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What is the body temperature above which heat stroke is considered a life-threatening condition?
What is the body temperature above which heat stroke is considered a life-threatening condition?
During the onset phase of febrile illness, which of the following symptoms is NOT typically present?
During the onset phase of febrile illness, which of the following symptoms is NOT typically present?
Which of the following is a manifestation of the course phase of febrile illness?
Which of the following is a manifestation of the course phase of febrile illness?
What is the primary mechanism of hypothermia?
What is the primary mechanism of hypothermia?
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During the defervescence phase of febrile illness, which of the following symptoms is typically present?
During the defervescence phase of febrile illness, which of the following symptoms is typically present?
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What is the primary goal of fever management?
What is the primary goal of fever management?
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Which of the following is a characteristic of heat stroke?
Which of the following is a characteristic of heat stroke?
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What is a common complication of prolonged fever?
What is a common complication of prolonged fever?
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What is the normal range of body temperature?
What is the normal range of body temperature?
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What is the term for a body temperature above the normal range?
What is the term for a body temperature above the normal range?
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What is the term for an extremely high body temperature?
What is the term for an extremely high body temperature?
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What type of fever is characterized by a body temperature that alternates at regular intervals between periods of fever and periods of normal or subnormal temperature?
What type of fever is characterized by a body temperature that alternates at regular intervals between periods of fever and periods of normal or subnormal temperature?
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What is the term for a condition that is the result of excessive heat and dehydration?
What is the term for a condition that is the result of excessive heat and dehydration?
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What is the term for a temperature that rises to fever level rapidly following a normal temperature and then returns to normal temperature within a few hours?
What is the term for a temperature that rises to fever level rapidly following a normal temperature and then returns to normal temperature within a few hours?
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What is the term for a body temperature less than 36°C?
What is the term for a body temperature less than 36°C?
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Progesterone can raise body temperature by about how much above basal temperature?
Progesterone can raise body temperature by about how much above basal temperature?
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What is a common clinical manifestation of hypothermia?
What is a common clinical manifestation of hypothermia?
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Which of the following nursing interventions is NOT suitable for a client with hypothermia?
Which of the following nursing interventions is NOT suitable for a client with hypothermia?
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What is the most convenient site for measuring body temperature?
What is the most convenient site for measuring body temperature?
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What is a disadvantage of using the rectal site for measuring body temperature?
What is a disadvantage of using the rectal site for measuring body temperature?
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What is a common clinical manifestation of hypothermia in the early stages?
What is a common clinical manifestation of hypothermia in the early stages?
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Which of the following is NOT a sign of hypothermia?
Which of the following is NOT a sign of hypothermia?
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What is the primary goal of nursing interventions for a client with hypothermia?
What is the primary goal of nursing interventions for a client with hypothermia?
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What is an advantage of using the tympanic membrane site for measuring body temperature?
What is an advantage of using the tympanic membrane site for measuring body temperature?
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What is the average body temperature of an adult when measured orally?
What is the average body temperature of an adult when measured orally?
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What is the term for breathing that involves the contraction and relaxation of the diaphragm?
What is the term for breathing that involves the contraction and relaxation of the diaphragm?
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What is the term for a pulse with an irregular rhythm?
What is the term for a pulse with an irregular rhythm?
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What is the term for elevated body temperature?
What is the term for elevated body temperature?
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What is the term for a life-threatening condition with a body temperature greater than 41°C (106°F)?
What is the term for a life-threatening condition with a body temperature greater than 41°C (106°F)?
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What is the term for an extremely high body temperature?
What is the term for an extremely high body temperature?
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What is the term for the process of turning from liquid into vapour?
What is the term for the process of turning from liquid into vapour?
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What is the term for abnormally high blood pressure?
What is the term for abnormally high blood pressure?
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What is the primary mechanism by which the body loses heat through conduction?
What is the primary mechanism by which the body loses heat through conduction?
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Which hormone immediately increases the rate of cellular metabolism in many body tissues?
Which hormone immediately increases the rate of cellular metabolism in many body tissues?
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What is the term for the continuous and unnoticed water loss from the body?
What is the term for the continuous and unnoticed water loss from the body?
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What is the role of the hypothalamus in regulating body temperature?
What is the role of the hypothalamus in regulating body temperature?
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What is the primary mechanism by which the body loses heat through radiation?
What is the primary mechanism by which the body loses heat through radiation?
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Which of the following increases the body's heat production?
Which of the following increases the body's heat production?
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What is the term for the heat loss accompanying insensible water loss?
What is the term for the heat loss accompanying insensible water loss?
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What is the role of thyroxine in the body's heat production?
What is the role of thyroxine in the body's heat production?
