Fever

Question 1

Fever

Answer 1

An elevation in the set point of the body’s temperature.

Question 2

What is temperature homeostasis controlled by?

Answer 2

anterior portion of the hypothalamus, which acts as a thermostat that sets the body’s target temperature

Question 3

Definition Ineffective Thermoregulation

Answer 3

Temperature fluctuation between hypothermia and hyperthermia

Question 4

Defining Characteristics Ineffective Thermoregulation

Answer 4

cool skin, cyanotic nail beds, fluctuations of body temp above or below normal, flushed skin, seizures, piloerection, shivering, increased RR and HR

Question 5

Why would antibiotics be prescribed for fever?

Answer 5

Used for the bacterial cause of a fever.

Question 6

Peak Level

Answer 6

measures highest concentration of medication in the plasma, drawn 30-60 minutes after dose administered, done after several doses

Question 7

Trough Level

Answer 7

Measures the lowest concentration of the medication in plasma, drawn immediately prior to next dose

Question 8

Antipyretics

Answer 8

Inhibit synthesis of prostaglandins, lowers the set point, and reduces discomfort

Question 9

Peak & Trough levels

Answer 9

provides information to the healthcare team about the effectiveness and toxicity of a drug in the plasma. it monitors for therapeutic and toxic levels

Question 10

TNIs Fever

Answer 10

monitor VS, assess skin color and skin T, monitor WBC, HCT, and other pertinent values for indications of infection, dehydration, remove excess blankets when client warm and provide extra warmth when client chilled, provide adequate nutrition and fluids to meet increase metabolic needs and prevent dehydration, measure I & O, administer order antipyretics, provide tepid sponge bath and oral hygiene, reduce physical activity to limit heat production

Question 11

Septicemia

Answer 11

Presence of pathogenic microorganisms in the blood

Question 12

Reye Syndrome

Answer 12

acute encephalopathy of unknown cause in children under the age of 15 after a viral illness. Thought to be associated with the use of aspirin during a viral illness

Question 13

Cooling Blanket

Answer 13

Commercially available cooling device used to reduce body temperature

Question 14

Fever of Unknown Origin (FUO)

Answer 14

Fever exceeding 101F on several occasions with unknown cause

Question 15

TNI cooling blanket

Answer 15

place blanket on bed and cover with sheet or lightweight blanket, frequent temperature monitoring is necessary to avoid excessive cooling of the body, assess patient comfort

Question 16

Nursing Responsibilities for Peak and Trough levels

Answer 16

obtain blood sample, check sample results, notify MD and administer medication on a timely manner

Question 17

Hyperthermia

Answer 17

body temperature exceeding the set point, which usually results from the body or external conditions creating more heat than the body can eliminate, such as in heat stroke, aspirin toxicity, seizures, or hyperthryroidism

Question 18

What therapeutic effects does fever have?

Answer 18

increased white blood cell activity, interferon production and effectiveness, and antibody production and enhancement of some antibiotic effects

Question 19

Over Three Temperature reading

Answer 19

pinna up and back

Question 20

Under Three Temperature reading

Answer 20

pinna down and back

Question 21

Cel. and Fahr. Converting Formula

Answer 21

C=(Fahrenheit Temp-32)X5/9

Question 22

Heat Exhaustion

Answer 22

not a true fever. excessive heat and dehydration (paleness, dizziness, N, V, fainting, increased T)

Question 23

Heat Stroke

Answer 23

Not a true fever. Exercising in hot weather (warm, flushed skin, and do not sweat, unconscious, seizures, T =106+)

Question 24

Hypothermia

Answer 24

Core body T lower than the lower limit of normal. R/T - impaired hypothalamic thermoregulation, inadequate heat production, excessive heat loss

Question 25

Core Temperature

Answer 25

T of deep tissues of the body, remains constant

Question 26

Surface Temperature

Answer 26

T of the skin, SC tissue, and fat. Rises and falls in response to the environment

Question 27

What effects heat production?

Answer 27

basal metabolic rate (decreases with age), muscle activity (shivering, increase rate), epinephrine/norepinephrine/sympathetic stimulation/stress response (immediate increase in rate), fever (increase cellular metabolic rate)

Question 28

Heat Loss

Answer 28

radiation, conduction, convection, evaportation

Question 29

Radiation

Answer 29

Transfer of heat from surface to surface. "to radiate"

Question 30

Conduction

Answer 30

One molecule transfers heat to a molecule of a lower T. Molecules must have contact. T difference of molecules determines the amount of heat loss.

