Thermoregulation

Question 1

core temperature regulated by…

Answer 1

hypothalamus/preoptic area

Question 2

3 processes that regulate temperature

Answer 2

shivering - increase temp

sweating - decreases temp

vasoconstriction - increase temp/conserve heat

Question 3

3 main parts for body temperature regulation

Answer 3

• sensors
• hypothalamus
• effector system

Question 4

where are the most sensors for temp regulation located in the body?

Answer 4

skin

-more for cold than warmth

Question 5

Factors for affecting heat production

Answer 5

• BMR
• Muscle activity
• thyroxine output
• fever
• epinephrine, norepinephrine, stress response

Question 6

BMR

Answer 6

minimal amount of energy to sustain vital processes; changes throughout the day

Question 7

muscle activity

Answer 7

increases BMR; muscles burn energy at rest

Question 8

thyroxine output

Answer 8

hormone release by thyroid; metabolism

Question 9

fever

Answer 9

raises BMR, therefore…heat

Question 10

4 heat transfer processes

Answer 10

• radiation
• conduction
• convection
• evaporation

Question 11

radiation

Answer 11

NO physical contact

heat transfer through electromagnetic waves

Ex: sunlight, warming hands by fire

Question 12

conduction

Answer 12

transfer heat through direct touch

PHYSICAL CONTACT

Question 13

convection

Answer 13

heat transfer in gas or liquid

Ex: hot air balloon

Question 14

evaportation

Answer 14

liquid changes to a gas;

Ex: sweat evaporating on skin, boiling kettle of water

Question 15

febrile response phases

Answer 15

chill and flush

Question 16

chill phase

Answer 16

body warms itself to raise core temp to new set point.

-warms itself by peripheral vasoconstriction, shivering, warmth-seeking behaviors

“brain sets thermostat to high temp to inhibit growth - now the body does the work to get it there.”

Question 17

flush phase

Answer 17

body cools itself

-cools itself by peripheral vasodilation, sweating, cool-seeking behavior

“brain sets thermostat to lower temp to return to homeostasis - now the body has to do the work to lower temp”

Question 18

benefits of fever

Answer 18

• protective mechanism
• enhances neutrophils & t-lymphocytes
• slows growth of bacteria and viruses
• may slow growth of certain tumors
• may act synergistically with penicillin
• early exposure to fevers caused by infections may protect children from asthma, allergies, and cancer in adulthood

Question 19

neutrophils

Answer 19

WBC that fights bacteria

Question 20

t-lymphoctyes

Answer 20

WBC that fights viruses

Question 21

hyperthermia

Answer 21

• body temp increases uncontrollably
• brain damage and death can occur
• delirium, convulsions, coma
• heat stroke/heat exhaustion
• may be due to neurological impairment/brain injury

Question 22

malignant hyperthermia

Answer 22

rare response to anesthesia, can be deadly or inherited

-can be screened for genetic risk

Question 23

hypothermia

Answer 23

excessive loss of heat

-inadequate heat protection, impaired hypothalamic thermoregulation, vasoconstriction and tissue ischemia

Question 24

vasoconstriction for extended period of time….

Answer 24

ischemia or gangrene

Question 25

fever is controlled by...

Answer 25

hypothalamus

Question 26

fever and death/brain damage...

Answer 26

fever very rarely causes brain damage or death. however it can adversely affect critically ill patients

Question 27

antipyretics

Answer 27

used to prevent or reduce fever.

Question 28

Types of antipyretics

Answer 28

- acetaminophen - ibuprofen - naproxen - aspirin

Question 29

acetaminophen

Answer 29

tylenol, tempra - acts on hypothalamus by peripheral dilation - liver damage with overdose - can be given q4-6 hrs - use with caution in liver disease

Question 30

ibuprofen

Answer 30

advil, motrin - NSAIDs - inhibits prostaglandin - q6-8 hrs OVER 6 mths of age - use with caution with kidney disease

Question 31

naproxen

Answer 31

- NSAID | - over the age of 12

Question 32

aspirin

Answer 32

- ASA - inhibits prostaglandin - NEVER to a child (linked to Reye Syndrome)

Question 33

newborn and thermoregulation

Answer 33

- less SubQ fat - blood vessels closer to surface - brown adipose fat - premies have less brown adipose fat

Question 34

brown adipose fat

Answer 34

non-shivering thermogenesis

Question 35

children and thermoregulation

Answer 35

handle high temps well if healthy

Question 36

elderly

Answer 36

- less SubQ fat - less active - sensitive to extremes in environment temp - thermoregulation not as efficient

Question 37

Types of Temperature Assessments

Answer 37

- mouth/oral - rectum - axillary - tympanic membrane (ear) - temporal artery

Question 38

mouth/oral temp assessment

Answer 38

PRO: -accessible, convenient CON: - can break - inaccurate if ingested cold/hot liquid or smoked - could injure mouth after oral surgery

Question 39

rectum temp assessment

Answer 39

PRO: -reliable measurement CON: - inconvenient, unpleasant - difficult if patient can't turn on side - stool may interfere - may be contraindicated in clients with cardiac problems

Question 40

axillary temp assessment

Answer 40

PRO: -safe and noninvasive CON: must be left in place for a long time

Question 41

tympanic membrane

Answer 41

``` (ear) PRO: -readily accessible -reflects core temp -very fast -less scary for kids ``` CON: - can be uncomfortable - involves risk of injuring membrane - repeated measurements can vary - R/L can differ - presence of cerumen can affect reading

Question 42

temporal artery

Answer 42

PRO: - safe and noninvasive - very fast - less scary for children CON: - requires electronic equipment that may be expensive or unavailable - variation in technique is needed if client has perspiration on forehead

Question 43

Culture & fever

Answer 43

- ethnic differences in parental management of fever | - fever phobia in many cultures, ethnic groups

Question 44

hispanics and fever...

Answer 44

more likely to believe fever can cause brain damage and death

Question 45

African Americans and fever...

Answer 45

more likely to over treat with ibuprofen and more concerned about febrile seizures