Week 2 - Fever Flashcards
1
Q
Define fever?
A
100.4F (38C)
2
Q
What is normal body temperature?
A
98.6F
3
Q
What are the complications of fever?
A
- Febrile seizure
- Dehydration
- Change in mental status
- Coma
- Increased risk of contractions in infant
4
Q
Below body temp?
A
Hypothermia
5
Q
Above body temp?
A
Hyperthermia
6
Q
Normal range for rectal?
A
97.9-100.4
7
Q
Normal range for oral
A
95.5-99.5
8
Q
Normal range for axillary
A
94.5-99.3
9
Q
Normal range for tympanic
A
96.3-100
10
Q
Normal range for temporal
A
97.9-100.1
11
Q
F to C
A
5/9 * (F-32)
12
Q
C to F
A
(9/5 * C) + 32
13
Q
Routes of thermometers
A
- Rectal (infants)
- Oral
- Ear
- Skin (imprecise)
14
Q
What is the accuracy of basal thermometers?
A
0.1F
15
Q
What is the accuracy of mercury thermometers?
A
0.2F
16
Q
What is the accuracy of digital thermometers?
A
0.2F
17
Q
What is the accuracy of infra-red thermometers?
A
0.2F
18
Q
What is the accuracy of non contact thermometers?
A
0.4F
19
Q
What is the accuracy of color change thermometers?
A
2.0F
20
Q
What are oral thermometers?
A
Placed under tongue slightly to one side
Avoid exercise and ingesting hot or cold items for at least 5 minutes
21
Q
What is the most accurate thermometer?
A
Rectal
22
Q
What is the preferred thermometer for babies?
A
Rectal
23
Q
How do you use rectal thermometers?
A
- Inserted one inch and leave in place
- Water soluble lubricant may be used
- Buttocks is separated by thumb and first finger
- Butt is pinched closed holding it in place
24
Q
How do you use axillary thermometers?
A
- Should not be used directly after vigorous activity or bathing
- Tolerable by some children
25
How is ear (infrared) thermometers used?
1. Probe cover is applied and the probe is placed in ear canal
2. Firm pressure is applied to sell ear canal from ambient air
3. Additional reading in other ear is useful
26
How are temporal (infrared) thermometers used?
1. Place on the side of forehead over the temporal artery and move across forehead
2. Push hair from thermometer
3. Provides reading in seconds
4. Automatically shuts off after 30 secs
27
What causes fevers?
1. Idiopathic
2. Infection
3. Immunizations
4. First signs of cancer
5. Blood clots
6. Autoimmune
7. Teething
8. Pharmacological agents
28
What are the goals of fever therapy?
Alleviate discomfort of fever not to achieve a specific temp
29
What are non pharmacologic therapies for fevers?
1. Eat light foods that are easy to digest. body and prevent dehydration.
2. Get plenty of rest.
3. Take a slightly warm, not cool, bath or apply damp washcloths to the forehead and wrists.
4. Dress lightly (even if you have chills).
5. Drink plenty of fluids to help cool body and prevent dehydration
30
What are the pharmacologic treatment for fevers?
1. Acetaminophen
2. Salicylates
3. NSAIDs
31
How is salicylates a fever treatment?
1. Provides analgesic, antipyretic, and anti-inflammatory actions
2. Inhibit prostaglandin synthesis
3. Aspirin and magnesium salicylate
32
What is aspirin?
1. Indicated for prevention of thromboembolic events (MI/stoke)irreversible inhibition of platelet function for the lifetime of the platelet
2. Decreases valproic acid metabolism
33
What is aspirin dosing?
1. Onset: 1-2hr
2. can have platelet effect up to 7 days(should d/c
2-7 days before surgery)
3. Dosing is every 4 to 6 hrs. prn
4. Doses are 325-500mg tabs/suppositories
5. Maximum dose: 4g/day
34
Why should you avoid giving aspirin-ASA to children?
1. Increased risk of Reyes syndrome in children younger than 15
2. Only prescribed for Kawasaki's disease and Juvenile Rheumatoid Arthritis
35
What is acetaminphen APAP?
1. Inhibits prostaglandin production
2. Reduces fever and treat mild pain
3. Slightly reduces immune response to some vaccines
36
What is APAP dosing?
1. Onset: 30min
2. Dosing is every 4 to 6 hrs. prn (every 8hrs for
3. Duration of action approx.. 4hrs (6-8hrs in extended release formulations)
4. Dose: 325-1000mg
5. Max dose: 3g -4g/day
37
What is the major cause of acute liver failure?
APAP toxicity
38
What are the early signs of APAP toxicity?
1. Nausea
2. Vomiting
3. Drowsiness
4. Confusion
5. Abdominal pain
39
What is APAP children dosing?
1. Weight based dosing: 10-15 mg/kg PO Q4-6H prn
OR 10-20 mg/kg PR Q4-6H prn
2. Max dose: 75 mg/kg daily (PO/PR)
OR Do not exceed 5 doses in 24 hours
40
What are NSAIDs
1. Inhibits prostaglandin synthesis arthritis
2. Fever, minor pains without inflammation
3. Inhibits Renal clearance of digoxin
4. Increase phenytoin
5. Non-aspirin NSAID increased heart events in patients with CVD
6. Alcohol consumption increases risk of GI bleeding
41
What is the ibuprofen dosing?
1. Onset: 30 min
2. Duration of action is about 6 to 8 administration hrs.
3. Dosing is every 4 to 6 hrs. PRN
4. Doses are 200-400mg
tablets/capsules and suspensions
5. Maximum dose: 1200mg in 24hrs
42
What is Naproxen dosing?
1. Onset: 30min
2. Duration of action is about 12 hrs.
administration
3. Dosing is every 8 to 12 hrs. PRN (first dose may take 2 tabs)
4. Doses are 220 mg tablets/capsules
and suspensions
5. Maximum dose: 660mg in 24hr
43
Children dosing of ibuprofen?
1. Weight based: 5-10 mg/kg Q6-8H
2. Max dose: 1200 mg/day (up to 4 doses/ 300g per dose)
3. Do not recommend for children less than 6
months
44
Packaging of Infant ibuprofen dosing
IBU 50mg/1.25mL
Indicated for ages 6-23 months
Available in dye-free formula
45
Packaging of children IBU?
IBU 100 mg/ml
Available in dye-free formulation
Indicated for ages 2-11 years
46
Child dosing of Naproxen?
DO NOT recommend to children below 12 years of Children 12 and above is the same as adult dosing
47
Aspirin/NSAID adverse effects of stomach ulcers and GI bleeding?
Patients 60 or older and with GI problems
48
Aspirin/NSAID adverse effects of hypertension?
Increases BP
49
Aspirin/NSAID adverse effects of liver disease?
Patients with hepatic problems
50
Aspirin/NSAID adverse effects of kidney dysfunction?
Patients with renal abnormalities
51
Aspirin/NSAID adverse effects of asthma?
Patients with asthma
