Fever (called Pyrexia or Febrile Response) occurs when the body’s temperature rises to 37ᴼC. It can be measured by thermometer through the mouth. But, if it is measured per rectum, it will be 37.7ᴼC.
Because of recent circumstances, contactless temperature is obtained using infrared thermal reading apparatuses like Thermoscan and Thermoflash.
When the body is overwhelmed with germs, bacteria, microorganisms, or viruses, a fever takes place.
But sometimes, non-infectious components such as lack of water in the body, heat-related illness (sunstroke), or wounds also lead to Fever. Drugs also cause Fever, like Ephedrine, Sulfa Drugs, Interferon, etc.
Most basic conditions like hyperthyroidism, cardiovascular diseases, and types of malignancy can also give rise to Fever.
If the Fever is not managed correctly, it will lead the patient to the danger of several conditions like febrile seizures.
Febrile seizures mainly occur in patients of 6 months to 6 years aged. The long-term and continuous febrile seizures lead the infants to brain damage.
What is Fever?
The rise in body temperature is called Fever.
It is because of the interruption of the thermoregulation of the body. The thermoregulation is disrupted when the body consumes or brings out more excessive heat than usual.
Behind the usual conflict is an experienced core temperature of the body’s internal organs, 102.2 °F or 39 °C. The moderate to high rise in the temperature of 40 °C (104 °F) may be risky for life.
How does Fever differ from Hyperthermia?
The Hypothalamus of the brain controls the rise in body temperature.
Fever is a non-permanent rise of body temperature from the average temperature value. It is produced by the following:
- Activation of cytokine (a protein that affects the immune system)
- Inflammation disorders like Alzheimer’s disease, heart disease, etc.)
- Infectious illnesses like Tuberculosis, Malaria, etc.
Whereas, Hyperthermia is an available elevation of body temperature that:
- Surpasses the heat-losing ability of the body
- It leads to the collapse of the thermoregulation function of the Hypothalamus.
Causes of Fever:
Several causes of Fever are discussed below:
- Merged impacts of occupations cause Fever.
- The lack of water and salts in our surroundings also causes it. For example, runners accomplish their tasks in severely hot weather, and some adults stop using air conditioners in hot weather due to expenses.
- Fever is rapidly disclosed in alcohol, diuretics, and phototoxic agent users. Or in those people who have hormonal disorders.
- Randomly, Fever occurs due to heat cramps, heat exhaustion, and heat stroke.
- Malignant Fever occurs in the reaction of people with paralysis (succinylcholine) and anesthetics (halothane). Its reaction probably leads to the killing of those people that have a congenital tendency.
- The danger of Fever is the rise in elders, infants, adults, old aged people, obese people, and those with pre-existing and long-term diseases.
Some other factors are also associated with Fever:
- Dehydration (lack of water in the body)
- Increase of metabolism
- Use of medicine or drugs
- Long-term exposure in the warm environment
- Wound or damage
- High-intensity exercises
- Sweating impotence
Medication that causes Fever:
These medicines are prescribed to get rid of bacterial or fungal infections. There are various categories of antibiotics. Frequently used antibiotics are:
b) Anti-arrhythmia drugs:
These are prescribed to regulate abnormal cardiac muscle rhythm. Mostly used are:
These are prescribed to treat epileptic convulsions. These are also called anti-epileptic drugs. More prescribed are:
- Phenytoin (diphenylhydantoin)
- Carbamazepine (used in bipolar diseases)
The use of narcotics increases body temperature. These are also known as illicit drugs. Mostly used illegal drugs are:
- Marijuana (cannabis)
- PCP (phencyclidine)
- MDMA (ecstasy)
e) Anti-fungal drugs:
These are used to prevent fungal infections. Anti-fungal drugs are mentioned below:
- Amphotericin B
- Sulfa Drugs
f) Anti-hypertensive drugs:
Drugs used to treat hypertension (high blood pressure) are called anti-hypertension drugs. Commonly used is:
What are the symptoms of Fever?
There are several symptoms and signs of Fever:
- The rise in the average temperature of the body
- Warming and reddening of the skin
- Increased heart rate
- Elevated respiration
- Body weakness
- Lessening of hunger
Factors that have impacts on body temperature:
The alteration of body temperature is usually observed in children, adults, and older people.
- In children: body temperature is higher than the average baseline temperature. It is due to their higher metabolic rate.
