Fever

Question 1

Fever

Answer 1

Term used to describe an increase in body temp above the normal (37C).
Monitoring of body temp is commonly used to determine the presence of infection.

Question 2

Fever of known origin

Answer 2

Described as a body temp above 38.3 on several occasions for over three weeks without an apparent cause despite extensive investigation in pts without neutropenia or immunosuppression.

Question 3

Post operative fever

Answer 3

Most often noninfectious

Non infectious causes:
* Atelectasis
* Increased basal metabolic rate (d/t stress on the body)
* Dehydration
* Drug reactions

Increasing lung inflation by turning, coughing, deep breathing and IS use helps to increase lung expansion–decreased lung expansion is a major cause of postop fever (atelectasis)

Question 4

Infectious causes of post op fever

Answer 4

• Usually accompanied by subjective complaints and a WBC elevation with left shift (bandemia– increase immature WBC)
• A WBC elevation over 30,000 is NOT usually due to infection rather heme or onc related like leukemia.
• Surgical incisions
• IV sites
• Point of entry for any catheter
• Urinary tract
• Lungs
• Sinusitis (NG tubes)
• Abscess

Question 5

Initial treatment of post op fever

Answer 5

In the absence of any indication of an infection, the first response should include hydration and measures to expand lung inflation.

Question 6

Treatment of infectious post op fever

Answer 6

• Supportive fluid therapy and tylenol
• Treat the apparent underlying source
• Gram stain and culture and sensitivity all invasive lines or catheters as indicated.