Module 1 Unit 1 - Thermoregulation

Question 1

Intermittent Fever

Answer 1

Temp returns to normal range at least once per 24hr. EX: nocturnal fevers

Question 2

Remittent Fever

Answer 2

Temp does not return to normal range and varies by a few degrees in either direction. May look intermittent but the fever doesn’t break.

Question 3

Sustained/continuous Fever

Answer 3

Temperature remains elevated with few variations

Question 4

Recurrent or Relapsing Fever

Answer 4

One or more episodes of fever as long as several days with one or more days of normal temps between episodes.

Question 5

Normal Temp range in Celcius

Answer 5

36-37.5

Question 6

Normal Temp range in Farenheit

Answer 6

97-99.5

Question 7

4 stages of fever

Answer 7

Prodrome
Chill
Flush
Defervescence

Question 8

Prodrome

Answer 8

Mild headache, fatigue, malaise, fleeting pains

Question 9

Chill

Answer 9

uncomfortable sensation, shaking, rigors, vasoconstriction.

New Hypothalamus set point. Temp Rising.

Question 10

Flush

Answer 10

Cutaneous vasodilation

skin warm and flushed

Question 11

Defervescence

Answer 11

Initiation of sweating

Question 12

Diagnostic Criteria for Fever of Unknown Origin (FUO)

Answer 12

Temp > 38.3C (101F) for 3 weeks or longer.

At least one week of diagnostic testing that does not identify a cause.

Question 13

Common Causes of FUO’s

Answer 13

Malignancies
HIV, TB, Abscesses
Drug Fevers
Cirrhosis
Non-Hodgkin lymphoma IN ELDERLY PT's

Question 14

What must be considered as cause for fever in infants 1-28 days old?

Answer 14

Bacteremia or Meningitis
S/S:
Lethargy, poor feeding, hypoventilation, Poor tissue oxygenation, cyanosis

Question 15

What constitutes a significant fever in infants < 3 Months

Answer 15

100.4

Question 16

What should be considered as possible cause for fever before 1 year? (2yr for girls)

Answer 16

UTI

Question 17

Why are fevers difficult to detect in some elderly pt’s?

Answer 17

May not reach the usual febrile temp range due to lower baseline temp.

Question 18

How can you detect fevers in elderly pt’s with lower baseline temps

Answer 18

Look at trends and look for the other S/S’s
Unexplained changes in functional ability
Worsening mental state
weakness/fatigue
weight loss

Question 19

Common cause of heat cramps

Answer 19

Fluid replacement with only water (electrolyte loss)

Question 20

Heat exhaustion cause

Answer 20

gradual loss of salt and water after prolonged exertion in heat

Question 21

Heat exhaustion S/S

Answer 21

Thirst 
Fatigue
Nausea
Oliguria
Giddiness
Delirium
Hyperventilation
Tachycardia
Moist skin
Elevated Temp

Question 22

Heat Stroke S/S

Answer 22

Tachycardia
Hyperventilation
Dizziness
Weakness
Emotional Lability
N/V
AMS/Delirium
Convulsions
Collapse
Skin hot and dry - no sweating

Question 23

Heat Stroke vs heat exhaustion S/S

Answer 23

Stroke includes convulsions, collapsing and HOT DRY SKIN not moist skin

Question 24

Malignant Hyperthermia is genetic. How is it inherited?

Answer 24

Autosomal Dominant

Question 25

2 theories on cause of Neuroleptic Malignant Syndrome

Answer 25

1. Alteration in function of hypothalamic thermoregulatory center caused by neuroleptic drugs that block dopamine receptors in the hypothalamus and basal ganglia
2. Spectrum of genetic defects responsible for calcium regulation cause reaction with neuroleptic drugs since they often increase skeletal muscle contractions

Question 26

Neuroleptic Malignant Syndrome S/S

Answer 26

Explosive Onset
Muscle rigidity
Altered Consciousness
Autonomic NS dysfunction
HYPERTHERMIA

Question 27

When can a low grade fever indicate sever infection?

Answer 27

High risk infants and elderly pt’s

Question 28

First Sign of Hypothermia

Answer 28

Lack of coordination, stumbling

Question 29

S/S of hypothermia

Answer 29

Slurred speech
irrationality/impaired judgement
Amnesia
hallucinations
Blue Puffy Skin
DILATION OF PUPILS
Decreased RR
Weak Irregular pulse

Question 30

What happens to cardiac rhythm in hypothermia

Answer 30

A-fib or V-fib.

Question 31

Passive Rewarming

Answer 31

moving to a warmer environment than current body temp

Question 32

Active Total Rewarming

Answer 32

Warm liquids PO, Warm Blanket

Question 33

Active Core Rewarming

Answer 33

Tube placed into stomach or bladder (severe cases) and warm liquid is given