Fever is an elevation of body temperature that exceeds normally daily variation and occurs in conjunction with an increase in the hypothalamic set point for e.g. 37⁰C- 39⁰C.

1. FEVER
SOLOMON M KAYASA

2. INTRODUCTION
• A fever is a body temperature that’s higher
than is considered normal.
• It’s also called a high temperature,
hyperthermia, or pyrexia, and it’s usually a
sign that your body is working to keep you
healthy from an infection.

3. INTRODUCTION
• Temperature control mechanisms of human beings
keep the body’s core temperature relatively
constant despite extremes in environmental
conditions and physical

4. • The normal body temperature ranges from 36.5
to 37.5 ℃ maintained by the hypothalamic
regulatory centre.
• During a 24 hour period, temperature varies
from lowest levels in the early morning to
highest in the late afternoon.

5. GENERAL OBJECTIVE
• At the end of the lesson, students should be able
to demonstrate an understanding on the
management of patients with fever.

6. SPECIFIC OBJECTIVES
• At the end of the lesson students should be
able to:
• Define fever
• Mention the causes of fever
• Describe the patterns of fever
• State the signs and symptoms of fever
• Outline the management of fever.

7. DEFINITION OF TERMS
• Body temperature is the degree of hotness or
coldness of a body.
• It is the somatic sensation of heat or cold. It is
the degree of or intensity of heat of a body in
relation to external environment.

8. THERMOREGULATION
• The body temperature is the difference between
the amount of heat produced by body processes
& the amount of heat lost to the external
environment.
• Body Temperature = Thermogenesis–Heat Loss

9. DEFINITION OF TERMS CONT’D…
• Core temperature: it is the temperature of internal
body tissues below the skin & subcutaneous
tissues. The sites of measurement are rectum,
tympanic membrane, esophagus, pulmonary artery
& urinary bladder.

10. • Homeostasis is the ability or tendency of an
organism or cell to maintain internal equilibrium
by adjusting its physiological processes.
• Hyperpyrexia is a high fever, usually above 41ºC
(105.8ºF).

11. • Surface body temperature- it refers to the body
temperature of external body tissues at the
surface that is of the skin & subcutaneous
tissues.

12. FEVER
• Fever (pyrexia) is an increase above normal
(considered to be 37ºC or 98.6ºF) in body
temperature.
• A person with a fever is said to be febrile and with a
fever is said to be afebrile.
• Pyrogen-a substance, typically produced by a
bacterium, which produces fever when introduced
or released into the blood.

13. PHYSIOLOGY OF THERMOREGULATION
• The body maintains the body temperature through
metabolic processes in the body e.g homeostasis.
• In humans, temperature homeostasis is controlled
by the thermoregulatory center in the
hypothalamus.

14. PHYSIOLOGY OF THERMOREGULATION
The hypothalamus receives inputs from two
sets of thermoreceptors:
receptors in the hypothalamus monitor the
temperature of the blood.
receptors in the skin monitors the external
temperature.

15. PHYSIOLOGY OF THERMOREGULATION
• The thermoregulatory centre sends impulses
to several different effectors to adjust body
temperature.
• When the message has reached the
hypothalamus, a series of reactions follow.

17. FACTORS AFFECTING BODY
TEMPERATURE
• A variety of factors affect body temperature.
These factors include circadian rhythms, age,
gender, stress, and environmental temperatures.

18. GENDER
• Women tend to experience more fluctuations in
body temperature than do men, probably the
result of changes in hormones.
• The increase in progesterone secretion at
ovulation increases body temperature as much as
0.3º to 0.6ºC (0.5º to 1ºF).

20. CIRCADIAN RHYTHMS
• Are 24-hour cycles that are part of the body's
internal clock, running in the background to carry
out essential functions and processes.
• For instance, body temperature is usually about
0.6ºC (1º to 2º F) lower in the early morning than
in the late afternoon and early evening.

22. AGE
• Older adults lose some thermoregulatory control
with aging and are at risk for harm from extremes
of temperature.
• The body temperature of infants and children
changes more rapidly in response to both hot and
cold air temperatures.

23. ENVIRONMENTAL TEMPERATURE
• Most of us respond to changes in environmental
temperature by wearing clothing that either
allows increased heat loss when it is hot or retains
heat when it is cold.

24. STRESS
• Psychological stress can trigger physiological
responses, including an increase in body
temperature. A neural circuit that underlies this
stress-induced heat response has been identified.

