Headaches & Fever Flashcards
What are the major groups of headaches?
Primary and secondary
Primary headaches account for ___% of headaches
90
Which major group of headache has an underlying medical condition?
Secondary
Which major group of headache can be fixed via self care?
Primary
What are the subgroups in primary headaches?
- Tension-type
- Migraine
- Sinus
What is the onset in sinus headaches?
Simultaneous with sinus symptoms
What is the onset in migraines?
Sudden
What is the onset in tension-type headaches?
Gradual
How long do migraines last?
Hours to 2-3 days
How long do sinus headaches last?
Days (resolved with sinus symptoms)
How long do tension-type headaches last?
Hours to days
What are some exclusions for self-treatment?
- Severe head pain
- > 10 days with or without treatment
- Last trimester of pregnancy
- < 8 years of age
- High fever or signs of serious infection
- History of liver disease
- Consumption of ≥3 alcoholic drinks per day
- Secondary headache – head trauma, stroke, substance abuse or withdrawal, bacterial or vial infection, or disorders of cranial structures
- No formal diagnosis of migraine headache
What are some non-pharmacological treatments for tension-type headaches?
Relaxation exercises + physical activity that involves stretching
Which type of headaches have non-pharmacological treatments?
Tension-type and migraines
What are some non-pharmacological treatments for migraines?
- Keep a regular schedule (sleep, eat, etc)
- Manage stress
- Diet restrictions w/ triggers
- Avoid hunger / low glucose
What is the recommended dose of APAP for <12 years of age?
Weight based; 10-15mg/kg every 4-6 hours
What is the max dose of APAP for <12 years of age?
480mg/dose or 2400mg/day
What is the recommended dose of APAP for ≥12 years of age?
325-1000 mg every 4-6 hour
What is the max dose of APAP for ≥12 years of age?
Max: 4g
Recommended: 3250mg
What is the recommended dose of Ibuprofen for <12 years of age?
Weight based; 5-10 mg/kg every 6-8 hours
What is the recommended dose of Ibuprofen for ≥12 years of age?
200-400 mg every 4-6 hours as needed
What is the max dose of Ibuprofen for <12 years of age?
300 mg/dose or 1200mg/day
What is the max dose of Ibuprofen for ≥12 years of age?
1200mg/day
What is the recommended dose of Naproxen for <12 years of age?
DO NOT USE
What is the max dose of Naproxen for ≥12 years of age?
Doesn’t list, but you can take 2 tabs within the first hour (660mg)
What is the recommended dose of Naproxen for ≥12 years of age?
Take 220 mg every 8-12 hours as needed
What is the recommended age for aspirin use?
≥19 years old
What is acetaminophen’s boxed warning?
Risk of hepatotoxicity
What are NSAID’s boxed warnings?
- Serious cardiovascular thrombotic events
2. Serious gastrointestinal bleeding, ulcerations, and perforation
What is Aspirin’s boxed warning?
Reye’s Syndrome, dont take if you are a kid w/ chicken pox or has flu-like symptoms
What should you take if you’re pregnant?
Acetaminophen
What should you absolutely avoid if you’re pregnant?
NSAIDs and aspirin.
When should you follow up on episodic tension-type headaches?
6-12 weeks
When should you follow up on chronic tension-type headache
4-6 weeks
When should you follow up on migraine headaches?
Within 10 days
Which age group can use rectal thermometers?
<3 months
Which age group can use oral thermometers?
≥3 years
Which age group can use temporal thermometers?
≥3 years
Which age group can use tympanic thermometers?
≥3 years
Which thermometer is the most reliable?
Rectal
Which age group should avoid Naproxen + Aspirin?
≤12 years
Fever, Rectal temperature?
100.4˚F
Fever, Oral temperature?
99.5˚F
Fever, Axillary temperature?
99.3˚F
Fever, Tympanic temperature?
100.0˚F
Fever, Temporal temperature?
0-2months = 100.7˚F
3months-2years: 100.3˚F
>4years: 100.1˚F
What are the exclusions for self-treatment of fever?
- <3 months of age with rectal temperature ≥100.4F (38.0 C)
- > 3 months of age with rectal temperature ≥104.0F (40.0 C) or equivalent
- Severe symptoms of infection
- Risk of hyperthermia (temperature >106F)
- Impaired O2 utilization in pulmonary or cardiac disease
- Impaired immune function
- CNS damage
- <2 years of age with fevers that persists >24 hours
- > 2 years of age with fevers that persists >3days with or without treatment
- Children with history of febrile seizures
- Children who displays any of these symptoms:
•Spots or rash
•Sleepy, irritable, or hard to wake up
•Vomiting and cannot keep down fluids; refuses to
drink any fluids
•Repeated diarrhea
•Stiff neck
What are the non-pharmacologic treatments of fever?
- Drink more water
- Wear lightweight clothing
- Remove blankets
- Maintain comfortable room temperature
What is not an acceptable non-pharmacologic treatment for fever?
Ice water bath or alcohol sponge bath
How many days can you use acetaminophen or ibuprofen for self-treatment of fever?
Max = 3 days