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Berad, Brandon L. BSN 3 H June 26, 2010 Mr. Marvin Pulao

A. Description of the Learned  The patient, Felicidad Ramirez, 65 y/o Female, came into the ER with chief complaints of fever, and cough. she would like to know more about interventions that could be done to lessen the severity of her disease and more importantly be able to teach her family these to further prevent the disease from happening or getting worse. B. Learning Need  Fever, its definition, causes and management to lessen the severity of it. C. Learning Diagnosis: Readiness for Enhanced Learning: Fever as manifested by clients claim to know more about fever. D. Goal  The client will know how to prevent such disease and when the disease happens she would know what to do.

LEARNING OBJECTIVE Upon completion of the topic on interventions of fever, the client would able to: 1. Be able to explain what fever is.





 Importance of knowing fever

 One to One discussion with pamphlet

 2 mins. discussion, Handout: What is fever

 Instant oral feedback: The client will be able to define fever in her own words  Instant oral feedback: The client would be able to enumerate atleast 4 causes of fever

2.Be able to enumerate some causes of fever

 Some diseases that cause fever

 One to One discussion with pamphlet

 3 mins. discussion, Handout: Cases wherein fever is present

3. Be able to know what interventions to be done incase a fever has taken place.

 Interventions and some medications

 One to One discussion with pamphlet

 5 mins discussion, Handout: Interventions and medications

 The client would be able to state what to do and what medications to intake in cases of fever  The client would be able to enumerate the at least 4 factors affecting body temperature

4. Be able to know the factors which may affect the body temperature

 Factors affecting body temo

 One to One discussion with pamphlet

 3 mins. discussion, Handout: Types of fever and its factors

Learning Content: 1) Fever (also known as pyrexia or controlled hyperthermia) is a common medical sign characterized by an elevation of temperature 1 or more above the normal 98.6 degrees Fahrenheit (F) or 37 degrees Celsius (C), Fever is a symptom of a disease or infection. It is not a disease. Fever helps the body fight infections by making the body's defense systems work more efficiently. Bacteria and viruses cannot live at higher temperatures and are killed by fever. It is usually just referred to as hyperthermia, in that hyperthermia is an increase in body temperature over the body's thermoregulatory set-point, due to excessive heat production and/or insufficient thermoregulation

2) Causes: Fever can be caused by many conditions. Fever is commonly caused by infection. Immunizations, teething, autoimmune disorders, inflammatory disorders, blood clots and certain cancers are other possible causes. Some conditions that cause them are: infections such as strep throat, pneumonia, flu and chickenpox, tissue injuries, silicosis, tumors or cancer diseases that cause inflammation, rheumatoid arthritis, medications, and being in a hot environment for too long. that is why fever mainly can be a sign of an underlying disease

3) INTERVENTIONS AND MANAGEMENT  Drink plenty of water - It is important to drink fluids when you have a fever. It is important because fever causes considerable fluid loss through the
skin and perspiration. Because it is difficult to measure fluid loss, it is good to drink 1 to 2 quarts of extra fluid each day that you have a fever. But do not drink too much water for it may cause hyponatremia (deficient sodium in the body).

 Remove excess clothing and/or blankets - The room should be comfortable, not too hot or cool. Try one layer of lightweight clothing, and one lightweight blanket
for sleep. If the room is hot or stuffy, a fan may help. covering up the patient too much would increase the body s temperature which may cause other problems and irritability, that why we have to keep the patient in a normal body temperature to promote comfort and rest.

 Tepid sponge baths Tepid sponge bathes are done by merely taking a wet sponge or cloth and wiping it on the patient, because the water spread through the skin would lower the temperature of the body. When TSB or bathing a patient, do not use alcohol as water or do not mix alcohol with the water because the patient may inhale the alcohol fumes causing more problems. be sure that the environment would not be too cold for it would make the patients temperature drop and make it too low.  Medications - The following medications may be used at home to treat a fever:

y y y

Acetaminophen (Tylenol and others) can be used to lower a fever. The recommended pediatric dose can be suggested by the child's health-care provider. Adults without liver disease or other health problems can take 1000 mg (two "extra strength" tablets) every four to six hours or as directed by your physician. Ibuprofen (Motrin/Advil) can also be used for fever in patients over 6 months of age. Discuss the best dose with your doctor. For adults, 400-600 mg (two to three 200 mg tablets) can be used every six hours. Aspirin SHOULD NOT BE USED FOR FEVER IN CHILDREN OR ADOLESCENTS. Aspirin use in children and adolescents during a viral illness (especially chickenpox and influenza) has been associated with Reye syndrome. Reye syndrome is a dangerous illness which causes prolonged vomiting, confusion, and even coma and liver failure.

4) Factors affecting body temperature  Age Infants at birth leave a warm, relatively constant environment and enters a new one in which temperature fluctuates widely, this is why we have to cover up the babe, Clothing must be adequate and exposure to temperature extremes must be avoided. In Older adults, they too are sensitive of temperature because of deterioration in control mechanisms, particularly poor vasomotor, reduced amount of subcutaneous tissue, reduced sweat gland activity and decreased metabolism.  Exercise Muscle activity requires increased blood supply and an increase CO2 and fat breakdown, This increases metabolism which increases heat production.  Hormone level Women experience more heat fluctuations than men, because of the menstrual cycle. Progesterones rise and fall affects the body temperature of women. women who are also stopped menstruating experience periods of intense body heat and sweating from 30 seconds to 5 minutes. This is due to the instability of the vasomotor control for vasodilatation and vasoconstriction.  Stress Physical and emotional stress increases the bodys temperature through hormonal and nueral stimulation.  Environment The bodys response would depend on the environment. References: Fundamentals of Nursing by Potter and Perry http://www.mamashealth.com http://www.medicinenet.com http://en.wikipedia.org http://hubpages.com