Fever Flashcards

Question

what is bold standard for measuring body temp

Answer 1

- rectal: consistenyl estimates core body temp CI: recent anorectal surgery, injury, pathology, premature infants, severe hemorrhoids - can produce BM in infants

Answer 2

CI: lethargy, confusion, when nasal breathing is difficult - wait over 10 min after oral cavity has been heated or cooled (after smoking, or ice cream)

Answer 3

- alternative to rectal and roal methods: convenient, noninvasive, quick ( \<2 sec) - dec accuracy with inproper palcement; expensive - COP does not reccomend t for less than 2 y/o (others say less than 6 months) ^bc ear canal not large enough for daimeteer -\> cant get reading in

Answer 4

Non contact * alternative to rectal and oral method * convenient and non invasive, quick * prone to error Axillary * unreliable and elast accurace -\> used to screen for fever * acessible, safe, less, frightening * affected by hypotension, cutaneous vasodilation, prior cooling of patient * ust be helf under armpit for up to 5 min Temp strips * contain liq crystals that register temp by changing colours * nor accurate and not reccommended for temp measurement

Answer 5

digital probe

Answer 6

- analyze ifno collected and identify any real or potential **drug therapy problems** \*medications need to be **I**ndicated, **e**ffective **s**afe and something they can **a**dhere to \*look for red flags \*most feveres are self limiting but can cause a lot of discomfort, could indicate underlying pathologic condition that required prompt medical evaluation

Answer 7

Age \< 3 months - Presence of stiff neck (pot meningitis), seizure, localizedpain, redness, swelling or heat - New wheeze/cough - Recent cancer therapy (could be caused by the agent) - Child appearing very ill, excessively fussy, irritable, crying inconsolably or other symptom(s) worrying theparents/caregivers (e.g., difficult to rouse, confused or delirious)

Answer 8

- Age 3-6 months (esp if not fully vaccinated) - High fever - Persistent wheeze/cough - New onset rash and fever - Dehydration/vomiting (if serious could have suke in fontanel, tearless crying, ask colour of urine of child) - Recent surgery or dental procedure - Recent travel (pot food poisoning) - Recent consumption of raw or undercooked meat or fish - Recent initiation of new medication - Fever has not resolved after 72 h

Answer 9

Fever lasting 3 days or less, fever less than 40.5 and no red flags present \*must have all 3 of these

Answer 10

- Fever is usually benign andself-limited - Fever is an important defensemechanism that enhances theimmune system - The possible elimination of avaluable diagnostic or prognostic sign - Possible AE’s of antipyretic medications

Answer 11

Enhanced QOL: relieve symptoms associated with fever that may cause substantial discomfort - Treatment of fever does little harm and has not been shown to clinically alter the course of common bacterial and viral infections

Answer 12

treat the child not the number - a child w/ fever temp but not presenting symptoms would not really be candidate for OTC whereas somebody with a lower fever but really presenting symptoms would

Answer 13

- revove excess clothing/ bedding - inc fluid intake (inc clear fluid by 1-2 oz/hour or 2-4 oz/hour if adult) - avoid physical exertion maintain ambient temp at 20-21 C - sponde with tepid/cold water (ONLY if give medication to lower set point because this will only decrease the skin temp. if you do this without giving an antipyretic they will feel hotter because their body is trying to compensate more) - apple ice packs or cooling blankets (again same as above)

Answer 14

1. Dose: * Child: 10-15 mg/kg q4-6h PRN * Adult: 1000mg 2. Max daily dose * neonates 60 mg/kg * older infants/children 75 mg/kg \*5 doses in a day * adult: 4000 mg 3. Onset * \<1 hr 4. TIme to peak effects * 2-4 hr 5. Duration of effect * for pain & fever: 4-6 hr 6. Adverse effects * uncommon with infrequent and recommended self care dose 7. Other info/concerns * \*\*Acetaminophen is leading cause of acute liver failture * hepetotoxicity in acute overdose or w/ therapeutic doses in certain conditions: chronic alc use (\> 3 drinks/day, malnutrition, concurrent use of drugs inducing CYP450 enzymes

Answer 15

1. Dose * child: 5-10 mg/kg q6-8h prn * adult: 400 2. Max daily dose * child: 40 mg/lg * adult: 1200 3. Onset: * \<1 hr 4. Time to peak effect * 2-4 hours 5. Duration of effect * pain: 406 hr, fever 6-8 hr 6. Adv effects * Uncommon with infrequent use and recommended self care dose 7. Other info/concerns: * CVD: hypertension * HI: dyspepsia, abdominal pain, nephrotoxicity in children with: pre-existing renal disease, dehydration, concurrent nephrotoxic agents \*\*if you gave ibuprofen to a dehydrated chld they can get renal failure

