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OTC > Exam 3 - Fever > Flashcards

Exam 3 - Fever Flashcards

1
Q

What is the leading cause of ED visits for those under 15

A

Fever

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2
Q

Where is body temperature regulated

A

Hypothalamus

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2
Q

Why do we get fevers

A

The body’s defense against infection - a sign your body is fighting

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3
Q

What is hyperpyrexia

A

When body temp is over 106

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3
Q

What is hyperthermia

A

Malfunctioning of normal hypothalamus level from excess heat exposure

NOT the same treatment as fever

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4
Q

What are pyrogens

A

Any substance that increases the body temperature and activates the body’s host defense

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4
Q

What symptoms are associated w/ hyperpyrexia

A

Mental and physical symptoms

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5
Q

What can cause hyperpyrexia

A

Fever or hyperthermia

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6
Q

What is an oral temperature over 100 caused by

A

Pyrogen

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7
Q

What is the range for a normal body temp

A

97.5 - 98.9

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8
Q

What is the principal reason to treat a fever w/ an OTC

A

Alleviate discomfort

DO NOT use to treat a specific temp

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8
Q

What population has the highest response to pyrogens

A

Children

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9
Q

Temperatures under ____ is unlikely to be a concern in young adults

A

103

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10
Q

What is a common sign of fever

A

Chills

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11
Q

What causes chills w/ a fever

A

Vasoconstriction and muscle rigidity

(Vasoconstriction reduces blood flow, making you cold. Muscle rigidity makes you cold because muscles are warmer when they are being moved)

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12
Q

What is a subjective way to detect a fever

A

Feel the forehead or cheek

*not accurate

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13
Q

Thermometers are considered ____

A

Medical devices

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13
Q

When should you NOT use an oral thermometer to check a patient’s temp

A

Recent oral surgery
Mouth breathing
Hyperventilation
Not fully alert
Uncooperative/confused
Children under 3

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13
Q

What is the gold standard for taking temp

A

Rectal

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14
Q

What is considered a normal temperature when measured rectally

A

97.9 - 100.4

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14
Q

When monitoring temperature, it is important to use…

A

The same thermometer and the same spot of measurement

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15
Q

What is considered a normal temperature when measured orally

A

95.9 - 99.5

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16
Q

What is considered a fever when measured rectally

A

> 100.4

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16
Q

What is considered a fever when measured orally

A

> 99.5

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17
Q

What is considered a normal temperature when measured via axillary route

A

94.5 - 99

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18
Q

What is considered a fever when measured via axillary route

A

> 99

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19
Q

What is considered a normal temperature when measured via tympanic route

A

96.3 - 100.4

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20
Q

What is considered a fever when measured via tympanic route

A

> 100.4

21
Q

What is considered a fever when measured via temporal route (age groups)

A

0-2 months: > 100.7

3-47 months: 100.3

Older than 4 years: > 100.1

(47 months = almost 4 years)

22
Q

What is considered a normal temperature when measured via temporal route

A

97.9 - 100.1

23
Q

List all normal temperature and fever ranges for all routes of temperature measurement

A

Rectal:
- normal = 97.9 - 100.4
- fever = > 100.4

Oral:
- normal = 95.9 - 99.5
- fever = > 99.5

Axillary:
- normal = 94.5 - 99
- fever = > 99

Tympanic:
- normal = 96.3 - 100.3
- fever = > 100.4

Temporal:
- normal = 97.9 - 100.1
- fevers:
— 0-2 months = > 100.7
— 3-47 months = > 100.3
— above 4 years = > 100.1

24
Q

Where is an electronic probe used

A

Oral
Rectal
Axillary

25
Q

How long does it take to get a reading from an electronic probe

A

10 - 60 seconds

26
Q

When can you start using tympanic thermometers

A

At 6 months of age

26
Q

Why should we avoid axillary temperature readings if possible

A

They are not reliable and have large variations

27
Q

At what rectal temperature should you take an infant younger than 4 months old to the ER

A

> 100.4

28
Q

What causes febrile seizures

A

No defined cause

28
Q

At what axillary temperature should you take an infant younger than 4 months old to the ER

A

> 99

28
Q

At what oral temperature should you take an infant younger than 4 months old to the ER