Question 31

Convection

Answer 31

Dispersion of heat through air currents

Question 32

Evaportion

Answer 32

Vaporization of moisture from R tract and mucosa of the mouth and from skin (insensible water loss/heat loss)

Question 33

Temperature Control

Answer 33

Sensors in the periphery and in the core, Integrator in the hypothalamus, Effector system that adjusts the production and loss of heat.

Question 34

Hyperpyrexia

Answer 34

Very high fever

Question 35

Other words for fever

Answer 35

pyrexia, hyperthermia, febrile

Question 36

Intermittent Fever

Answer 36

T b/w periods of fever and periods of normal or subnormal

Question 37

Remittent Fever

Answer 37

wide range of T fluctuations occurs over a 24hr period, all higher than normal

Question 38

Relapsing Fever

Answer 38

short febrile periods of a few days with periods of 1-2 days normal T

Question 39

Constant Fever

Answer 39

Fluctuates minimally, above normal

Question 40

Fever Spike

Answer 40

T that rises rapidly and then returns to normal within a few days

Question 41

Phases of Fever

Answer 41

Prodromal, Chill, Flush, Defervescence

Question 42

Prodromal Phase

Answer 42

non-specific complaints, "don't feel good," headache and muscle ache, fatigue

Question 43

Chill Phase

Answer 43

Increase HR and RR, vasoconstriction, c/o chills, cool skin, piloerection

Question 44

Flush Phase

Answer 44

vasodilation, warm, flushed skin, c/o feeling warm, diaphoresis, increase thirst, concentrated urine, postural hypotension

Question 45

Piloerection

Answer 45

goose bumps

Question 46

Defervescence Phase

Answer 46

diaphoresis, fever resolves

Question 47

Fever and Comfort Needs

Answer 47

administer antipyretics as prescribed, provide extra warmth or remove blankets depending on fever phase, ensure gown and bed linens are dry

Question 48

Fever General TNIs

Answer 48

monitor T and VS, monitor mental status, promote comfort, monitor nutrition status, accurately measure I & O/ fluid status, monitor ordered labs (WBC)

Question 49

Fever Oxygenation TNIs

Answer 49

monitor O2 sat, administer supplemental O2 prn, prevent shivering, provide rest

Question 50

Fever Fluid TNIs

Answer 50

monitor I & O carefully, force fluids as ordered (po and IV), provide frequent oral care, estimate insensible loss

Question 51

Fever Nutrition TNIs

Answer 51

offer foods that are easily digested, increase carbohydrates and protein, increase calories as ordered

Question 52

Fever Safety and Security TNIs

Answer 52

side rails up, assistance when OOB, call bell within reach, seizure precautions as appropriate

Question 53

Antibiotics

Answer 53

Used for the bacterial cause of a fever

Question 54

TNIs Antibiotics

Answer 54

may obtain C & S prior to treatment, assess for allergies, cross sensitivities with with PCN, effectiveness, assess IV site freq, side effects = GI, CNS, rash, anemia, assess for allergic reaction

Question 55

Cefazolin (ancef, kefzol)

Answer 55

1st generation cephalosporin - bactericidal

Question 56

Cefazolin Use

Answer 56

surgical prophylaxis, R infections, UTI, Bone/joint and skin infections

Question 57

Gentamicin (Garamycin)

Answer 57

Aminoglycoside. Bactericidal, effective against aerobic gram-negative infections

Question 58

Gentamicin

Answer 58

systemic infections, bowel prep prior to surgery (sterilize), effective against aerobic gram-negative infections, assess for allergic reaction, IV preferred route, monitor peak and trough levels

Question 59

TNIs Antipyretics

Answer 59

cautious use with other medications, do not use aspirin with children, acetaminophen, NSAIDS commonly used

Question 60

What are most fevers caused by in children?

Answer 60

virus

Question 61

What is the preferred antipyretic drug for children?

Answer 61

acetaminophen

Question 62

What NSAID is approved for fever reduction in children as young as 6 months of age?

Answer 62

ibuprofen

Question 63

What cooling methods can RNs teach parents to use safely with febrile children?

Answer 63

wear minimal clothing, expose skin to air, reduce room temperature, increase air circulation, apply moist compress to forehead