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Study Notes
Heat Stroke and Febrile
- Heat stroke: a life-threatening condition with a body temperature greater than 41°C (106°F)
- Clinical manifestations of febrile (fever):
- Onset (cold/chill phase): • Increased heart rate • Increased respiratory rate and depth • Shivering • Pallid (pale), cold skin • Complaints of feeling cold • Cyanotic nail beds • “Gooseflesh” appearance of the skin • Cessation of sweating
- Course (plateau phase): • Absence of chills • Skin that feels warm • Photosensitivity • Glassy-eyed appearance • Increased pulse and RR • Increased thirst • Mild to severe dehydration • Drowsiness, restlessness, delirium, convulsions • Herpetic lesions of the mouth (ulcers) • Loss of appetite (if the fever is prolonged) • Malaise, weakness, aching muscle
- Defervescence (fever abatement/flush phase): • Skin that appears flushed and feels warm • Sweating • Decreased shivering • Possible dehydration
Hypothermia
- Hypothermia: a core body temperature below the lower limit of normal
- Physiological mechanisms of hypothermia: • Excessive heat loss • Inadequate heat production to counteract heat loss • Impaired hypothalamic thermoregulation
- Clinical manifestations of hypothermia: • Decreased body temperature, pulse, respiration • Severe shivering (initially) • Feelings of cold and chills • Pale, cool, waxy skin • Frostbite (discolored, blistered nose, fingers, toes) • Hypotension • Decreased urinary output • Lack of muscle coordination • Disorientation • Drowsiness progressing to coma
Nursing Interventions
- For clients with fever: • None mentioned
- For clients with hypothermia: • Provide a warm environment • Provide dry clothing • Apply warm blankets • Keep limbs close to body • Cover the client’s scalp with a cap or turban • Supply warm oral or intravenous fluid • Apply warming pads
Assessing Body Temperature
- Common sites for measuring body temperature: • Oral • Rectal • Axillary • Tympanic membrane • Skin/temporal artery
- Advantages and disadvantages of sites used for body temperature measurement:
• Oral:
- Accessible and convenient
- Disadvantages: thermometers can break if bitten, inaccurate if client has just ingested hot or cold food or fluid or smoked, could injure the mouth following oral surgery • Rectal:
- Reliable measurement
- Disadvantages: inconvenient and more unpleasant for client, difficult for client who cannot turn to the side, could injure the rectum, presence of stool may interfere with thermometer placement • Axillary:
- Safe and noninvasive
- Disadvantages: thermometer may need to be left in place for a long time to obtain an accurate measurement • Tympanic membrane:
- Readily accessible, reflects the core temperature, very fast
- Disadvantages: can be uncomfortable, involves risk of injuring the membrane if the probe is inserted too far, repeated measurements may vary
Factors Affecting Body Temperature
- 5 factors that affect body temperature: • Progesterone: raises body temperature by about 0.3°C to 0.6°C above basal temperature • Stress stimulation: stimulation of the sympathetic nervous system can increase the production of epinephrine and norepinephrine, thereby increasing metabolic activity and heat production • Environment: extremes in the environment temperature can affect a person’s temperature regulatory system • Basal metabolic rate (BMR): the rate of energy utilization in the body required to maintain essential activities such as breathing • Muscle activity: including shivering, increases the metabolic rate
Alterations in Body Temperature
- Normal range: 36°C – 37.2°C
- Abnormal alterations in body temperature: • Pyrexia/hyperthermia/fever/febrile: 38°C • Hyperpyrexia: 41°C • Hypothermia: less than 36°C
Types of Fever
- 4 common types of fever: • Intermittent fever: a body temperature that alternates at regular intervals between periods of fever and periods of normal or subnormal temperature • Remittent fever: the occurrence of a wide range of temperature fluctuations, more than 2°C (3.6°F) over a 24-hour period, all of which are above normal • Relapsing fever: the occurrence of short febrile periods of a few days interspersed with periods of 1 or 2 days of normal temperature • Constant fever: a state in which the body temperature fluctuates minimally but always remains above normal • Fever spike: a temperature that rises to fever level rapidly following a normal temperature and then returns to normal temperature within a few hours • Heat exhaustion: a condition that is the result of excessive heat and dehydration
Regulation of Body Temperature
- The system that regulates body temperature: • Sensors in the periphery and in the core • An integrator in the hypothalamus
- Heat loss from the body:
• Radiation: the transfer of heat from the surface of one object to the surface of another without contact between two objects, mostly in the form of infrared rays
• Conduction: the transfer of heat from one molecule to a molecule of lower temperature
• Convection: the dispersion of heat by air currents
• Evaporation: continuous vaporization of moisture from the respiratory tract and from the mucosa of the mouth and from the skin
- Insensible water loss: continuous and unnoticed water loss
- Insensible heat loss: accompanying heat loss
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Description
Identify the clinical manifestations of febrile illness, including onset symptoms such as increased heart rate and shivering. Learn to recognize the signs of heat stroke and fever.