A

> 99.5

29
Q

What % of children from ages 6 months to 5 years old have a febrile seizure

A

2-5%

30
Q

When do the chances for having a febrile seizure peak

A

18-24 months

31
Q

What increases the risk of febrile seizures

A

How fast the fever comes and how high the fever is

32
Q

What raises the risk of reoccurrence of a febrile seizure

A

If younger than 1 year when first seizure occurs and a family history of epilepsy

33
Q

After one seizure, what happens to the risk of developing epilepsy, impaired movement, and other neurologic disorders

A

Unlikely that risk will change

34
Q

What does the American Academy of Pediatrics NOT recommend use for prophylactic treatment of febrile seizures

A

Anti-epileptics
Antipyretics

35
Q

What is recommended for comfort when there is a risk of febrile seizures

A

Antipyretics

35
Q

When can febrile seizures return

A

If the child has another fever

36
Q

What OTC can prevent febrile seizures

A

NONE

Antipyretics can reduct fever, but will not prevent seizure

37
Q

When should we suspect a pt may have a drug fever

A

In patients that don’t have an obvious source of fever

37
Q

What is drug fever

A

Febrile response to admin of medication

38
Q

If hyperthermia is due to a drug, when should the fever decrease

A

24-72 hrs within stopping agent

38
Q

How can we detect that a fever is caused by a drug

A

Note the relationship between the fever and admin of medication

Note the temp elevation despite clinical improvement

39
Q

What two OTC drugs can cause fever

A

Cimetidine
Salicylates

40
Q

Should we reduce fever before vaccines

A

Currently not recommended to use antipyretics before or after vaccination

However, symptomatic fevers after vaccination should be treated

41
Q

What are serious complications of fever

A
  • Seizures
  • Coma
  • Irreversible neurologic/muscle damage
  • Dehydration
  • Delirium

(SCIDD)

42
Q

Who is most at risk for serious complications from fever

A

Infants
Elderly

42
Q

What causes infants and elderly to be most at risk for serious complications from a fever

A
  • Dehydration
  • Decreased sweating capacity
  • Fever increases oxygen demand, elderly tend to have COPD or CHF
43
Q

General treatment rules for fevers over 101

A

Use both non-drug and oral antipyretics

44
Q

General treatment rules for fevers under 101

A

Treat if pt is uncomfortable/elderly

45
Q

Goals for treating fever

A
  • find and remove cause
  • decrease discomfort caused by the fever
  • use treatment when benefits outweigh risk
46
Q

What are the exclusions to self treatment of fever in adults

A

Vomiting
Hyperthermia risk/fever for > 3 days
Stiff neck
Diarrhea
Severe headache
CNS damage
Rash
Immunocompromised
Sore throat
Pt on steroids
Impaired oxygen (COPD, CHF)
Ear pain
Rectal fever over 104

(Very Hot Snacks Do Seem CRISPIER)

47
Q

What are the exclusions to self care treatment of fever in children

A

Very sleepy
Hard to wake up
Fever over 104
Irritable
Looks very ill, drowsy, fussy
Overheated/had seizure previously
Less than 6 mo w/ rectal temp >104
Vomiting/diarrhea
Fever > 24 hrs in child under 2
Spots/rash
Fever > 3 days in child 2+ yrs
Refuses to drink

(Very High Fevers In Little Ones Look Very Fucking Scary, For Real)

48
Q

What rectal temperature excludes children under 6 months from self care

A

> 100.4

49
Q

What are some non-pharm options for fever treatment

A

Lightweight clothing
Decrease room temp
Fluid intake increase

50
Q

When can sponging be considered for a fever

A

When oral temp is > 104 and 1 hr after a dose of oral med

51
Q

Why should you not bathe someone w/ a fever in water or alcohol

A

Can increase body temp because of shivering

Uncomfortable and can be dangerous

Does not reduce the body’s temp set point

52
Q

How much should fluid be increased for adults w/ fever

A

60-120 mL per hour

53
Q

How much should fluids be increased in children w/ fever

A

30-60 mL/hr

54
Q

What are some good fluid choices for someone w/ fever

A

Sports drinks
Fruit juice
Balanced electrolyte
Water

OTC (21 decks)

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