rate
  • increased respiratory rate
  • oxygen need increases
  • Febrile seizures-benign, common between 6 months-3 years, run in families, does not hurt brain
23
Q

Temperature Variations

A
  • Oral Temp: 98.6 degrees F
  • Rectal Temp: 99.6 degrees F
  • Tympanic Temp: 99.6 degrees F
  • Axillary Temp: 97.6 degrees F
24
Q

What is Fever?

A
  • 100.4 degrees F or higher for rectal temp
  • 101 degrees F oral-under 2-3 months-rectal temp 100.4 is considered fever and infant should be assessed for serious illness (blood, urine cultures, lumbar puncture)-lowest in morning and highest in the evening
25
Q

Acetaminophen

A

-acts on hypothalamus, peripheral dilation-liver damage with overdose-tylenol, tempra-can be given every 4-6 hours-use with caution in liver disease

26
Q

Ibuprofen

A
  • nonsterodial anti-inflammatory drug (NSAID)-inhibits prostaglandin-advil, motrin-can be given every 6-8 hours over 6 months of age-use with caution with kidney disease
  • CANNOT BE GIVEN UNDER 6 MONTHS OF AGE
27
Q

Naproxen

A
  • NSAID

- over 12 years of age

28
Q

Aspirin (ASA)

A
  • inhibits prostaglandin

- never to a child-linked to Reye Syndrome

29
Q

Oral Temp (Advantages/Disadvantages)

A
  • Advantages: accessible and convenient
  • Disadvantages: thermometer can break if bitten; inaccurate if client has just ingested hot or cold food or fluid or has just smoked; could injure the mouth following oral surgery
30
Q

Rectum Temp (Advantages/Disadvantages)

A
  • Advantages: reliable measurement
  • Disadvantages: inconvenient and more unpleasant for clients; difficult for client who cannot turn to the side; could injure rectum following rectal surgery; presence of stool may interfere with thermometer
31
Q

Axillary Temp (Advantages/Disadvantages)

A
  • Advantages: safe and noninvasive

- Disadvantages: thermometer must be left in place a long time to obtain an accurate measurement

32
Q

Tympanic Membrane Temp (Advantages/Disadvantages)

A
  • Advantages: readily accesible; reflects the core temp; very fast; may be less scary for small children
  • Disadvantage: can be uncomfortable; involves risk of injuring the membrane if the probe is inserted too far; repeated measurements may vary; left and right measurements can differ; presence of wax can affect the reading
33
Q

Temporal Artery Temp (Advantages/Disadvantages)

A
  • Advantages: safe and noninvasive; very fast; less scary for small children
  • Disadvantages: requires equipment that may be expensive or unavailable; variation in technique is needed if the client has perspiration on the forehead

Nursing Fundamentals (4 decks)

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