fever Flashcards
rectal temp
97.9-100.4 F
>100.4F
100% talking shit into your ear in front of you (>100 F for rectal, tympanic, temporal)
oral temp
95.9-99.5 F
>99.5 F
axillary temp
94.5-99.3 F
>99.3 F
tympanic temp
96.3-100 F
>100 F
100% talking shit into your ear in front of you (>100 F for rectal, tympanic, temporal)
temporal
97.9-100.1 F
>100.1 F
100% talking shit into your ear in front of you (>100 F for rectal, tympanic, temporal)
most accurate
rectal
0-2 months old temp:
> 100.7 F
3-47 months (<4 yo) old temp:
> 100.3 F
when does body incr body temp due to diurnal rhythm?
late afternoon and early evening
fever causes
Infection, drugs, vigorous activity, malignancy, tissue damage such as MI or surgery, antigen-antibody reaction, dehydration, heat stroke, CNS inflammation, hyperthyroidism, gout
Negative effects of fever
Discomfort, increased metabolic rate and chills
Harmful effects with hyperpyrexia (> 106 F)
Beneficial effects
- Some microbes are thermo-labile (sensitive to temp, fever helps kill them)
- Improved antigen recognition, T-lymphocyte function and leukocyte motility (improved immune response)
Fever complications
- Dehydration
- Change in mental status (delirium, coma, irreversible neurological damage
- Muscle damage
- Seizure
febrile seizure risk factors
daycare, developmental delay, family history, > 30 day neonatal hospital stay
antipyretics usage for febrile seizure?
recommended, but does not decrease risk of recurrence
drug induced fever
-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
fever non-drug treatment
-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
body sponging recommended temp?
not recommended for < 104 F
don’t use __ for body sponging
isopropyl or ethyl alcohol -> alcohol poisoning
fever drug treatment, children warning
- 30% of parents unable to measure accurate APAP dose
- 51% of children received inaccurate dose
- Appropriate measuring device
- Demonstrate proper measurement
effectiveness btwn NSAIDs
- APAP and ibuprofen similar efficacy, ibuprofen slightly more effective for fever
- Naproxen less data
using antipyretics after vaccines?
- Antipyretic immediately after vaccines reduced fever, but also reduced antibody response, although still protective
- not recommended
length of fever for
contraindications to self-treatment, children
-Patients > 2 years with fever
> 3 days
-Child < 2 years with fever > 24 hours
temp for contraindications to self-treatment, children
> 3 months: Rectal temp ≥
104 F or equivalent
-< 3 months: rectal temp ≥
100.4 F
other contraindications to self-treatment, children
- 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
contraindications to self-treatment, adults and children
- 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)
