Health Assessment: Fever

1. Continuing Assessment: FEVER

2. Body Temperature - The balance
between the heat produced by the body
and the heat lost from the body
Hypothalamus – the heat regulating
center of the body

3. TYPES OF BODY TEMPERATURE
• Core Temperature – temperature of the deep
tissues of the body. Measured by taking oral and
rectal temperature
• Surface Temperature – temperature of the skin,
subcutaneous tissue, and fat. Measured by
taking axillary temperature

4. Processes Involved in Heat Loss:
1. Radiation – transfer of heat from the surface
of one object to the surface of another without
contact between two objects
Ex: It feels warm in a crowded room.
2. Conduction – transfer of heat from one
surface to another. It requires temperature
difference between the two surfaces
Ex: Application of moist wash cloth over skin

5. 3. Convection – the dissipation of heat by air
currents
Ex: Exposure of the skin towards an electric fan
4. Evaporation – continuous vaporation of
moisture from the skin, oral mucosa, or
respiratory tract (insensible heat loss)
Ex: Tepid Sponge Bath increases peripheral
circulation, thereby increasing heat loss by
evaporation)

8. ALTERATIONS IN BODY TEMPERATURE
• Pyrexia – body temperature above normal range
Also called as hyperthermia or fever
• Hyperpyrexia – Very high fever
Usually 41 Degree Celsius and above
• Hypothermia – Subnormal core body
temperature

9. TYPES OF FEVER
1. Intermittent Fever – Temperature fluctuates
between periods of fever and periods of normal /
subnormal temperature
2. Remittent Fever – Temperature fluctuates
within a wide range over the 24 hour period but
remains above normal range

10. 3. Relapsing Fever – Temperature is elevated
for few days, alternated with 1 or 2 days of
normal temperature
4. Constant Fever – Body temperature is
consistently high
Very high temperatures (41-42 degree-celsius)
cause irreversible brain cell damage

11. DECLINE OF FEVER
1. Crisis – Sudden decline of fever. This indicates
impairment of the function of the
hypothalamus
2. Lysis – Gradual decline of fever. This indicates
that the body is able to maintain homeostatis.
This is the desired decline of fever.

12. METHODS OF TEMPERATURE TAKING
1. ORAL – most accessible and convenient
method
- If the client has taken hot or cold food, or has
smoked, allow 15 minutes to elapse before
measuring oral temperature
- Place thermometer under the tongue, directed
towards the side
- Wash thermometer
Before use: From bulb to the stem
After use: From stem to bulb

13. CONTRAINDICATIONS TO ORAL
TEMPERATURE TAKING
• Oral lesions or surgery
• Cough
• Nausea and vomiting
• Presence of oro-nasal pack, nasogastric tube,
endotracheal tube
• Seizure-prone
• Unconscious
• Restless, Disoriented, Confused

14. 2. Rectal – most accurate measurement of
temperature
- Assist client to assume lateral position
- Lubricate thermometer before insertion
- Insert thermometer by 0.5 – 1.5 inches
- Instruct client to take a deep breath during the
insertion of the thermometer to relax the
internal sphincter

15. CONTRAINDICATIONS TO RECTAL
TEMPERATURE TAKING
• Anal or Rectal conditions or surgeries
• Diarrhea
• Quadriplegic clients.
Vagal stimulation may occur, causing
bradycardia and suncope

16. 3. Axillary – Safest and most non-invasive
method of temperature taking (will not
penetrate through anything)
- Pat dry the axilla
- Place the arm tightly across the chest to keep the
thermometer in place

17. 4. Tympanic
- Useful with toddlers who squirm at the restraint
needed for the rectal route
- Useful for pre-schoolers who are not yet able to
cooperate for an oral temperature and fear the
use of rectal thermometer

18. ROUTE TEMPERATURE RANGE
Oral 36.5 – 37.5
Axillary 35.8 – 37.0
Rectal 37.0 – 38.1
Tympanic 36.8 – 37.9