Module 1 Unit 1 - Thermoregulation Flashcards
Intermittent Fever
Temp returns to normal range at least once per 24hr. EX: nocturnal fevers
Remittent Fever
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.
Sustained/continuous Fever
Temperature remains elevated with few variations
Recurrent or Relapsing Fever
One or more episodes of fever as long as several days with one or more days of normal temps between episodes.
Normal Temp range in Celcius
36-37.5
Normal Temp range in Farenheit
97-99.5
4 stages of fever
Prodrome
Chill
Flush
Defervescence
Prodrome
Mild headache, fatigue, malaise, fleeting pains
Chill
uncomfortable sensation, shaking, rigors, vasoconstriction.
New Hypothalamus set point. Temp Rising.
Flush
Cutaneous vasodilation
skin warm and flushed
Defervescence
Initiation of sweating
Diagnostic Criteria for Fever of Unknown Origin (FUO)
Temp > 38.3C (101F) for 3 weeks or longer.
At least one week of diagnostic testing that does not identify a cause.
Common Causes of FUO’s
Malignancies HIV, TB, Abscesses Drug Fevers Cirrhosis Non-Hodgkin lymphoma IN ELDERLY PT's
What must be considered as cause for fever in infants 1-28 days old?
Bacteremia or Meningitis
S/S:
Lethargy, poor feeding, hypoventilation, Poor tissue oxygenation, cyanosis
What constitutes a significant fever in infants < 3 Months
100.4
What should be considered as possible cause for fever before 1 year? (2yr for girls)
UTI
Why are fevers difficult to detect in some elderly pt’s?
May not reach the usual febrile temp range due to lower baseline temp.
How can you detect fevers in elderly pt’s with lower baseline temps
Look at trends and look for the other S/S’s
Unexplained changes in functional ability
Worsening mental state
weakness/fatigue
weight loss
Common cause of heat cramps
Fluid replacement with only water (electrolyte loss)
Heat exhaustion cause
gradual loss of salt and water after prolonged exertion in heat
Heat exhaustion S/S
Thirst Fatigue Nausea Oliguria Giddiness Delirium Hyperventilation Tachycardia Moist skin Elevated Temp
Heat Stroke S/S
Tachycardia Hyperventilation Dizziness Weakness Emotional Lability N/V AMS/Delirium Convulsions Collapse Skin hot and dry - no sweating
Heat Stroke vs heat exhaustion S/S
Stroke includes convulsions, collapsing and HOT DRY SKIN not moist skin
Malignant Hyperthermia is genetic. How is it inherited?
Autosomal Dominant
2 theories on cause of Neuroleptic Malignant Syndrome
- Alteration in function of hypothalamic thermoregulatory center caused by neuroleptic drugs that block dopamine receptors in the hypothalamus and basal ganglia
- Spectrum of genetic defects responsible for calcium regulation cause reaction with neuroleptic drugs since they often increase skeletal muscle contractions
Neuroleptic Malignant Syndrome S/S
Explosive Onset Muscle rigidity Altered Consciousness Autonomic NS dysfunction HYPERTHERMIA
When can a low grade fever indicate sever infection?
High risk infants and elderly pt’s
First Sign of Hypothermia
Lack of coordination, stumbling
S/S of hypothermia
Slurred speech irrationality/impaired judgement Amnesia hallucinations Blue Puffy Skin DILATION OF PUPILS Decreased RR Weak Irregular pulse
What happens to cardiac rhythm in hypothermia
A-fib or V-fib.
Passive Rewarming
moving to a warmer environment than current body temp
Active Total Rewarming
Warm liquids PO, Warm Blanket
Active Core Rewarming
Tube placed into stomach or bladder (severe cases) and warm liquid is given
