Week 7: Fever, Med administ Flashcards
What part of the brain regulates core body temp? What is the normal body temp?
Hypothalamus
37 degrees celsius
What is considered a fever for the following measurement methods
Rectal
Tympanic
Oral
Axillary
Rectal: 38+
Tympanic: 38+
Oral: 37.5+
Axillary: 37.2+
Compare and contrast fever, high fever, hyperpyrexia.
Fever: 38+ (rectal)
High fever: 40.5+ (oral)
Hyperpyrexia: 41.1+ oral
Differentiate between the 2 types of pyrogens
(exogenous + endogenous)
Exogenous
- microorganisms and toxins
- Induce formation & release of the endogenous pyrogens
Endogenous
- proteins produced by the macrophages in response
- their release causes symptoms such as myalgias
What is the order of the pathophysiology of fever (5)
- Immune response mediators
- Leukocytes
- Pyrogenic cytokines
- Production of PGE 2
- Elevated set-point
Which part of the physiology do drugs target?
During the production of PGE2
What is hyperthermia?
- uncontrolled elevated body temp without elevation of the hypothalamus (malfunction in hypothalamus)
- young children and seniors are affected
- Antipyretics (ibuprofen, tylenol, aspirin) are not effective
What are the 4 drug classes that can induce fever?
- Anti-infectives
- Antineoplastics
- Cardiovascular
- CNS agents
What are characteristics of temporal and tympanic methods of measuring fever
Temporal (forehead)
- convenient, non-invase, quick
- prone to error, expensive
Tympanic (ear)
- Alternate to rectal
- accuracy decrease with improper placement
- will not work under 2 years
What is the recommended fever measuring technique for the following ages:
0-2 years
2-5 years
5+ years
0-2 years
1. rectal
2. Axillary
2-5 years
1. Rectal
2. Axillary tympanic
5+ years
1. Oral
2. Axillary, tympanic
When would you refer to emergency department vs primary care proviedr
Emergency:
- less than 3 months
- child very ill (seizures, swelling)
Primary care:
- 3-6 months
- High fever, not resolved after 72 hours
What are 3 factors you can safely self-treat
- Fever lasting less than 3 days
- Fever less than 40.5 degrees
- No red flags
When should we treat and not treat fever during pregnancy? What can you give?
Always treat for pregnancy
- Tylenol is safe
- NO NSAIDS during 1st and 3rd trimester
What are some nonpharm strategies for fever?
- Increase fluid intake
child: 1-2 oz/hr
Adult: 2-4 oz/hr - remove excess clothing
What are the doses of tylenol and advil for children per kg.
Acetaminophen
- 10-15mg/kg q4-6h prn
- MAX daily: neonates 60mg/kg, older children 75mg/kg (5 doses a day)
Advil
- 5-10mg/kg q6-8h prn
- MAX daily: 40mg/kg (4 doses a day)
