Thermoregulation Flashcards
(33 cards)
1
Q
Normal Thermoregulation–Heat Production
A
- basal metabolism
- muscular activity (shivering)
- Thyroxine and epinephrine (stimulating effects on metabolic rate)
- temperature effect on cells
2
Q
Normal Thermoregulation–Heat loss
A
- radiation
- conduction/convection
- evaporation (vaporization)
3
Q
Factors affecting heat production
A
- basal metabolic rate
- muscle activity
- thyroxine output
- fever increase
- epinephrine, norepinephrine, stress response
4
Q
Radiation
A
through electromagnetic waves (sunlight)
5
Q
Conduction
A
through direct touch
6
Q
Convection
A
through gas or liquid (heat rising/hot air balloon)
7
Q
Evaporation
A
liquid changes to gas (boiling water)
8
Q
Core Temp is controlled by
A
hypothalmus
9
Q
3 processes that regulate temperature
A
- shivering (increase temp)
- sweating (decrease temp)
- vasoconstriction (increase temp)
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
11
Q
Children Thermoregulation Considerations
A
handle high temps well if healthy
12
Q
Elderly Thermoregulation Considerations
A
- decreased subQ fat
- less active
- sensitive to extremes in environment temp
- Thermoregulation not as efficient
13
Q
Normal Oral Body Temp
A
96.8 degrees F- 98.6 degrees F
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
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)
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
Acetaminophen
-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
Ibuprofen
- 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
Naproxen
- NSAID
| - over 12 years of age
28
Aspirin (ASA)
- inhibits prostaglandin
| - never to a child-linked to Reye Syndrome
29
Oral Temp (Advantages/Disadvantages)
- 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
Rectum Temp (Advantages/Disadvantages)
- 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
Axillary Temp (Advantages/Disadvantages)
- Advantages: safe and noninvasive
| - Disadvantages: thermometer must be left in place a long time to obtain an accurate measurement
32
Tympanic Membrane Temp (Advantages/Disadvantages)
- 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
Temporal Artery Temp (Advantages/Disadvantages)
- 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
