CC pt 3 Fever Flashcards
what are normal body temperatures
Rectum : 37.5
Mouth: 37
Armpit: 36.5
Ear: 37.5
What is cause of fever
Virus, bacterial infection, heat exhaustion, inflammatory conditions, malignant tumor, medications/immunizations
Other symptoms with fever
Sweating, chills, headache, muscle ache, dehydration, weakness
What is recomended temperature methods for age
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
pros and cons of ear thermometers
quick and comfortable (older than 6 months) but are hard to get accurate measure and arent for newborns
how far does rectum need to be inserted for temp
about 1 inch. best to show parent video over describing
How to move ear for good reading
Change angle for more accurate reading
Little kid below you: pull down
Older kids bit higher: pull ear up
What to do with fever for different ages
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
Physical measures to manage fever in kid
- warm if shivering regardless of temp
- wait for cooling until fever is done rising
- child bothered by heat use gentle cooling
- no cold on febrile child
- goal is to keep comfortable and relaxed
child dosing for acetaminophen
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
Although tylenol fever and sore throat is in CC section, what does it lack for CC
Lacks any help for cough of child, fever is not common part of a cold
How is ibuprofen used
For 8 hours of relief, reduces pain and fever. Onset is half an hour
What is the dosing for ibuprofen
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
difference in children and pediatric advil
Child: 100mg/5ml
Ped: 40mg/ml
Is acetaminophen or ibuprofen harder on the stomach
At OTC doses ibuprofen does not have more side effects, but is bit harder on stomach. Nuisance side effects of nausea, abdominal pain, dyspepsia
ASA
No longer option, only for cardiovascular over 18
Problem with child overdoses, causing of Reye’s syndrome
Can you use naproxen for fever in canada
No
Issues in fever management
- need to treat if child is distressed
- fever phobia leading to want to always treat
- 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 - Simultaneuous acet and ibu
-acet every 4 hours with ibu every 8. is okay if don’t pass acet max - Antipyretics for vaccine pain
-concern of lower immune response
6.Febrile Seizures
-caused by viral infection, last few minutes, scary but harmless to child - Fever in elderly
-fever drops down, 38 is a concern. but cannot be used as main symptom
Max acet dose for adult
4 g
What is the concern with alternating acet and ibu
Dosing errors instead of drug s/e
How long does fever last after vaccine. When is recomended to treat after
within 24 hours to 1-2 days
Treat fever 6-8 hours after immunization
Treatment for after febrile seizure
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
