Week 1- Fever Flashcards

1
Q

Normal axillae body temp:

A

97.5 with range of 94.5-99.1

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2
Q

Normal oral body temp:

A

97.9 with range of 95.9-99.5

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3
Q

Normal rectal temp:

A

98.6 with a range of 97.9-100.2

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4
Q

Normal infrared tympanic temp:

A

97.9 with a range of 96.3-99.5

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5
Q

Lowest temp is between what hours?

A

4am and 8 am

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6
Q

When does body temp peak?

A

Between 4-6 pm

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7
Q

What individual and environmental factors affect body temp?

A
Age (slightly higher in young infants)
Sex 
Physical activity 
Ambient air temp 
An atomic site
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8
Q

Where is core body temp most accurately measured?

A

Pulmonary artery

Other deep tissue locations (lower esophagus, nasopharynx)

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9
Q

Definition of fever?

A

Rectal greater than 100.4

Oral greater than 100.0

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10
Q

When does cellular damage occur with fever?

A

Doesn’t occur until 105.8-107.6

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11
Q

What beneficial effects does fever play in fighting infection?

A

Retards growth and reproduction of bacteria and viruses.
Enhances neutrophil production and T-lymphocyte proliferation.
Aids in the body’s acute phase reaction.

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12
Q

Does the degree of fever always correlate with severity of illness?

A

No it does not

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13
Q

Primary goal with fever?

A

Improve the child’s overall comfort rather than focus on the normalization of body temperature.

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14
Q

What controls the temperature the body tries to maintain?

A

Hypothalamic set point

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15
Q

What is the physiology of a fever?

A

Induces macrophages to release cytokines that function as endogenous pyrogens -> circulate to anterior hypothalamus -> increase local levels of prostaglandin E2 -> induce an increase in setpoint.

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16
Q

The human body generates heat by:

A

Metabolic processes

17
Q

Heat conservation is maintained by:

A

Vasoconstriction and heat preference behaviors

18
Q

Heat loss occurs by:

A

Sweating, evaporation, conduction, radiation, convection, vasodilation, cold preference behaviors

19
Q

Negative effects of fever:

A
Increased metabolic rate
- increased fluid loss
- increased oxygen consumption 
- increased caloric needs 
- can precipitate seizures 
Associated symptoms
- HA
- Malaise
- Anorexia
- Irritability 
Respiratory status 
- tachypnea
-tachycardia
20
Q

Petechiae or purpuric rashes are associated with?

A

Bacteremia

21
Q

Purpura associated more often with what?

A

Meningicoccemia

22
Q

Reliable method for determining degree of illness:

A

Yale observation scale

23
Q

6 variables in Yale observation scale?

A
Quality of cry 
Reaction of parent stimulation 
State variation 
Color 
Hydration 
Response
24
Q

What score on the Yale observation scale indicates a serious bacterial infection?

A

16 or more

25
Q

Clinical red flags for serious infection in children older than 1 month?

A
Parental concerns 
Physician instinct
Changes in crying pattern. 
Drowsiness
Inconsolable 
Moaning 
Crackles
Cyanosis
Decreased BS
Poor peripheral circulation
SOB
Decreased skin elasticity 
Hypotension 
Meningeal irritation 
Petechiae rash 
Seizures
26
Q

Normal WBC?

A

5000-15000

Bands should be less than 1500

27
Q

Elevated procalcitonin is better or worse predictive value of infection than WBC?

A

Better- marker of inflammation and bacterial infection.

28
Q

When is chest X-ray indicates?

A

Infants over 1 month with respiratory symptoms- tachypnea, refractions, O2 sats <95%

Fever >102.2

WBC >20000

29
Q

Lab findings consistent of serious bacterial infections:

A
UA unspun- more than 10WBC/HPF
WBC: more than 15000
ANC- more than 10000
CRP- more than 40
Procalcitonin level- more than 0.5
30
Q

Tylenol dosing

A

10-15 mg/kg/dose q4-8 hrs

31
Q

Motrin dosing

A

6 months and up
Fever <102.5 5mg/kg/dose
Fever > 102.5 10mg/kg/dose

Do not exceed 40mg/kg/day

32
Q

Asthmatics May be sensitive to:

A

NSAIDS

33
Q

What is a prolonged fever?

A

Rectal temp >101 or oral temp greater than 100 for 2-3 weeks or more and no known etiology