Thermoregulation Lecture Notes PDF

# Thermoregulation - Thermoregulation is constantly maintaining a stable core body temperature - **Normothermia** (36.2°C-37.6°C) - **Hypothermia** (Below 36.2°C) - Mild (34 °C-36.2°C) - Moderate (30°C-34°C) - Severe (30°C) - **Hyperthermia** (Above 37.6°C-41.5°...

# Thermoregulation - Thermoregulation is constantly maintaining a stable core body temperature - **Normothermia** (36.2°C-37.6°C) - **Hypothermia** (Below 36.2°C) - Mild (34 °C-36.2°C) - Moderate (30°C-34°C) - Severe (30°C) - **Hyperthermia** (Above 37.6°C-41.5°C) - Hyperpyrexia is extremely high body temperature (41.5°C) - **Fever** is a rise in the body temperature due to a change in the hypothetical setpoint due to foreign antigens (e.g. pyrogens) - **Temperature Balance** (What are the factors/things that affect the body's heat production?) - **Basal Metabolic Rate** is the rate of energy the body uses to maintain essential activities such as breathing - Can either increase or decrease the body heat production - Metabolic rates decrease with age, the younger in age, the higher the metabolic rate - **Muscle Activity** (e.g. shivering) to produce heat - **Thyroxine Output** (hormone produced by the thyroid gland and is crucial in regulating metabolism) - Increase thyroxine levels is increased Epinephrine (hormone & neurotransmitter) - **Epinephrine, Norepinephrine and Sympathetic Stimulation/Stress Response** - Epinephrine and norepinephrine are hormones and neurotransmitters that increases the rate of metabolism and causes vasoconstriction that increases body temperature - **Fever** - What is the **Hypothalamus role?** - **Risk Factors?** - Age (old and very young) - Infants can't conserve heat, they don't shiver, they have a large body surface area, and low subcutaneous fat. Instead of having subcutaneous fat, they have brown fat (nonshivering thermoregulation- NST) - Homeless population - Financial status/issues - Mental health conditions - Individuals who work and play sports outside - **Prevention Strategies?** - **Hypothermia** - Wear appropriate clothing - Moisture wicking clothes - No alcohol consumption - Adequate nutrition - Helps with the metabolism of the body - **Hyperthermia** - No alcohol consumption - Wear sunscreen at least 30 SPF - Wear appropriate clothing (light colors) - **SCREEN FOR MALIGNANT HYPERTHERMIA** - **4 Methods of Heat Loss** - **Convection:** heat transfer from warm to cool air - **Conduction:** direct contact heat transfer from warm to cooler surface - **Radiation:** heat transfer from warm to cooler objects close by without direct contact - **Evaporation:** heat transfer from water droplets to vapor (sweat, baby getting out of the bath, etc.) - **Fahrenheit-Celsius Conversion Formula is F=1.8C+32** - **Clinical Judgment** ## The 6 functions of clinical judgment 1. **Recognize cues** 2. **Analyze cues** 3. **Prioritize hypotheses** 4. **Generate solutions** 5. **Take action** 6. **Evaluate outcomes** ## The Nursing Process 1. **Assessment** 2. **Analysis** 3. **Planning** 4. **Implementation** 5. **Evaluation** The Nursing Process: **ADPIE/AAPIE** (Assessment, Analyze Cues, Planning, implementing, Evaluation) ### Clinical judgment: - Recognize cues - Analyze cues - Prioritize hypotheses - Generate solutions - Evaluate outcomes ### Combining Clinical Judgment & Nursing Process - Assessment (Recognizing cues) - Analyze (Analyze cues) - Planning (Prioritize hypotheses) - Implementation (Generate solutions) - Evaluation (Take action & Evaluate outcomes) ## Hypothermia S/S and Interventions ### Mild (90°F to 95°F [32°C to 35°C])S/S - Shivering - Blood pressure increases (due to vasoconstriction and the blood is flowing to the central circulation/central part of the body (eg.heart, lungs, kidneys, liver)) - However, mild hypothermia can display as high and low blood pressure b/c as your blood volume starts to drop due to vasoconstriction and focusing on those central circulation/major organs, the blood volume in the periphery of your body (arms, hands, legs, feet) also drops; so, you may not be able to detect blood pressure As the body warms up, vasodilation of the periphery can cause Diuresis (all the blood from the peripheral/sides of the body is now being shunted back to the central/major organs and the blood is being filtered fast) - Need to be concerned about dehydration because now the individual has issues with controlling urination and is losing more fluid because the kidney may be overstimulated from the blood coming back from the peripheral to the central body - Increase in heart rate - Respirations elevated ### Interventions - Remove wet clothing - Warm blankets - Warm oral fluids ### Moderate (82.5°F to 90°F) [28°C to 32°C]) S/S - Altered Mental Status (Confused, Appear to be drunk, etc.) - Decreased clotting ability (caused by impaired platelet aggregation and thrombocytopenia) ### Interventions - Warm IV Fluids *Do not rewarm too quickly (could cause cardiac arrest and the body is not metabolizing as quickly when the body is cold; so when the body is warmed to **WARM THE CORE OF THE BODY FIRST!!!!** ### Severe (Below 82.4°F [28°C]) S/S - Severe hypotension (if you can attain a BP) - SPO2 drastically low (if detectable) - May lose extremities due to no blood flow to periphery (frostbite) ### Interventions - Remove Wet Clothing - Monitor urinary output w/ urinary catheter - Great indicator of perfusion, low urine output is indicative of low/bad perfusion Continue to attempt to resuscitate them until they are warm **They are not dead until they are warm and dead**