9) Implementation Acute Care Fever

Question 1

What is the objective of fever treatment?

Answer 1

• Increase heat loss
• Reduce heat production
• Prevent complications

Question 2

What factors determine fever treatment procedures?

Answer 2

• Cause of fever
• Any adverse effects
• Strength, intensity, and duration of fever

Question 3

What is the nurse’s role in fever treatment?

Answer 3

• Assess patient
• Implement temperature-reducing strategies

Question 4

How may the cause of fever be determined?

Answer 4

• Isolate causative pyrogen
• Obtain cultures (urine, blood, sputum, wound)
• Prescribe antibiotics to destroy bacteria

Question 5

What are considerations for fever in children?

Answer 5

• Most caused by viruses, brief duration
• Immature temperature control mechanisms
• Risk of dehydration and febrile seizures

Question 6

What indicates a fever may be drug-related?

Answer 6

• Accompanied by allergic symptoms like rash, pruritus
• Treatment is withdrawing the medication

Question 7

What medications reduce fever by increasing heat loss?

Answer 7

• Nonsteroidal antipyretics like acetaminophen, salicylates, indomethacin, ketorolac

Question 8

How do corticosteroids affect fever?

Answer 8

• Reduce heat production by interfering with immune system
• Can mask signs of infection
• Not used to treat fever directly

Question 9

What is important to know about corticosteroids?

Answer 9

• They suppress the body’s ability to develop fever in response to pyrogens

Question 10

What nonpharmacological methods increase heat loss for fever?

Answer 10

• Evaporation (sponge baths, alcohol water baths)
• Conduction (water-circulating cooling blankets)
• Convection (cooling fans)
• Radiation

Question 11

What precautions are needed with cooling blankets?

Answer 11

• Follow manufacturer instructions
• Risk of skin breakdown and freeze burns
• Use bath blanket between patient and cooling blanket
• Wrap extremities to prevent injury

Question 12

Why should traditional cooling methods be used cautiously?

Answer 12

• Can lead to shivering which increases energy expenditure
• Have no advantage over antipyretic medications

Question 13

What nursing measure helps reduce shivering?

Answer 13

• Wrapping the patient’s extremities

Question 14

What should be obtained during each fever phase?

Answer 14

• Core temperature

Question 15

What factors should be assessed for fever?

Answer 15

• 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)

Question 16

Why are blood cultures obtained?

Answer 16

• To coincide with temperature spikes when antigen-producing organism is most pervasive

Question 17

How can heat production be minimized?

Answer 17

• Reduce activities increasing oxygen demand
• Allow rest periods
• Limit physical activity

Question 18

How can heat loss be maximized?

Answer 18

• Reduce external covering to promote radiation and conduction heat loss
• Keep clothing and linens dry for conduction and convection

Question 19

How are increased metabolic needs met?

Answer 19

• Provide oxygen as ordered
• Stimulate appetite
• Offer balanced meals
• Provide fluids to replace losses

Question 20

How is patient comfort promoted?

Answer 20

• Encourage oral hygiene
• Control environment temperature without inducing shivering

Question 21

How are fever phases identified?

Answer 21

• Examine previous temperature trends

Question 22

What is the first priority in treating heatstroke?

Answer 22

• Move patient to a cooler environment

Question 23

What interventions help cool the body in heatstroke?

Answer 23

• Reduce clothing covering body
• Place cool, wet towels over skin
• Use oscillating fans for convective heat loss

Question 24

What emergency medical treatments may be used for heatstroke?

Answer 24

• Intravenous fluids
• Irrigation of stomach and bowel with cool solutions
• Cooling blankets

Question 25

What is the priority in treating hypothermia?

Answer 25

• Prevent further decrease in body temperature

Question 26

What are key interventions for hypothermia?

Answer 26

• Remove wet clothes, replace with dry clothes
• Wrap patient in blankets

Question 27

How can hypothermic patients be rewarmed in healthcare settings?

Answer 27

• Use forced-air warming blankets

Question 28

What should be done for hypothermia away from healthcare settings?

Answer 28

• 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

Question 29

What education is important after a febrile episode?

Answer 29

• Importance of taking and completing antibiotics as directed

Question 30

Who is at risk for fluid volume deficit with fever?

Answer 30

• Children and older adults
• Encourage intake of preferred fluids

Question 31

How are nursing interventions evaluated?

Answer 31

• Compare patient’s actual response to expected care plan outcomes
• Determine if goals were met or plan needs revision

Question 32

What should be done after any temperature intervention?

Answer 32

• Measure patient’s temperature to evaluate change

Question 33

What other evaluative measures can be used?

Answer 33

• Palpate skin
• Assess pulse and respirations

Question 34

How is intervention effectiveness determined?

Answer 34

• Temperature returns to acceptable range
• Vital signs stabilize
• Patient reports feeling comfortable