UNITVII VITAL SIGNS PRESENTED BY Mrs PRASHMA LEARNING

UNIT-VII VITAL SIGNS PRESENTED BY: Mrs. PRASHMA

LEARNING OBJECTIVES • • • Define fever(pyrexia) Explain the types and phases of fever List out the causes of fever List out the signs and symptoms of fever Define hyperthermia List out the causes for hyperthermia Discuss the nursing interventions for clients with fever Define hypothermia Explain the physiological mechanisms of hypothermia List out the clinical signs of hypothermia Discuss the nursing interventions for clients with hypothermia

INTRODUCTION Fever is a natural response to chemicals called cytokines that are released by cells of the immune system when activated. It usually indicates an infection but there are other conditions which can cause it. A fever is adaptive — it helps the body to fight infection better than at basal temperature (98. 6 on average)

Temperature alterations Fever (Pyrexia) Fever is an elevation of body temperature above the usual range that is 38 to 40 C is called pyrexia or fever

Types and Phases of fever Onset or invasion : The period when the body temperature is rising. Fastigium or stadium: body temperature has reached its maximum and remains constant at a high level. Defervescence or decline : elevated body temperature is returning to normal Crisis : sudden return to a normal temperature from a very high temperature with in a few hours

Patterns of fever Sustained fever A constant body temperature continuously above 38 C(100. 4 F) that demonstrates little fluctuation intermittent Fever spikes interspersed with usual temperature levels. Temperature returns to acceptable value at least once in 24 hours Remittent Fever spikes and falls without a return to normal temperature levels short febrile periods of a few days are interspersed with periods of 1 or 2 days of normal temperature. Relapsing A temperature that rises to fever level rapidly following a normal temperature and then return to normal within a few hours is called a fever spike.

Lysis : temperature falls in a zig zag manner For 2 -3 days before reaching normal limit Constant fever : temperature varies not more than 2 degrees between morning and evening and does not reach normal for a period of time. Inverse fever : higher temperature in the morning hours and lower temperature in the evening

Hectic or swinging fever : the difference between high and low point is very great Rigor: Sudden severe attack of shivering in which the body temperature rises to stage of hyper pyrexia Heat exhaustion: occurs when profuse diaphoresis results in water and electrolyte loss

Causes of fever • Hot environment • Excessive exercise • Neurogenic factors like injury to hypothalamus • As an undesired side effect of a therapeutic drug • Infectious disease Grades of fever 1. Low grade fever: 37. 1 -38. 2 C (98. 8 -100. 6 F) 2. High grade fever: 38. 2 -40. 5 C(100. 6 -104. 9 F) 3. Hyperpyrexia : >40. 5 C(104. 9 F)

Signs and symptoms of fever Symptoms • Flushed face • Hot dry skin • Anorexia • Headache • Nausea and vomiting • Body aches • Scant highly colored urine Signs • Increased heart rate, respiratory rate and depth • Shivering, pale and cold skin

Signs • Increased heart rate, respiratory rate and depth • Shivering, pale and cold skin

Hyperthermia • It is elevated temperature due to failed thermoregulation that occurs when a body produces or absorbs more heat than it dissipates. • Temperature ranges ->37. 5 - 38. 3 degree celcius (99. 5 -100. 9 degree fahrenheit)

Causes 1. Heat stroke : prolonged exposure to sun or high environmental temperatures. These condition causes heat stroke- a dangerous heat emergency with a high mortality rate.

Causes(CONT…. ) 2. Drugs – e. g : antidepressants, cocaine, antipsychotics 3. central nervous system damage: cerebral hemorrhage, hypothalamic injury 3. endocrinopathy: thyrotoxicosis can lead to increased thermogenesis

Nursing Interventions for clients with Fever • Monitor vital signs. • Assess skin color and temperature. • Monitor white blood cell count, hematocrit value. • Remove excess blankets when the client feels warm, but provide extra warmth when the client feels chilled. • Provide adequate nutrition and fluids. 17

• Measure intake and output. • Reduce physical activity to limit heat production, especially during the flush stage. • Administer antipyretics as ordered. • Provide oral hygiene to keep the mucous membranes moist. • Provide a tepid sponge bath to increase that loss through conduction. • Provide dry clothing and bed linens. 18

Hypothermia: is a core body temperature below the lower limit of normal 35 C. Classification of hypothermia: 1. Mild: 34 – 36 C 2. Moderate: 30 – 34 C 3. Severe: < 30 C 19

The three physiologic mechanisms of hypothermia are: 1. Excessive heat loss. 2. Inadequate heat production to counteract heat loss. 3. Impaired hypothalamic thermoregulation. 20

The Clinical Signs of Hypothermia • Decreased body temperature, pulse, and respirations. • Severe shivering (initially) • Feelings of cold and chills. • Pale, cool, waxy skin. • Hypotension and disorientation. • Decreased urinary output. • Lack of muscle coordination. • Drowsiness progressing to coma. 21

Nursing Interventions for Clients with hypothermia • • Provide a warm environment. Provide dry clothing. Apply warm blankets. Keep limbs close to body. Cover the client's scalp with a cap or turban. Supply warm oral or intravenous fluids. Apply warming pads. 22

SUMMARY • Today we discussed about meaning of fever, types and phases of fever, causes and signs and symptoms of fever and also about hyperthermia and nursing interventions for clients with fever. Apart from this we also discussed about hypothermia, mechanisms, signs and symptoms and nursing management of patients with hypothermia.

CONCLUSION A fever is a body temperature that is higher than normal. A normal temperature can vary from person to person, but it is usually around 98. 6 F. A fever is not a disease. It is usually a sign that our body is trying to fight an illness or infection.

EVALUATION Short essay 1. Expalin the types and phases of fever MCQ’s 2. A type of fever in which body temperature alternate at regular intervals between periods of fever and periods of normal and subnormal temperature • A. Constant • B. Intermittent • C. Relapsing • D. Remittent

Evaluation (cont…) 3. A sudden feeling of cold with shivering • Rigor • Crisis • Lysis • Rigor mortis

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