9) Implementation Acute Care Fever Flashcards
What is the objective of fever treatment?
- Increase heat loss
- Reduce heat production
- Prevent complications
What factors determine fever treatment procedures?
- Cause of fever
- Any adverse effects
- Strength, intensity, and duration of fever
What is the nurse’s role in fever treatment?
- Assess patient
- Implement temperature-reducing strategies
How may the cause of fever be determined?
- Isolate causative pyrogen
- Obtain cultures (urine, blood, sputum, wound)
- Prescribe antibiotics to destroy bacteria
What are considerations for fever in children?
- Most caused by viruses, brief duration
- Immature temperature control mechanisms
- Risk of dehydration and febrile seizures
What indicates a fever may be drug-related?
- Accompanied by allergic symptoms like rash, pruritus
- Treatment is withdrawing the medication
What medications reduce fever by increasing heat loss?
- Nonsteroidal antipyretics like acetaminophen, salicylates, indomethacin, ketorolac
How do corticosteroids affect fever?
- Reduce heat production by interfering with immune system
- Can mask signs of infection
- Not used to treat fever directly
What is important to know about corticosteroids?
- They suppress the body’s ability to develop fever in response to pyrogens
What nonpharmacological methods increase heat loss for fever?
- Evaporation (sponge baths, alcohol water baths)
- Conduction (water-circulating cooling blankets)
- Convection (cooling fans)
- Radiation
What precautions are needed with cooling blankets?
- Follow manufacturer instructions
- Risk of skin breakdown and freeze burns
- Use bath blanket between patient and cooling blanket
- Wrap extremities to prevent injury
Why should traditional cooling methods be used cautiously?
- Can lead to shivering which increases energy expenditure
- Have no advantage over antipyretic medications
What nursing measure helps reduce shivering?
- Wrapping the patient’s extremities
What should be obtained during each fever phase?
- Core temperature
What factors should be assessed for fever?
- Contributing factors like dehydration, infection, environment
- Physiological response to temperature
- Vital signs
- Skin color and temperature
- Shivering and diaphoresis
- Patient comfort and well-being
- Fever phase (chill, plateau, fever break)
Why are blood cultures obtained?
- To coincide with temperature spikes when antigen-producing organism is most pervasive
How can heat production be minimized?
- Reduce activities increasing oxygen demand
- Allow rest periods
- Limit physical activity
How can heat loss be maximized?
- Reduce external covering to promote radiation and conduction heat loss
- Keep clothing and linens dry for conduction and convection
How are increased metabolic needs met?
- Provide oxygen as ordered
- Stimulate appetite
- Offer balanced meals
- Provide fluids to replace losses
How is patient comfort promoted?
- Encourage oral hygiene
- Control environment temperature without inducing shivering
How are fever phases identified?
- Examine previous temperature trends
What is the first priority in treating heatstroke?
- Move patient to a cooler environment
What interventions help cool the body in heatstroke?
- Reduce clothing covering body
- Place cool, wet towels over skin
- Use oscillating fans for convective heat loss
What emergency medical treatments may be used for heatstroke?
- Intravenous fluids
- Irrigation of stomach and bowel with cool solutions
- Cooling blankets
What is the priority in treating hypothermia?
- Prevent further decrease in body temperature
What are key interventions for hypothermia?
- Remove wet clothes, replace with dry clothes
- Wrap patient in blankets
How can hypothermic patients be rewarmed in healthcare settings?
- Use forced-air warming blankets
What should be done for hypothermia away from healthcare settings?
- Lay patient under blankets next to warm person
- Give conscious patient hot liquids like soup
- Avoid alcohol and caffeine
- Cover head, place near fire/warm room, use heating pads
What education is important after a febrile episode?
- Importance of taking and completing antibiotics as directed
Who is at risk for fluid volume deficit with fever?
- Children and older adults
- Encourage intake of preferred fluids
How are nursing interventions evaluated?
- Compare patient’s actual response to expected care plan outcomes
- Determine if goals were met or plan needs revision
What should be done after any temperature intervention?
- Measure patient’s temperature to evaluate change
What other evaluative measures can be used?
- Palpate skin
- Assess pulse and respirations
How is intervention effectiveness determined?
- Temperature returns to acceptable range
- Vital signs stabilize
- Patient reports feeling comfortable
