Nursing Care Plan For Fever

For a better understanding of nursing care plan for fever, let’s start with the very basic concept.

Read this article completely and carefully to master the nursing care plan for fever.

Definition

Fever is an abnormally high body temperature, usually accompanied by shivering, headache, and in severe instances, delirium.

Fever is a sign of disease and it is a protective function. Increase in the temperature prevents the growth of an organism causing disease. There is the destruction of bacteria through phagocytosis and producing immune bodies.

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Causes of Pyrexia/Fever

The possible causes can be infections, a disease of the nervous system, certain malignant neoplasm, blood diseases such as leukemia, embolism, and thrombosis. Heat stroke from exposure to the hot environment, dehydration, surgical trauma and crushing injuries, skin abnormalities that interfere with heat loss, allergic reactions to foreign protein sand pyogens can also be possible causes of pyrexia.

Types

  • Constant or continuous fever during which temperature varies not more than two degrees between morning and evening and does not reach normal for a period of days or weeks.
  • Intermittent or swinging or quotidian fever during which temperature rises from normal or subnormal to high fever and back at regular intervals. The interval may vary from a few hours to three days, usually, the temperature is higher in the evening than in the morning.
  • Remittent fever is a fever characterized by a variation of more than two-degree between morning and evening but does not reach back to normal.
  • Inverse fever: In this type, the highest range of temperature is recorded in the morning hours. And the lowest in the evening which is contrary to that found in the normal course of fever.
  • Relapsing fever is one in which there are brief febrile periods followed by one or more days of normal temperature.
  • Irregular fever:  When fever is entirely irregular in its course it is called irregular fever.
  • Sustained fever: Constant body temperature, continuously above 38 degrees (C). Or 100.4 degree (F). That demonstrates little fluctuation.
  • Crisis: Crisis is a sudden return to a normal temperature from a very high temperature within a few hours.

Defense Mechanisms Against Pyrexia

Body defends against pyrexia in a variety of ways. Like the body enhances the body’s immune system by stimulating W.B.C. production. Increased temperature reduces the content of iron in blood plasma thus suppressing the growth of bacteria. Fever also fights against viral infection by stimulating interferon ( body’s natural virus-fighting substance) Fever result from an alteration in the hypothalamus.

Hormones promote the body defense against infection, Inducing febrile episode. The body produces and conserves heat and therefore person experiences chill, shivering, and cold. Skin becomes warm and flushed because of the vasodilatation. Body is unable to promote heat loss or reduce heat production

Nursing Care

Objectives

To increase heat loss, reduce heat production, prevent complication, promoting balance between heat production and heat loss.

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Assessment

Obtain frequent temperature readings, assess for contributing factors such as dehydration, infection and environmental temperature. Identify physiological response to fever, obtain all vital signs, assess skin color and temperature, assess for the presence of thirst and malaise.

Assess clients comfort and wellbeing, observe for shivering and diaphoresis.

Nursing Intervention

Minimize heat production, reduce the sequence of activities that increase oxygen demand, such as excessive turning and ambulation, allow rest period, and limit physical activity. Maximize heat loss and minimize external covering on clients body, keep clothing and bed linen dry, prevent the patient from getting draughts. Expose the patient to cool air by an electric fan. Maximize heat loss by administration of cold drinks, application of cold compress and ice bags. Cold sponging and cold packs also increase heat loss. Application of cold bath and usage of hypothermic blanket also helps a lot.

Prevent shivering because shivering increases metabolic activities such as produces heat, increased oxygen demand, and circulation. It may also cause hyperventilation and respiratory alkalosis.

Promote client comfort, encourage oral hygiene and prevent dehydration. Control the temperature of the environment because it helps to maintain the normal body temperature. Provide complete rest to the client. The clothing should be light, loose, smooth, cotton, and non-irritating. Satisfy supplement for increased metabolic rate, and provide supplemental oxygen therapy

Encourage patient to take plenty of fluid, maintain intake out Butchart, provide small frequent feeds and make food palatable. Plenty of fluid and fruits will help to evacuate bowel regularly. Maintenance of personal hygiene, frequent mouth care is also important.

Safety of Patient

Never leave a patient alone because rigor and convulsions may occur at any time. Constant observation important. Evaluate urine output periodically.

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RIGOR

Rigor is a severe attack of shivering which may occur at the onset of disease characterized by a rise in temperature.

At the first stage, also called the cold stage, patient shivers uncontrollably and the skin is cold. Faceis pinched and pale, the pulse is feeble and rapid. Temperature rises rapidly to 103-degree (F). Therefore the patient will feel cold.

At the second stage, also called a hot stage, during which the patient becomes uncomfortably hot. His skin is very hot and dry. The patient will complain of an extreme thirst and headache and the shivering stops.

At the third stage, also called the sweating stage, during which the patient begins to sweat profusely, temperature decreases, the pulse rate also decreases, and thus pulse rate subsidies, discomfort also subsides, the patient may go into a state of shock and collapse, if not cared properly.

Care of Patient With Rigor

The patient suffering from rigor should never be left alone because rigor and convulsions may occur at any time. First stage care- during shivering attack he should be given hot drinks and have a blanket put around him until he feels warm. Apply warmth with a hot water bag because we want to increase the body temperature.

Give tepid sponging. it is important to observe carefully for first signs of swatting. Remove all blankets and hot appliances.

NURSING CARE OF PATIENT WITH HYPOTHERMIA

The patient is rewarmed by placing him in a warm room, with warm blankets and drinks thus increasing the body temperature. Prevent a further decrease in body temperature by removing wet clothes and replacing them with a dry cloth because it helps to increase body temperature. If possible give hot liquids such as soup, and most importantly avoid alcohol and caffeinated fluid because they affect blood pressure. Keep the head covered.

Nursing Care Plan For Fever

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