- In adults: the body temperature is as average as the baseline temperature.
- In older people: in more than 65 aged people, the body temperature is always noted to be lower than the standard baseline temperature. It is observed that as age increases, the body temperature lowers. The lower body temperature can lead to several infections due to the weakening the body’s immune system.
A German Physician, Carl Wunderlich, researched in 1868. He declared that the females’ body temperature is higher than the males’.
But in 1993, this research was rejected because it was studied that there is no difference in male and female body temperature.
It was declared that women’s body temperature is altered with their conditions. At the beginning of the menstrual cycle, a decrease occurs in the female’s body temperature; during the ovulation period and pregnancy, the body temperature increases.
3. the day:
A fluctuation in the body temperature is noted concerning the time of the day.
In the morning: usually, the body temperature is lower.
In the afternoon: it is slightly increased because it rises with the time of the day.
4. Physical activity or Exercise:
When the muscles are working, they require energy. More energy is required during high-intensity Exercise, so the muscles generate more heat. It results in a rise in body temperature.
5. Tension or stress:
In a state of tension or stress, the body’s temperature increases. The reasons are mentioned below:
Due to the release of stress hormones (cortisol and adrenaline)
Also, an increased heart rate leads to high blood pressure that can cause brain hemorrhage or heat stroke.
It is an accommodative reaction of the body while handling possible dangers and risks.
6. Food intake:
Body temperature is also changed after taking the meal. In some people, it is decreased, and in others, it is increased. The alteration in the body is due to an increase in the rate of metabolism in the patient’s body.
7. Smoking and drugs intake:
- Drugs: Some drugs are involved in the alteration of the body’s thermoregulation.
- Smoking: during smoking, the penetration in the body temperature is noted.
To obtain the desired upshots, the patient will:
- Conserve the actual body temperature according to usual restrictions.
- Express the essential facets that come up with Fever
Continue to exist freely from hazardous and harmful issues because of Fever, like:
- Damage of brain
- Non-performance of body organs
- Nursing evaluations for Fever:
Evaluations of nurses regarding Fever:
1. Evaluation of fever symptoms:
The potential signals for Fever are mentioned below:
- Redness of skin
- Feel hot while touching
- Headache or eyes pain
- Abnormal heart rate, respiratory rate, or temperature
2. Evaluation of entire states:
Here are some disorders that can lead to Fever.
- Thyroids problems
- Contaminations or infections
- Dysfunction of the spinal cord due to injury
- Lesion or wound in the brain
3. Vital signs observation:
At a temperature of 104°F or higher, Fever happens.
It will lead to abnormal heart rate and respiration.
Widely used thermometers that can give accurate results are:
4. Observation of neurological condition:
To evaluate the neurological state of the patient, observe the following:
Degree of awareness
Inclination or orientation
Confusion or temporary madness can also occur in severe cases.
5. Evaluation of dehydration:
The indications for the lack of water in the body (dehydration) are:
The rough appearance of the skin
Desiccation of mucous
Lack of urination
Abnormal (dark) color of urine
Tachycardia (rapid heartbeats)
Lack of sweating (caused by spinal cord injuries)
Excessive sweating may lead to dehydration
6. Evaluation of malignant Fever:
Malignant Fever happens due to the use of anesthetics. It can take place during or after the surgery. It can be associated with rapid cooling.
Its indications included:
- Slow or fast breathing
- The higher temperature of the body
- Fast heartbeat
- Unusual heart rhythms
- Stiffness of muscles
7. Lab work assessment:
Lab work is mainly done for the evaluation of dehydration, electrolytes imbalance, and organs dysfunction, such as:
The occurrence of proteins in the urine leads to the muscles breaking up.
Nursing Principles and Conciliations for Fever:
Here we will discuss the nursing conciliations for fever healing.
1. Awareness of the indications of heat exhaustion and heat-related diseases:
- Heat-related diseases happen due to thermoregulatory failure.
- Heat exhaustion is the rise in actual body temperature.
It occurs due to the following:
- Orthostatic hypotension
- Muscular pain
- Exertion fever affects runners, which can give rise to heat exhaustion. It happens due to hot weather.
2. Awareness of the indications of heat stroke:
Heat stroke occurs because of the rising of actual body temperature, and it is due to thermoregulation failure. The Central Nervous System also contributes to it.