25. EXERCISE
• Hard work or strenuous exercise can increase
body temperature to as high as 38.3 ⁰C to 40
⁰C.

26. MECHANISM OF HEAT LOSS

27. FEVER
• Fever also known as pyrexia is defined as an
elevation of body temperature of above 37.5 ℃
mediated by an increase of the hypothalamic
heat regulatory set-point (Potter & Perry 2009).

28. • Common medical sign characterized by an
elevation of temperature above the normal range
of 36.5 -37.5oC due to an increase in the body
temperature regulatory set point (Karakitsos and
Karabinis, 2008).

29. • Loss of

31. WHAT CAUSES FEVER?
• The cause of fever may be infectious or non-
infectious

32. INFECTIOUS
• Pyrogens are substances that cause fever eg fungi,
viruses, and bacteria.
• Pyrogens causes fever by inducing release of
endogenous pyrogens (IL-1, Tumor necrosis factor,
Interferon-y and IL-6) produced by the host cells
that elevates the hypothalamic set point.

33. NON-INFECTIOUS
• Non-infectious causes include
• Inflammation caused by trauma
• Neoplastics
• Environmental
• Drug-mediated
• Immunological causes

34. TYPES OF FEVER
• Continuous fever: Temperature remains above
normal throughout the day and does not
fluctuate more than 1 °C in 24 hours, e.g. lobar
pneumonia, typhoid, meningitis, urinary tract
infection, brucellosis, or typhus.

35. • Intermittent fever: The temperature elevation is
present only for a certain period, later cycling back
to normal, e.g. malaria, kala-azar, pyaemia, or
septicemia.

36. • Remittent fever: Temperature remains above
normal throughout the day and fluctuates more
than 1 °C in 24 hours, e.g., infective endocarditis.

37. • Pel-Ebstein fever: A specific kind of fever
associated with Hodgkin's lymphoma, being high
for one week and low for the next week and so
on.
• However, there is some debate as to whether this
pattern truly exists.

38. • A neutropenic fever: also called febrile neutropenia, is
a fever in the absence of normal immune system
function.
• Because of the lack of infection-fighting neutrophils, a
bacterial infection can spread rapidly; this fever is,
therefore, usually considered to require urgent
medical attention.

39. • Neurogenic fever is the result of damage to the
hypothalamus from pathologies such as
intracranial trauma, intracranial bleeding, or
increased intracranial pressure. This type of fever
does not respond to antipyretic medications
(Porth & Matfin, 2009).

40. • Fever of unknown origin (FUO) also known as pyrexia
of unknown origin(PUO) is body temperature ≥ 38.3°
C (101° F) that lasts 3 weeks or longer and does not
result from transient and self-limited illness, rapidly
fatal illness, or disorders with clear-cut localizing
symptoms or signs or with abnormalities on common
tests such as chest x-ray, urinalysis, or blood cultures.

41. • This kind of fever is more commonly seen in people
receiving immune-suppressing chemotherapy than
in apparently healthy people.

42. • Febricula is an old term for a low-grade fever,
especially if the cause is unknown, no other
symptoms are present, and the patient recovers
fully in less than a week.

44. GRADES OF FEVER
• Low grade fever: 37.5º-38.2ºC(98.8-100.6Fº)
• High grade fever: 38.2º-40.5ºC(100.6-104.9ºF)
• Hyperpyrexia: >40.5ºC(104.9ºF)

45. CLASSIFICATION ACCORDING TO
PERIOD
• Acute fever; type of fever which takes less than
7 days. It is characteristic of infectious diseases
such as malaria and viral related upper
respiratory tract infections.

46. CLASSIFICATION ACCORDING TO
PERIOD
• Sub-acute fever; type of fever that take less than 2
weeks in duration.
• This type of fever may be seen in cases of typhoid
fever and intra-abdominal abscess.

47. CLASSIFICATION ACCORDING TO
PERIOD
• Chronic Fever; type of fever which takes more than
2 weeks.
• Is typical of chronic bacterial and viral infections e.g
T.B, HIV and cancer.

49. MANAGEMENT OF FEVER

50. NURSING DIAGNOSIS

51. Lets take a break

52. HYPOTHERMIA
• Is a condition in which an organism's
temperature drops below that required for
normal metabolism and bodily functions.

53. ASSIGNMENT
• What are the differences between fever and
hyperthermia?
• Go and read on the management of
hypothemia

54. REFERENCES
• Axelrod & Diringer (2008). Temperature management in acute neurologic
disorders. Neurol. Clin . 26 (2): 585-603.
• Karakitsos & Karabinis (2008). Hypothermia therapy after traumatic brain
injury in children. N. Engl. J. Med. 359(11): 1179-80.
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