week 11: thermoregulation

Question 1

what is thermoregulation?

Answer 1

the process of maintaining core body temperature at a near constant value

Question 2

What sets the set point of thermoregulation?

Answer 2

the hypothalamus

Question 3

All physiological adjustments to body temperature is controlled by what?

Answer 3

hypothalamus

Question 4

When the body becomes cooler
define if these hormones are true in pairs
hypothalamus- thyroxine
anterior pituitary - TSH ( thyroid stimulating hormone)
thyroid gland- TSH - RH
adrenal medulla- epinephrine

in other words they decreased muscle tone and vasoconstriction when you are cold

Answer 4

first is false, this is TSH- RH ( thyroid-stimulating-hormone-releasing hormone)

thyroid gland is false, this is thyroxine

and false, it doesnt decrease muscle tone, it increases it!

Question 5

When the body becomes warmer define if these pairs are correctly matched.

Hypothalamus - TSH - RH stopped

sympathetic nervous system comes into play

what happens to muscle tone? and what does it initiate?

Answer 5

all true

vasodilation, decrease in muscle tone and initiate sweat production

Question 6

what are the concepts related to thermoregulation?

Answer 6

normothermia
hypothermia
hyperthermia
hyperpyrexia

Question 7

Body temperature in various states

what is the temp for :
normothermia
hypothermia
hyperthermia
hyperlexia
in an older adult

Answer 7

Normothermia 36.2 - 37.6
older adult oral temp 36.1-36.3

hypothermia <36.2

hyperthermia >37.6

hyperpyrexia >41.6

Question 8

what causes our body temperature to change?

Answer 8

fever
hyperthermia
hypothermia

Question 9

define what the statement is describing : immune system’s response to infection in the body

causes an increase in core body temperature

and from this description, re-call we know hypothalamus is in charge of adjustment to body temperature ( regulator), what does it do?

Answer 9

fever

triggers hypothalamus to change the set point

Question 10

hyperthermia

what does the hypothalamic do?

what is the temperature?

and define its characteristics

Answer 10

hypothalamic set point does NOT change

temperature rises above 37.6

excessive heat production, inability to cool, hypothalamic regulator dysfunction

Question 11

hypothermia

what does the hypothalamic do?

what is the temperature?

and define its characteristics

Answer 11

hypothalamic set point does not change

temperature drops below 36.2

excessive heat loss, insufficient heat production, hypothalamic regulation dysfunction

Question 12

define the characteristics of hypothermia

Answer 12

excessive heat loss
insufficient heat production
hypothalamic regulator dysfunction

Question 13

What is the body’s response to hypothermia?

Answer 13

muscle contraction ( shivering ) to initiate warmth

vasoconstriction ( conserve heat or reduce heat loss )

Question 14

Body response to hypothermia

prolonged exposure response

Answer 14

vasoconstriction

peripheral tissue ischemia

reduced perfusion

increased viscosity of blood in smaller vessels

results in failed
vasoconstriction resulting in vasodilation ( increased heat loss)

Question 15

define teh characteristics of hyperthermia

Answer 15

excessive heat production
inability to cool
hypothalamic regulator dysfunction

Question 16

what is the body’s initial response when experiencing hyperthermia?

Answer 16

sweat

Question 17

what is the prolonged response of the body when experiencing hyperthermia

Answer 17

sodium loss
dehydration

Question 18

what is the body’s severe response to hyperthermia

Answer 18

hypotension
tachycardia

Question 19

True or false. Body’s response to hyperthermia , when experiencing severe response is reduced perfusion and coagulation within the microcirculation and cardiovascular collapse

Answer 19

true

Question 20

factors that affect thermoregulation

populations at risk ?

who are the individuals at risk

Answer 20

Populations at risk:
* Older adults
* Infants and young children

Individual risk factors:
* Impaired cognition (inability to recognize dangerous environmental exposures)
* Preexisting medical conditions (CHF, diabetes, gait disturbances)
* Medications (tranquilizers, sedatives, antidepressants, vasodilators)
* Alcohol use
* Nutritional status
* Recreation or occupational exposure

Question 21

how does thermoregulation impact skin integrity

Answer 21

Mechanisms for thermoregulation require intact skin. The skin protects against heat loss