Its signs are:
- Flushed, hot, and dry skin
Heatstroke is an urgent situation. If it is not managed correctly, it will cause the patient’s death.
3. Removing un-needed clothes:
Uncovering the skin at room temperature gives rise to evaporation, due to which the heat decreases.
4. Giving of fever blanket, if needed:
If the body temperature is so high, a cooling blanket is used. Water is flowing in this blanket. So, it is used in the rapid cooling of the body.
To stop trembling, place the temperature adjuster at 1ºC less than the patient’s current body temperature.
5. Giving a squashy bath:
It is a non-pharmacological method in which cooling through evaporation is involved. But alcohol is not used because it can result from rapid cooling, leading to trembling.
6. Put the icepacks on the patient:
The most powerful way to regulate the body’s core temperature is to place the ice packs on; the inguinal region, jawbone, human trunks, and neck region.
If the core temperature becomes less than 39 degrees, remove the ice pack to avoid excessive cooling of the body’s Fever because it can lead to madness.
7. Observing the skin during cooling:
Long-term cooling may lead to skin injury. To lessen the chances of skin injury, you should have to:
- Cover the ice with clothes or towels.
- Change the region of icing.
8. Submergence of ice in water:
The most valuable and accurate cooling procedure is submerging ice in the water. It is a non-meddling method. It can decrease the body temperature from about 0.15ºC to 0.35ºC per minute.
9. Colder saline immersion in veins:
It is also an accurate method. Chilled saline can work for 10 to 20 minutes.
According to research, colder saline immersion of 18kg/cc can lower the core temperature by about ~1.0ºC. So, this method treats children suffering from severe brain injury fever.
A sedative is also brought on during saline immersion to prevent trembling. The reason is that trembling can increase body temperature.
10. Gastric cavity cleaning:
Gastric cleaning is also an effective process. It can decrease the temperature by about 15 degrees per minute. But, it is not appropriate for all patients.
Because; there is a danger that if the immersed saline may not adequately repossess, it can lead to water drunkenness that results in advanced damage.
11. Peritoneal cavity cleaning:
It is also an accurate and non-meddling method. It can decrease the body temperature by more than 0.08 to 0.16 degrees per minute. It is more efficient because of the massive exterior of the peritoneum.
12. Administration of room temperature and bed clothing:
It is necessary to adjust the environmental factors according to the patient’s body temperature.
a) Room temperature:
Adjust the room temperature concerning the patient’s body temperature.
b) Bed clothing:
Use bed sheets and blankets that are suitable to regulate the core temperature.
13. Avoid shivering:
The cooling methods are based on the patient’s physical responses. So, it is essential to keep an eye on shivering:
- Applying fast cooling procedures may lead to shivering.
- Extreme cooling causes shivering.
Shivering can increase the body temperature because the metabolic rate rises. A rise in metabolic rate increases the body temperature.
It is essential to prevent shivering because it can obstruct the results of cooling procedures.
14. Use of side rails:
Side rails are used to maintain the position of the patient’s bed. It is necessary to use the side rails for all patients but especially for convulsions patients.
15. Prevention of shivering by medications:
Diazepam or Chlorpromazine is used to prevent shivering.
It can assist in avoiding shivering that can give rise to:
- Body heat
- Intake of oxygen
- Cardio-respiratory functioning
According to research, colder saline immersed in veins with 20 mg of Diazepam can decrease the body temperature by about 0.2ºC to 1.5ºC. It works without raising the oxygen intake while immersing in saline.
It is essential to provide Diazepam to prevent shivering because; it works without affecting respiration and cardiac functioning.
16. Improving nutrition:
Improve the nutrition of patients by giving them food according to their requirements.
Fever may lead to loss of appetite, more requirements for energy, and a high metabolic rate. It is necessary to provide enough food to the patient to maintain it.
17. Look after the mouth of the patient:
Fever may lead to dehydration. And dehydration results in dryness of the mouth and scratches on the lips. It can be overcome by using excess water and applying petroleum jelly or balms on the lips.
18. Provide dry bed clothing:
A dry bed provides relaxation to the patient.
It also assists in avoiding excessive cooling.
But excessive cooling occurs due to more sweating/diaphoresis due to suspension.
19. Sufficient water intake:
If the patient can put it away, provide them cold water to decrease the core temperature. The lack of fluid and excessive sweating lead to Fever.
