Pyrexia – Body temperature above normal range. (also hyperthermia, fever)
Types of Fever
1. Intermittent Fever – The temperature fluctuates between periods of fever and periods of normal/subnormal temperature.
2. Remittent Fever – The temperature fluctuates within a wide range over the 24 hours period but remains above normal range.
3. Relapsing Fever – The 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°C) cause irreversible brain cell damage.
Clinical Signs of Fever
a. Onset (cold or chill stage) of fever
- Increased heat rate
- Increased respiratory rate and depth
- Pale, cold skin
- Cyanotic nail bed
- Complaints of feeling cold
- “goose flesh” appearance of the skin
- Cessation of sweating
- Rise in body temperature
b. Course of Fever
- Absence of chills
- Skin that feels warm
- Feeling of being neither hot nor cold
- Increased pulse and respiratory rates
- Increased thirst
- Mild to severe dehydration
- Drowsiness, restlessness, delirium and convulsions
- Herpetic lesions of the mouth (fever blisters)
- Loss of appetite to eat
- Malaise, weakness ad aching muscles
c. Defervescence (fever abatement)
- Skin that appears flushed and feels warm
- Decreased shivering
- Possible dehydration
Nursing Interventions in Clients with Fever
- Monitor vital signs
- Assess skin color and temperature.
- Monitor WBC, Hct and other pertinent laboratory records.
a. Elevated wbc levels indicate presence of infection.
b. Elevated Hct indicates dehydration.
- Remove excess blankets when the client feels warm; provide extra warmth when the client feels chilled.
- Provide adequate foods and fluids. To provide additional calories and to prevent dehydration.
- Measure Intake and Output.
- Maintain prescribed IV fluids as ordered by the physician.
- Promote rest. To reduce body heat production.
- Provide good oral hygiene. To prevent herpetic lesions of the mouth.
- Provide cool, circulating air using a fan. To dissipate heat by convection.
- Provide dry clothing and bed linens. To ensure comfort.
- Provide TSB (Temperature of water 80-98°F). To enhance heat loss by evaporation and conduction.
- Administer antipyretics as ordered. Temperature of 38.5°C and above usually require administration of antipyretic.