Sensations of the skin alert the person that they need to take precautions to prevent heat loss or promote heat loss

Question 22

define if these are true amongst age related changes that impact an older adults response to cool environments

decline in conservation responses :
* Declines in the sensation of cold
* Declines in vasoconstriction
* Distribution of fat – total body and intra-abdominal fat increase with age while subcutaneous fat decreases

Answer 22

true

Question 23

define if these are true amongst age related changes that impact an older adults response to cool environments

decline in heat generation :

*Delayed and diminished shivering
* Reduced cold-induced metabolic heat production
* Reduced tendency to protect self against the cold

Answer 23

true

Question 24

Age related changes that impact an older adults’ response to warm environments

heat dissipating responses : ( define if it’s true or false )
* Age related changes that increase risk for dehydration

• Diminished thirst response can lead to dehydration and heat stroke

*Decreased sweating response

• Skin less protective (decreased sebaceous
  glands, thinner epidermis)
• Decreased awareness of temperature

Answer 24

all true

Question 25

Risk factors for altered thermoregulation in response to cool environment what are the medical conditions that affect this ?

Answer 25

* Hypothyroidism * Sepsis * Malnutrition * Hypoglycemia

Question 26

Risk factors for altered thermoregulation in response to cool environment conditions that increase heat loss

Answer 26

inflammatory skin conditions burns

Question 27

Risk factors for altered thermoregulation in response to cool environments Medications

Answer 27

* Tranquilizers * Sedative-hypnotics * Anti-depressants * Alcohol

Question 28

Risk factors for altered thermoregulation in response to warm environments SELECT ALL THAT APPLIES medical conditions : * Hyperthyroidism * Cardiovascular disease * Diabetes * PVD

Answer 28

all true

Question 29

Risk factors for altered thermoregulation in response to warm environments what are the medications that contribute to this ?

Answer 29

* Diuretics * Anticholinergics * Antidepressants * Beta blockers

Question 30

Risk factors for altered thermoregulation in response to warm environments true or false. Alcohol--> induces diuresis and increases risk for heat production

Answer 30

true

Question 31

what are the plan interventions that prevent the older adult from experiencing hypothermia and hyperthermia

Answer 31

Body temperature is included in almost all assessments Provides baseline information regarding homeostasis and health in general assesment of the body temp

Question 32

what are we looking for during the plan interventions that prevent the older adult from experiencing hypothermia and hyperthermia ( assessment of the of the body temp )

Answer 32

* Outward appearance * Sweating/shivering? * Colour of skin * Touching skin for temperature * Taking temperature with a thermometer (rectal preferred method when assessing a patient for hypothermia or hyperthermia)

Question 33

what is the purpose of the asssesment?

Answer 33

Decrease the risk for altered thermoregulation (hypothermia and hyperthermia) for the older adult Detect both evidence for altered thermoregulation (hypothermia and hyperthermia -health related illness) in the older adult

Question 34

assessment of risk factors for altered thermoregulation medications/alcohol use:

Answer 34

tranquilizes, sedative-hypnotics, antidepressants,vasodilators

Question 35

assessment of risk factors for altered thermoregulation: select all that applies for the general risk factors pathological conditions ( e.g dementia) environmental risk factors - a temperature of 18 degrees can cause a serious drop in core body temperature social isolation housing conditions - air conditioning system - Heating system - Financial concerns - Risk for falls (orthostatic hypotension) Nutritional factors

Answer 35

all true

Question 36

what are the knowledge factors for assessment of risk factors for altered thermoregulation

Answer 36

education a key factor in preventing altered thermoregulation

Question 37

interventions to prevent alteration in thermoregulation a.environmental control b.appropriate clothing c.physical activity d.fluid/nutrition

Answer 37

all true

Question 38

go more in depth in fluid/nutrition in intervention to prevent alteration in thermoregulation

Answer 38

8-10 glasses of non caffenaed liquids/day education related to decreased thrist sensation small/frequent meals nurtition-vitamin a,c,e,zinc

Question 39

define if all are true in terms of interventions to prevent alteration in thermoregulation a.resources to pay for food,clothing b.immunizations - to prevent infections c.education is not needed, this is something your body just learn along the way

Answer 39

a and b is true c is false, education is needed regarding medications that can alter thermoregulation

