fever (copy pasta ver)

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

Answer 3

94.5-99.3 F

>99.3 F

Question 4

tympanic

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

0-2 months old temp:

Answer 6

> 100.7 F

Question 7

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

Answer 7

> 100.3 F

Question 8

when does body incr body temp due to diurnal rhythm?

Answer 8

late afternoon and early evening

Question 9

fever cause

Answer 9

Increased temp due to pyrogen (a substance, typically produced by a bacterium, that produces fever when introduced or released into the blood.)

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

Question 10

Hyperthermia

Answer 10

Malfunctioning of normal temp. control by excessive heat exposure or production

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

Treatment risk-benefit controversy

Answer 14

won’t treat/no need to treat if discomfort bearable due to benefits

Question 15

febrile seizure age

Answer 15

2-5% of children, 6 mo-5 yo, peak 18-24 mo

Question 16

febrile seizure risk factors

Answer 16

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

Question 17

febrile seizure characteristics

Answer 17

• Typically non-focal movements, < 15 min. and 1/24 hr period
• One seizure unlikely to cause significant neurologic impairment or epilepsy
• Antipyretics recommended, but do not decrease risk of recurrence

Question 18

fever complication risk factors

Answer 18

Heart disease
Pulmonary dysfunction
Infants
Brain tumors or hemorrhage
CNS infections
Preexisting neurologic damage
Decreased ability to dissipate heat
Elderly due to decreased thirst  perception and perspiration ability

Question 19

fever treatment

Answer 19

• Most fevers self-limiting
• Alleviate discomfort
• Focus on cause
• Assess risk-benefit ratio

Question 20

fever non-drug treatment

Answer 20

-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 not recommended for < 104 F
-Also treat with antipyretics
Never sponge with isopropyl or ethyl alcohol -> alcohol poisoning

Question 21

fever drug treatment

Answer 21

• 30% of parents unable to measure accurate APAP dose
• 51% of children received inaccurate dose
• Appropriate measuring device
• Demonstrate proper measurement
• Avoidance multiple APAP or ibuprofen products
• APAP and ibuprofen similar efficacy, ibuprofen slightly more effective for fever
• Naproxen less data
• Alternating antipyretics is in widespread use, but not recommended due to concerns regarding errors
• Antipyretic immediately after vaccines reduced fever, but also reduced antibody response, although still protective, not recommended

Question 22

drug induced fever

Answer 22

-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 23

contraindications to self-treatment

Answer 23

-History of seizures or febrile seizures in children
-Patients > 2 years with fever
> 3 days
-Child < 2 years with fever > 24 hours
-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
> 3 months: Rectal temp ≥
104 F or equivalent
-< 3 months: rectal temp ≥
100.4 F
-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)