CC pt 3 Fever

Question 1

what are normal body temperatures

Answer 1

Rectum : 37.5
Mouth: 37
Armpit: 36.5
Ear: 37.5

Question 2

What is cause of fever

Answer 2

Virus, bacterial infection, heat exhaustion, inflammatory conditions, malignant tumor, medications/immunizations

Question 3

Other symptoms with fever

Answer 3

Sweating, chills, headache, muscle ache, dehydration, weakness

Question 4

What is recomended temperature methods for age

Answer 4

birth to 2: rectum than armpit
2-5: rectum than ear or armpit
5+: mouth than ear or armpit

armpit is least accurate, rectum is most

Question 5

pros and cons of ear thermometers

Answer 5

quick and comfortable (older than 6 months) but are hard to get accurate measure and arent for newborns

Question 6

how far does rectum need to be inserted for temp

Answer 6

about 1 inch. best to show parent video over describing

Question 7

How to move ear for good reading

Answer 7

Change angle for more accurate reading
Little kid below you: pull down
Older kids bit higher: pull ear up

Question 8

What to do with fever for different ages

Answer 8

Less than 3 months: any fever = referall
3-6 months: temp of 39 and uncomfortable and irrital get referral
3mo-2yr: less than 39 is fine, over treat and see MD if over 1 day or 2 day for 2yr old
over 2: less than 39 fine, over treat and see MD if longer than 3 days

Question 9

Physical measures to manage fever in kid

Answer 9

1. warm if shivering regardless of temp
2. wait for cooling until fever is done rising
3. child bothered by heat use gentle cooling
4. no cold on febrile child
5. goal is to keep comfortable and relaxed

Question 10

child dosing for acetaminophen

Answer 10

10-15 mg/kg ever 4-6 hours. max is 75 mg/kg/day
(5 doses a day — 15 x 5 = 75mg/kg)

**weight trumps age for dosing

Question 11

Although tylenol fever and sore throat is in CC section, what does it lack for CC

Answer 11

Lacks any help for cough of child, fever is not common part of a cold

Question 12

How is ibuprofen used

Answer 12

For 8 hours of relief, reduces pain and fever. Onset is half an hour

Question 13

What is the dosing for ibuprofen

Answer 13

Over 6 months: 5-10 mg/kg every 6-8hr. Max 40 mg/kg/day
Children less than 6 months: 5 mg/kg every 8 hours.
-rare recommendation. package has age limit down to 4 months

Question 14

difference in children and pediatric advil

Answer 14

Child: 100mg/5ml
Ped: 40mg/ml

Question 15

Is acetaminophen or ibuprofen harder on the stomach

Answer 15

At OTC doses ibuprofen does not have more side effects, but is bit harder on stomach. Nuisance side effects of nausea, abdominal pain, dyspepsia

Question 16

ASA

Answer 16

No longer option, only for cardiovascular over 18
Problem with child overdoses, causing of Reye’s syndrome

Question 17

Can you use naproxen for fever in canada

Answer 17

No

Question 18

Issues in fever management

Answer 18

1. need to treat if child is distressed
2. fever phobia leading to want to always treat
3. alternating ibu and acet (tricky sinc)
   -ace central help, ibu peripherally
   -4 hour interval between each pill
   -may not wake up your kid for later doses
4. Simultaneuous acet and ibu
   -acet every 4 hours with ibu every 8. is okay if don’t pass acet max
5. Antipyretics for vaccine pain
   -concern of lower immune response
   6.Febrile Seizures
   -caused by viral infection, last few minutes, scary but harmless to child
6. Fever in elderly
   -fever drops down, 38 is a concern. but cannot be used as main symptom

Question 19

Max acet dose for adult

Answer 19

4 g

Question 20

What is the concern with alternating acet and ibu

Answer 20

Dosing errors instead of drug s/e

Question 21

How long does fever last after vaccine. When is recomended to treat after

Answer 21

within 24 hours to 1-2 days
Treat fever 6-8 hours after immunization

Question 22

Treatment for after febrile seizure

Answer 22

Cold down kid with cloth, provide normal dose of acet or ibu. Not drug induced so no worry. Doesnt reduce occurance just help fever proportions