Question 40

interventions to decrease the risk of hypothermia ( name 5)

Answer 40

* Maintain environmental temp at 23.9 * Ideal humidity – 40-50% * Access programs that can help the older adults with costs to improve home * Adequate clothing in cold weather * Body temperature above 36 degrees

Question 41

define if these interventions will help to decrease the risk of hypothermia

Answer 41

* Limit time outside * Provide head covering even in bed * Dry older adult quickly and thoroughly * Promote activity * Provide high protein meals and bedtime snacks to add heat and sustain heat production throughout the day and night

Question 42

assessment for hypothermia ( name them )

Answer 42

* Initially subtle changes–compare current temperature with baseline temperature * Assessment for temperature below 35 degrees C (compare to baseline) * Cool skin in unexposed areas (abdomen and buttocks) * May not complain of being cold or may not be shivering

Question 43

assessment for hypothermia as it progresses what could possibly happen?

Answer 43

lethargy, slurred speech, mental changes, impaired gait, puffiness to the face, slowed or irregular pulse, low blood pressure, slowed tendon reflexes and slow shallow respirations.

Question 44

assessment for hypothermia severe stages :

Answer 44

muscular rigidity, diminished urinary function, stupor or coma ( no shivering )

Question 45

pathological effects of hypothermia neurological respiratory skin cardiovascular musculoskeletal what could happen within these categories during a mild stage and severe stage of hypothermia

Answer 45

neurological mild: lethargy, lack of coordination severe: stupor, coma respiratory mild : rise in respiratory rate severe: undetectable skin mild: pale, cold, dry severe:cyanotic cardiovascular mild: rise in heart rate severe: undetectable pulse, cardiac arrest muscoskeletal mild : shivering , severe: no shivering

Question 46

define if these interventions could also be helpful when it comes to treating hypothermia warm blankets warm fluids dry clothing warm water bath core warming heated iv fluids

Answer 46

all true

Question 47

interventions to decrease the risk of hyperthermia (name 5 )

Answer 47

room temperature below 29.4 degrees fans 8-10 non-caffeinated drinks/day loose fitting clothing hat or umbrella when outdoors avoid outdoor activities

Question 48

True or false. Intervention to decrease the risk of hyperthermia, one of the things you can do is out ice pack or cold wet towels on the body.

Answer 48

true

Question 49

assessment for hypothermia

Answer 49

mild headache weak and lethargic nausea and loss of appetite absent sweating response

Question 50

assessment for hypothermia as it progresses

Answer 50

dizziness, dyspnea, tachycardia, vomiting, diarrhea, muscle cramps, chest pain, cognitive impairment and widening pulse pressure

Question 51

pathological effects of hyperthermia neurological respiratory cardiovascular GI musculoskeletal skin fluid and electrolyte what could happen within these categories during a mild stage and severe stage of hyperthermia

Answer 51

neurological : mild stage: mild headaches and dizziness severe stage : cerebral edema , cognitive impairment respiratory mild : n/a severe: respiratory disturbances, dyspnea cardiovascular mild : tachycardia , severe " cardiovascular disturbances, tachycardia, wide pulse pressure GI mild : vomiting, diarrhea, severe: vomiting, diarrhea musculoskeletal mild : muscle cramps, severe : n/a skin mild: diminished sweat response, warm and dry , severe: n/a fluid and electrolyte, mild : n/a , severe : decreased Na and K+

Question 52

what other interventions are there to treat hyperthermia?

Answer 52

remove clothing hydration cool packs cool blankets

Question 53

possible outcomes for altered thermoregulation: SELECT ALL THAT APPLIES preventing hypothermia and hyperthermia: * Baseline temperature is maintained * Body fluid intake is improved (urine color, hydration diary) * Improved understanding of risk The experience of altered thermoregulation: * Return to baseline temperature (and other vital signs) * Other symptoms resolved * Delirium – orientation is normal, attention is normal, no evidence of disturbed mental status

Answer 53

all true

Question 54

planning to intervene : what do we plan?

Answer 54

assessment of risk factors interventions to reduce risk assessment of hypothermia or hyperthermia interventions for hypo interventions to treat hyper rationale for interventions --> heat conservation, heat dissipation