Precise guide for DGNM, B.Sc Nursing & M.Sc Nursing Students .. regarding fever, and its management. Highly recommended for II B.Sc Nursing Students

1. FEVER
Mr. Aby Thankachan, M.Sc(N), PGDSH
Senior Tutor
Dept. of Medical Surgical Nursing
KMCH Con, Coimbatore

2. Heat production
• Heat is produced in the body through metabolism.
• The main heat production organs of the body are liver
and skeletal muscles.
• Heat production occurs during rest, voluntary
movements, involuntary shivering, and nonshivering
thermogenesis(brown adipose).

3. Heat loss
Heat is lost through physical mode. The main heat loss part
of the body is skin. (70%) (R29%,elimination1%)
• Radiation
• Conduction
• Convection
• Evaporation

5. DEFINITION OF PYREXIA
 When body temperature rises
above 99 degree f.or 37 degree
c. It is called pyrexia or fever.

6. CAUSES OF PYREXIA
 Infection
 Disease of nervous system
 Certain malignant neoplasm
 Blood diseases such as
leukaemia,embolism, and
thrombosis.

7. CAUSES OF PYREXIA
 Heat strok from exposure to hot
environment
 Dehydration
 Surgical trauma and crushing injuries
 Skin abnormalities that interfer with
heat loss
 Allergic reaction to foreign proteins
and pyogens.

8. THPES OF PYREXIA
 Constant pyrexia or continuous
fever- there is temperature
varies not more than two
degrees between morning and
evening and does not reach
normal for a period of days or
weeks.

9. INTERMITTENT PYREXIA OR QUOTIDIAN
FEVER OR SWINGING PYREXIA OR
HECTIC PYREXIA
 Temperature rises from normal or
subnormal to high fever and back at
regular intervals.
 The interval may vary from few hours
to three days,usually temperature is
higher in the evening than in the
morning.

10. REMITTENT FEVER
 Remittent fever is a fever
characterized by variation of
more than two degree between
morning and evening but does
not reach normal

11. 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.

12. RELAPSING FEVER
 Relapsing fever is one in which
there are brief febrile periods
followed by one or more days of
normal temperature.

13. IRREGULAR FEVER-
 When fever is entirely irregular
in its course it is called irregular
fever.

14. SUSTAINED FEVER
 Constant body temperature
.Continuously above 38 degree
c. Or 100.4 degree f. That
demonstrate little fluctuation.

15. TERMS USED TO DESCRIBE
PHASES OF FEVER
 on set or invasion- it is period
when body temperature is rising.
 fastigium or stadium- of fever is
the period when the body
temperature has reached its
maximum and remains fairly
constant at a high level.

16. TERMS USED TO DESCRIBE
PHASES OF FEVER
 Defervescence or decline-
period when the elevvated
temperarure is returing to
normal. The fever may subside
suddenly or gradually.

17. CRISIS
 Crisis is a sudden return to
normal temperature from a very
high temperature with in a few
hours or days. Crisis is divided
into true crisis and false crisis.

18. DEFENCE MECHANISM OF
PYREXIA
 Enhances body immune system
by stimulating w.B.C. Production
 Increased temperature reduces
the content of iron in blood
plasma
 Suppressing the growth of
bacteria

19. DEFENCE MECHANISM OF
PYREXIA
 Fever fights again viral infection
by stimulating interferon ( body’s
natural virus fighting substance
 Fever result from an alteration in
hypothalamus

20. DEFENCE MECHANISM OF
PYREXIA
 Hormones promote the body’s
defence against infection
 Induced febrile episode
 Body produces and conserves
heat
 Person experiences
chill,shivering, and cold

21. DEFENCE MECHANISM OF
PYREXIA
 Skin becomes warm and flushed
because of vasodilatation
 Body’s inability to promote heat
loss or reduce heat production

22. DEFENCE MECHANISM OF
PYREXIA
 Fever is sign of disease
 It is protective function
 Increase in the temperature prevents
growth of organism causing disease
 There is destruction of bacteria
through phagocytosis and producing
immune bodies.

23. NURSING CARE OF
PATIENT WITH PYREXIA
NURSING INTERVENTION OF
FEVER-
 1) minimize heat production- reduce
the frequency of activities that
increases oxygen demand,such as
excessive turing and ambulation,
allow rest period, limit physical
activity.

24. NURSING CARE OF
PATIENT WITH PYREXIA
NURSING INTERVENTION OF
FEVER-
 Maximize heat loss-minimize
external covering on clients body,
keep clothing and bed linen
dry,prevent patient from gettting
draughts.Expose patient to cool air
by an electical fan

25. NURSING CARE OF
PATIENT WITH PYREXIA
NURSING INTERVENTION OF
FEVER-
Maximize heat loss-
Administation of cool drinks
Application of cold compress and ice
bags
Cold sponging and cold packs.
Cold bath
Use of hypothermic blanket

26. NURSING CARE OF
PATIENT WITH PYREXIA
Satisty supplement for increased
metabolic rate- provide supplemental
oxygen therapy .
Replace fluid lost
Provide high caloric diet- because
oxygen consumtion in body tissues
increases.
Diet should be easily digestible and
palatable
Fluid intake upto3000ml.

27. NURSING CARE OF
PATIENT WITH PYREXIA
Encourage patient to take plenty
of fluid.
Maintain intake out put
chart.Provide small frequent
feeds.Make food
palatable.Plenty of fluid and
fruits will help to evacuate bowel
regularly.

28. NURSING CARE OF
PATIENT WITH PYREXIA
Maintenance of personal hygiene—
Frequent mouth care
Care of skin and pressure points.
Give sponge bath daily.If temperature
remains high cold sponging is given
to bring down the temperature.

29. HYPOTHERMIA
If the temperature falls below 95
degree f. Or 35 degree c. The
condition is called hypothermia.

30. NURSING CARE OF PATIENT
WITH HYPOTHERMIA.
patient is rewarmed by placing him in a
warm room, with warm blankets and
drinks. prevent a further decrease in
body temperature removing wet
clthes, replacing them with dry
cloth.if possible give hot liquids such
as soup.avoid alcohol and
caffeinated fluid . keep the head
covered.