fever

Question 1

rectal temp

Answer 1

97.9-100.4 F
>100.4F

100% talking shit into your ear in front of you (>100 F for rectal, tympanic, temporal)

Question 2

oral temp

Answer 2

95.9-99.5 F

>99.5 F

Question 3

axillary temp

Answer 3

94.5-99.3 F

>99.3 F

Question 4

tympanic temp

Answer 4

96.3-100 F
>100 F

100% talking shit into your ear in front of you (>100 F for rectal, tympanic, temporal)

Question 5

temporal

Answer 5

97.9-100.1 F
>100.1 F

100% talking shit into your ear in front of you (>100 F for rectal, tympanic, temporal)

Question 6

most accurate

Answer 6

rectal

Question 7

0-2 months old temp:

Answer 7

> 100.7 F

Question 8

3-47 months (<4 yo) old temp:

Answer 8

> 100.3 F

Question 9

when does body incr body temp due to diurnal rhythm?

Answer 9

late afternoon and early evening

Question 10

fever causes

Answer 10

Infection, drugs, vigorous activity, malignancy, tissue damage such as MI or surgery, antigen-antibody reaction, dehydration, heat stroke, CNS inflammation, hyperthyroidism, gout

Question 11

Negative effects of fever

Answer 11

Discomfort, increased metabolic rate and chills

Harmful effects with hyperpyrexia (> 106 F)

Question 12

Beneficial effects

Answer 12

• Some microbes are thermo-labile (sensitive to temp, fever helps kill them)
• Improved antigen recognition, T-lymphocyte function and leukocyte motility (improved immune response)

Question 13

Fever complications

Answer 13

• Dehydration
• Change in mental status (delirium, coma, irreversible neurological damage
• Muscle damage
• Seizure

Question 14

febrile seizure risk factors

Answer 14

daycare, developmental delay, family history, > 30 day neonatal hospital stay

Question 15

antipyretics usage for febrile seizure?

Answer 15

recommended, but does not decrease risk of recurrence

Question 16

drug induced fever

Answer 16

-Established by temporal relationship
-D/C suspected medication when possible
-Will decrease 24-72 hours after D/C
-D/C all medications if safe
If safe, rechallenge with 1 medication at a time

Question 17

fever non-drug treatment

Answer 17

-Replenish losses if not contraindicated
-Sports drinks, fruit juice, water, balanced electrolyte replacement products, ice pops–caution sugar with diabetes or diarrhea
-Wearing lightweight clothing
Removing blankets
-Room temp 68 F

Question 18

body sponging recommended temp?

Answer 18

not recommended for < 104 F

Question 19

don’t use __ for body sponging

Answer 19

isopropyl or ethyl alcohol -> alcohol poisoning

Question 20

fever drug treatment, children warning

Answer 20

• 30% of parents unable to measure accurate APAP dose
• 51% of children received inaccurate dose
• Appropriate measuring device
• Demonstrate proper measurement

Question 21

effectiveness btwn NSAIDs

Answer 21

• APAP and ibuprofen similar efficacy, ibuprofen slightly more effective for fever
• Naproxen less data

Question 22

using antipyretics after vaccines?

Answer 22

• Antipyretic immediately after vaccines reduced fever, but also reduced antibody response, although still protective
• not recommended

Question 23

length of fever for

contraindications to self-treatment, children

Answer 23

-Patients > 2 years with fever
> 3 days
-Child < 2 years with fever > 24 hours

Question 24

temp for contraindications to self-treatment, children

Answer 24

> 3 months: Rectal temp ≥
104 F or equivalent
-< 3 months: rectal temp ≥
100.4 F

Question 25

other contraindications to self-treatment, children

Answer 25

• History of seizures or febrile seizures in children
• Children unable to stay hydrated
• Refuses to drink any fluids
• Vomiting and can’t keep fluids down
• Repeated diarrhea
• Child develops a rash or spots
• Child very sleepy, irritable or difficult to wake

Question 26

contraindications to self-treatment, adults and children

Answer 26

• Severe symptoms of infection that are not self-limiting
• Risk for hyperthermia
• CV or pulmonary disease
• Impaired immune function (transplant, HIV, cancer chemotherapy)
• CNS injury (head trauma, stroke)