20. Normal intravenous saline:
An intravenous saline solution may accomplish the lack of fluid while trembling.
21. Antipyretic medications:
Antipyretics have a minor role in fever healing. They can’t cure heat-caused diseases like heat stroke. Mainly used antipyretics are:
Antipyretic medicines can assist in stopping the pyrogens from changing the set point of core temperature in the Hypothalamus. Hypothalamus can’t work correctly due to pressure.
Conciliations for malignant Fever:
The nurses should have proper medicines and instruments to treat the malignant Fever.
They should have a piece of complete knowledge of malignant Fever.
Here we discuss conciliations about malignant Fever.
1. History taking and physical assessment of patient:
Some diseases activate malignant Fever.
- Lesions /Abrasions
- Neuromuscular disorders
- High-intensity exercises
- Neuroleptic Malignant Syndrome
Some people have more danger of malignant Fever. Those are suffering from:
- Severe pain in muscles
- Muscles sickness
- The un-understandable rise in the body’s temperature
- Massive muscles
If the person has a risk of malignant Fever, it is essential for them to immediately consult with the Malignant Hyperthermia Association of the United States (MHAUS). MHAUS can give the person knowledge, instructions, further measures, and the history of Malignant Fever.
2. Observe the indications and starting of treatment:
Patients that are suffering from malignant Fever have some symptoms.
- High Fever
- Abnormal and rapid breathing
- Incomprehensive increase in carbon dioxide
- Problem in ventilation
- Assisted muscle contraction
Loss of lives due to malignant Fever can be 70%. But it can be reduced by 10% by immediately evaluating the indications and curing as soon as possible.
Malignant Fever has the chance to spread during an operation or after 24 hours of the operation. So, it is essential to assess the indications nearly.
3. Recognize 100% oxygen level:
100% oxygen with hyperventilation will assist in reducing the carbon dioxide and clear away the uneasy anesthetics.
According to MHAUS, enter the activated charcoal into inspiration and expiration aspects of respiration, if possible. Changing the filter every hour is critical because it becomes dripped after one hour.
4. Provide intravenous dose of Dantrolene:
It is essential to provide a dose of Dantrolene Sodium because; it obstructs the pathology of muscles and stops dead. This drug is accurate and necessary to cure Malignant Fever. Dantrolene Sodium obstructs the calcium ions released, so muscular contraction is inhibited.
Throughout dose of Dantrolene Sodium can result in the reduction of:
- End-tidal carbon dioxide
- Cardiac functioning
- Muscular stiffness
5. Putting off ice packs:
For the reduction of the core temperature of the body, ice packs are placed in the following:
- Inguinal region
- Armpit (between the shoulder girdle and thorax)
- Neck region
6. Placing urinary catheter:
The urinary catheter is used to observe urine color after every hour.
7. Cleaning with ice:
A severe decrease occurs in the body’s temperature by cleaning the rectum and stomach with cool water.
Cleaning the bladder should not be performed because it can change the outcomes of urine evaluation by altering the urine’s condition.
8. Prevention of hypothermia:
Prevent the cooling procedures when the core temperature of the patient’s body is at 38 degrees or less than 38 degrees.
9. Provide diuretic drugs:
Diuretics are used to regulate urine flow. The most commonly used diuretics are:
In malignant Fever, myoglobin accumulates in the kidneys due to the destruction of muscular cells. It can affect urine flow. So, diuretics are referred to maintain urine flow.
10. Consult with health care providers for further help:
Healthcare providers can help you to recognize the dangers of malignant fevers and the procedures to prevent and cure malignant Fevers.
Home Care Mediations and Patient’s Guidance:
Much mediation is redesigned to use at home. Guidance of the patient and the family about the disease assists them in managing the disease according to the state. It would help to arrest the drawbacks of Fever.
Here we will discuss the guidance necessary to provide the patients and their families:
- Find out that the patient knows to use the thermometer or measuring instrument present at their home.
- Guide the patient and their family about the indications and signs of Fever. Assist them in recognition of the aspects that are concerning to the Fever.
- Guide them about the instant care of Fever at home. If they at outside, place the patient quickly in a darkened area if they are at outside.
- For immediate cooling, give the patient a cool or spongy bath.
- Guide the patient to observe the indications of Fever at the higher temperature outside.