Answer 16

- combination of 325 mg acetaminophen and 97.5 mg ibuprofen \*inly indicated in adults and not yet indicated for fever

Answer 17

- block cyclooygenases which stop prostaglandind from being rpoduced both centrally and in periphery - acetaminophen MOA not well understood - not an NSAID and deos NOT stop prostaglandin synthesis peripherally, but does work as a cyclooxygnase inhibitor

Answer 18

1. Dose * Children 12 years and older: 220 mg q8-12h * adults: same 2. Max daily dose * 440 mg (self care) 3. Onset 1. \<1 hr 4. Duration of effect: * 7-12 hr 5. Adverse effects * dyspepsia, NV, abdominal pain, dizziness, headache 6. Other info/concerns * avoid use in fever for \<12 years of age * nephrotoxicity in children with pre exisitng renal disease, dehydration, nephrotoxic agents, CVD

Answer 19

* ONLY for adults \*dont give to children bc of Reyes \*only treats pain? ask 1. Dose * 325-650 mg q4-6 h 2. Max daily dose * 4000 mg 3. Onset * \<1 hr 4. Duration of effect * 4-6 hr 5. Adverse effects: 1. Dyspepsia, tinnitus, plateley dysfunction, GI mucosal damage 6. Other info/concerns * avoid in \< 18 bc those with viral illness may get Reyes syndrome * avoid in pat with renal failure, peptidic ulcer disease, heart failure and ASA sensitive asthma *

Answer 20

\* infrant drop = **80 mg/mL** childrens liquid =**160mg/5mL** (32 mg/mL) \*caused a lot of unintended overdosing

Answer 21

- basically equal efficacy - acetaminophen for a while was 1st choide becuase had more safety data, now have lots for both - ibuprofen may be more efefctive in treating fever: some evidence that it lowers temp faster and for longer duration - inbuprofen also seems better at reducing "distress" in treatment of fever in children - ibuprofen also seems to be better with respect ot temp control within 4 hours of first dose

Answer 22

- combo antipyretics dont work faster but are longer acting in the first 24 hours - canadian piediatric says: adding acetaminophen (paracetamol) to ibuprofen does not reduce fever faster than ibuprofe alone in children. Over 24 h children receieving the combo spend 2.5 - 4.4 hours without fever than children who took either drug alone \* AAP and CPS do NOT recommend because: risk of overdose, risk of dosing errors and inc adv effects - insufficient evidence to show combo therapy is effective in improving overall comfort level - it is okay to initate treatment with one but then switch fully to the toher if parients fever does not respond well to initial agent

Answer 23

\* fi ahve them is grounds for referral - occur once within first 24 hours period in febrile child with no underlying neurological history of infection - incidence: 2-5% of febrile episodes n children aged 6 months -5 years - neurological damage or permanent seizure disorders are RARE \*antipyretics often recommended for children in this age group, no role for anticonvulsants \*given an antipyretic at 1st sign of fever MAY prevent recurrent febrile seizures

Answer 24

1. Address medication and health related problems 2. initiate, modify, disc or administer mediation therapy 3. proivde education and self management training 4. contribute to coordination of care 5. schedule follow up care as needed to achieve goals of therapy

Answer 25

- if not providing mediaction, explain expceted source of illness and outline red flags that would necessitate reassessment - explain how to optimally take med (calc amount for them, say shake well if susp, throw out dosing cup and give syringe) - discuss how to manage issues that amy arise - eucate on implementarion of diet, exercise, other lifestyle changes - provide tools to empower the patient to become advocate for theri health

Answer 26

S: Signifiacne of acetaminophen toxicity "well tolerated but if you take too much can get liver damage" A: Limit alcohol consumption \*again heptotoxicity F: find all sources of acetaminophen in regimen \*acetaminophen is in 470 products, make sure ntohing else taking ahs it E: avoid exceeding the max daily dose \*acet overdoses accounts for ~50% of all cases of acute liver failure

Answer 27

- inform that it will take 72 H to get over it tell them what temperature to watch out for - only should really be testing temp 2-3 x/day

Answer 28

* Fever Reduction * desired outcome = temp reduction * should change after otc in 1-2 h * minotor max 2-3 times a day, if child acting fine dont worry too much * Discomfort * desired outcome = 50% reduction * time frame for chane = 2-3 hours after OTC * monitor daily * Side effects * desired outcome = none * could happen thoguhout course of therapy -\> minitor daily \*Rph to follow up 2-3 days

Fever Flashcards

(54 cards)