Unbalanced body normal temperature
- Body temperature above 99oF (37.2o) called fever or pyrexia.
- Fever is not a disease but a sign of a disease.
- Infection & malignancy.
- Heat stroke & dehydration.
- Crushing injury & surgical trauma.
- Allergic reaction.
Onset or invasion– -Fever start and increase.
Fastigium or stadium – Body temperature at maximum & constant level.
Defervescence or decline– Sudden and fast (crisis) or slowly (lysis) decreasing temperature to become normal.
Crisis– Fastly decreasing body temperature.-
- True crisis-patient condition also improves with decreasing temperature.
- False crisis -Without improving the condition of patient temperature decrease suddenly.
Lysis-Slowly fever becomes normal.
Constant or continuous– A sustained fever, with a slight diurnal variation (less than 2°C or 3.6oF) as in scarlet fever, typhus or pneumonia.
Remittent – A pattern of fever that varies over a 24-hour period (difference more than 2oC in evening and morning temperature) but does not return to normal.
- Temperature rises from normal or subnormal to high & back at regular interval higher temperature in evening and lower in morning).
- A Fever in which symptoms disappear completely between paroxysms (an exacerbation of the symptoms of a disease).
Inverse – Highest temperature in morning & lowest in evening.
Hectic or swinging – Difference between high & low temperature is very high
Relapsing – Normal temperature for one or two days after a brief period.
Irregular – Fever is completely irregular, so cannot classify into any group of fever mentioned above.
Fever of unknown origin (FUO) – An illness of at least 3 weeks duration with exceeding 38.3°C on
several occasions and diagnosis not established after 1 week of hospital investigation.
- Fever occurs by resetting of temperature regulating center of hypothalamus at a higher level (higher than 98.6oF) by the release of interleukin-1 (IL-1), interleukin-2(IL-2) and tumor necrosis factor from white blood cells (especially macrophages)
- Then the body tries to maintain that resetting higher temperature level.
Grade of fever or pyrexia
- Low pyrexia – 99o to 100oF (37.2o-37.8o C).
- Moderate pyrexia – 100o to 103oF (37.8°- 39.4c).
- High pyrexi a– 103° to 105F (39.4°-40.6oc).
- Hyperpyrexia & hyperthermia-Temperature above 105oF.
- Subnormal temperature– 95 to 98o F (35o– 36o C) or below normal.
- Hypothermia-Temperature below 95oF or 35oC.
- Mild hypothermia -90 to 95o
- Moderate hypothermia- 86o to 90o
- Severe hypothermia – Below 86o
A sudden paroxysmal shaking chill occurring during a febrile illness e,g malaria.
Respiratory alkalosis may occur in shivering due to hyperventilation.
Stages of rigor
(i) Cold Stage (the chill or rigor stage)-
- Uncontrolled shivering and tachycardia occur in this stage.
- Body feels cool and temperature rises to 103’F or more.
- Cover the patient with warm blankets and give warm drinks.
(ii) Hot Stage (febrile stage)
- Stop Shivering and patient become hot, dry, restlessness & thirsty.
- Temperature increasing continuously.
- Remove all blankets and give cold drinks & cold compression.
- Temperature increase up to and above 105F.
- Start cold sponging.
(iii )Sweating Stage (the third or terminal stage during which sweating occurs)-
- It is a dangerous stage, because patient may go in shock if not cared properly.
- Excessive diaphoresis with decreasing temperature and improving pulse of patient.
- Dry up the patient.
Care During Fever
- Give sweet drinks to treat fatigue.
- Temperature should be recorded at 10-15 minute interval in rigor.
- Neurogenic fever not responds to antipyretic drugs, so manage with cold therapy.
- Maintain body temperature.
- Satisfy nutritional needs of patient because O2, consumption or nutritional requirements increase 13% at 1oc or 7% at 1of temperature elevation.
- So give high-calorie diet & fluid (3000ml/day) to balance fluidIoss.
- Provide rest & sleep, maintain personal hygiene, provide safety and observe patient carefully.
- give medication like paracetamol and antibiotics to increase immunity level
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