- In the case of continuously high temperature of the body, you must feel a need to consult with your physician. In the older people notably. Because if they have a fever, they are suffering from an infection.
Some precautions to prevent the Fever:
- Reduce going outside
- Reduce the use of air conditioning or coolers
- Reduce the use of fans
- Drink excessive water
- Take more rest than usual
- Decrease taking a shower or bath
- Decrease exercises or physical activities
- In hot weather, wear lightweight and loose-fitting clothes.
- Use hats or caps in sunny weather
- Spend less time in sunny weather
Treatment of Fever:
Initially, treating the leading cause of Fever is more critical for treating Fever. If you treat the Fever but not the reason for the Fever, then your child will not be satisfied.
Keep an eye on the attitude and state of your child. If he is physically active, like his eating, drinking, and playing activities are normal, you do not need to treat the Fever. You have to observe your child because he will improve by himself.
Medicines that are used to treat Fever:
The frequently used and most effective medicines for the treatment of Fever are:
- Ibuprofen (Motrin and Advil)
- Acetaminophen (Tylenol)
These medicines are present in several forms:
- In liquid form (as syrup)
- In chewable form
- In powder form (dissolvable in fluid)
- In capsules or pills form.
Tylenol is also present as a suppository (tablets that are put into the rectum). It is used to stop vomiting in children.
How to use it?
The number of medicines that are taken for Fever:
- Acetaminophen (Tylenol) 5mg per kg(after every four hours for fever)
- Ibuprofen (Motrin/Advil) 10mg per kg(after every 6 hours as needed for fever)
Do not give ibuprofen to children less than 6 months aged. But if you want to give, then first consult the doctor. They will guide you in the accurate dosing for Fever.
You must follow the directions on the medicine pack about your child’s age and weight.
Treatment of Fever at home:
The care of Fever at home can also be helpful to your child to become healthier.
Here we discuss the precautions that can be taken at home:
- If your child suffers from a fever, you should wear him a light dress. And keep his room cold to feel better.
- If the water temperature is moderate (100 degrees Fahrenheit) and your child suffers from a 101-degree fever, he will feel this water cool.
- Place a bed sheet cooled by a cooler or refrigerator to feel them pleasant.
- Guide your child to drink an excess of water and to stay hydrated. The reason is that the Fever leads to a significant loss of body fluid. It results in dehydration.
Avoid doing this:
- Never provide aspirin to your child because it has several adverse effects. Those are mentioned below.
Aspirin leads to the following:
- Stomach disturbance
- Bleeding of intestines
- Liver and brain diseases (Reye syndrome)
- The most severe and adverse effect is Reye syndrome.
- Avoid rinsing your child by sponging. Because it causes trembling that results in an increase in body temperature.
- Do not use rubbing alcohol with a fever. The skin can absorb it, and its inhalation may lead to coma or death.
Fever Care Plan Conclusion:
Fever is an increase in the body’s core temperature (37ᴼC). Thermometers, thermoflash, and thermoscans can measure it. If the Fever is not treated well, it will lead to dehydration or heat strokes, etc. it can be treated by medications, nursing interventions or cooling measures, and home remedies.
If the body’s temperature is raised from 37ᴼC, this condition is called Fever. Several methods can treat it, like medications, prevention measures provided by nursing care, and home care.
Write a care plan for the Fever.
A proper meditation for a fever patient is:
- Lower the heat production of the body
- Heat loss of the body
- Maintenance and regulation of body functioning
- Increase the rest time
What are nursing recognitions for Fever?
A rise in the body’s core temperature is called Fever or pyrexia.
It can occur due to an alteration in the set point of the Hypothalamus. It is caused by inflammation or infectious diseases.
What are nursing medications for Fever?
Some nursing mediations are used to cure Fever:
- Use of cool water to lower the body temperature
- Take a sponge bath
- Use cooling blankets
- Prevent shivering
- Use excess fluid to maintain the body’s fluid balance
- Take proper rest.
What are the five main components of a nursing care plan?
These five components are:
What are the essential classifications of nursing interventions for Fever?
On a medical basis, nursing interventions are further divided into 7 classifications:
- Physiological complexes
- Physiological basic
- Health system
What are the usual nursing medications?
Some nursing mediations are:
- Proper medication
- Clinical care
- Proper nutrition
- Postpartum assistance
- Progressive recovery