Colds 7.3 Flashcards
Where can you take normal temperature and what are the temperatures (Celsius)
A) Rectum: 37.5
B) Mouth: 37
C) Armpit: 36.5
D) Ear: 37.5
Is a fever as the sole symptom worry some
- No unless very high or in an infant
What are causes of fever
- Virus
- Bacterial infection
- Heat exhaustion
- Some conditions
- Malignant tumor
Some meds/ immunizations
Symptoms of fever
- Sweating
- Chills and shivers
- Headache
- Muscle aches
- Loss of appetite
- Weakness
- Dehydration
What is the recommended method of measurement for <2y, 2-5, >5
a) <2: 1st choice: rectum (for accuracy), 2nd choice: armpit
b) 2-5: 1st: rectum, 2ndL ear, armpit
c) >5: 1st: mouth, 2nd: ear, armpit
Pros and cons of digital ear thermometers
a) Pros: quick and comfortable when used proper, good for use in >6months
b) Cons: arent good for newborns, earwax or small ears can interfere with accuracy
Temporal artery thermometers pros/ cons
a) Pros: read quickly and easily tolerated, good for >3 months and maybe newborns, most accurate alternative to rectal
b) Cons: may be more expensive
How to use a rectum thermometer in child
- Most reliable way to ensure fever is not missed, Show a video is better then words
- Clean-> cover the silver tip with petroleum-> place baby on back with knees bent-> gently insert thermometer in rectum about 1 inch in-> remove, read temp and clean
How to use oral thermometer in child
- Not recommended in <5y
- Clean-> put the tip under childs tongue -> close mouth and keep in mouth for about 1 minute until hear beep-> remove, read temp and clean thermometer
When to treat a fever in <3 mo, 3mo-2y, >2y
a) <3mo: any fever refer to MD
b) 3mo - 2 y: less then 39C no need to treat,
- Greater then 39C treat and seek md if longer then a day
c) >2y: less then 39C no need to treat
Greater then 39C treat and seek MD if longer then 3days
What is considered a high fever
> 39.5 C
Treatment of fever
a) Non pharmaceutical
- If cold warm the child to increase comfort
- Wait to give any cooling measures until fever is not rising anymore
- Don’t use cold on febrile child
- Keep comfortable
b) Pharmaceutic
- Acetaminophen or ibuprofen
- Do not give ASA (aspirin)
Should you give children and teenagers ASA
no don’t give under 18
Children dosing of acetaminophen
- 10-15mg/kg every 4-6H
- Max 75 mg/kg/day
What is more important either in dosing weight or age
Weight
What does ibuprofen do
- Is an NSAID and reduces pain and fever
- Relief can be expected in 30 minutes
Ibuprofen children dosing
a) Children over 6 mo: 5-10mg/kg every 6-8 hour(say 8 hours)
- Max 40 mg/kg day
b) Children under 6 months: 5mg/kg/ every 8 hours
- Don’t often make recommendations under 6 months but age limit goes down to 4 months
Is ibuprofen better then acetaminophen for the stomach
- At otc levels they are very similar
Adverse side effects of ibup and acet
Nausea, abdominal pain, dyspepsia, heartburn
What is ASA
- Asprin
- Don’t give under 18 years as link to reyes syndrom
Is naproxen used for fever in canada
- No its not
Do you need to treat a fever
- If a parent is coming in to the pharmacy, let them know they don’t need to but help them if they want
What is fever phobia
There is many unrealistic and exaggerated misconceptions with children who have a fever such as seizure, brain damage or even death
Can you use both ibprofen and acetaminophen at the same time
- Yes you can acet works centrally and ibu works peripherally
- Can lead to dosing errors tho
a) Alternative
- Can add an acet dose on each ibup dose
- Acet can be taken every 4-6 hours - Can lead to dosing errors tho
Can you use antipyretics for pain of vaccinations
- Fevers from vaccines begin within 24 hours and can last 1-2 days
- Some people believe that there is a reduction in antibody response if you use an antipyretic after vaccination, some don’t and some maybe
- Sask health says to wait 6-8 hours after immunization if child is uncomfortable, refusing fluids or not sleeping
What are febrile seizures
- Convulsions that can happen when a child has a fever above 38C
- Febrile means feverish
- They are scare but generally harmless
What to do if your child has a febrile seizure
- Stay calm
- Place child on floor or ground
- Remove any nearby objects
- Place your child on there side to prevent choking
- Loosen any clothing around the head and neck
- Watch for signs of breathing problems
After a febrile seizure can you give an antipyretic
- Yes give the normal dose of acet or ibu
Do antipyretics prevent febrile convulsions
- No evidence
