• Basal Metabolic Rate • Exercise / Shivering • Secretion of Thyroxine, epinephrine, and norepinephrine • Inflammation / Fever
Factors affecting Heat Production (BMR)
• Radiation • Conduction • Convection • Evaporation
types of heat loss
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• Basal Metabolic Rate • Exercise / Shivering • Secretion of Thyroxine, epinephrine, and norepinephrine • Inflammation / Fever
Factors affecting Heat Production (BMR)
• Radiation • Conduction • Convection • Evaporation
types of heat loss
Body Temperature
reflects the balance between the heat produced and the heat lost from the body: measured in heat units called degrees
core temperature
surface temperature
2 types of body temperature
core temp
Temperature of the deep tissues of the body (abdominal and pelvic cavity) ▪ Remains relatively constant
surface temp
Temperature of the skin, subcutaneous tissue, and fat ▪ Rises and falls in response to the environment
heat balance
the amount of heat produced by the body equals the amount of heat lost.
Basal Metabolic Rate (BMR
Rate of energy utilization in the body required to maintain essential activities (breathing). o Metabolic rate decreases with age. The younger the person, the higher the BMR
Muscle Activity
Including shivering increases the metabolic rate (affects heat production)
Thyroxine Output
Increased thyroxine output increases the rate of cellular metabolism throughout the body
Epinephrine, norepinephrine, and sympathetic stimulation / stress response
These hormones immediately increase the rate of cellular metabolism in many body tissues
fever
Increases the cellular metabolic rate and thus increases the body's temperature further.
radiationconduc
- transfer of heat from the surface of one object to the surface of another without contact between the two objects. (Example: Infrared rays)
conduction
transfer of heat from one molecule to a molecule of lower temperature and this cannot lake place without contact between the molecules and normally accounts minimal heat loss
convection
dispersion of heat by air currents
evaporation
continuous vaporization of moisture from the respiratory fact and from the mucosa of the mouth and from the skin.
insensible water loss
– continuous and unnoticed water loss
insensible heat loss
continuous, unnoticed water loss plus heat loss and accounts for about 10% of basal heat loss. As body temperature increases, vaporization accounts for greater heat loss.
age
exercise
stress
environment
diurnal variations
hormones
FACTORS AFFECTING BODY TEMPERATURE
infant
- greatly influenced and must be protected from extreme temperature
children
vary until puberty The younger they are, the more they are greatly influenced
older adult
sensitive to extreme environmental temperature due to decreased thermoregulatory controls
Older people (75 y/o and more)
at risk for hypothermia due to loss of subcutaneous fat, inadequate diet, lack of activity, reduced thermoregulatory efficiency.
diurnal variations
Body temperatures normally change throughout the day, varying as much as 1 degree Celsius between early morning and late afternoon
exercise
strenuous exercise increases body temperature if you have a sedentary lifestyle, less heat production
hormones
more in women than men especially during ovulation due to progesterone secretion. Especially if women reach their menopausal stage or 40s
stress
highly stressed or anxious patient could have an elevated body temperature due to the stimulation of the SNS (produces epi and norepi that increases metabolic activity thus heat production
environment
extremes in environmental temperatures can affect the person's temperature regulatory systems
36 to 37.5-degree Celsius (96.8 to 99.5-degree Fahrenheit)
Normal Body Temperature
pyrexia
Body temperature above the usual range. o aka hyperthermia, and fever in laymen's term
febrile
patient with fever
afebrile
patient without fever
intermittent fever
remittent fever
relapsing fever
constant fever
types of fever
intermittent fever
body temperature alternates at regular intervals (ex. malaria)
remittent fever
wide range of temperature fluctuations in different centigrade (mostly above normal) in a 24-hour period (Example: common colds or influenza)
relapsing fever
short febrile periods of a few days with periods of 1-2 days of normal temperature.
constant fever
body temperature fluctuates minimally but still above normal (Example: typhoid fever)
fever spike
– temperature that rises to fever level rapidly following a normal temperature and then returns to normal within a few hours (Example: bacterial and viral blood infection)
heat exhaustion
result of excessive heat and dehydration. Signs - paleness, dizziness, nausea, vomiting, fainting and moderately increased temperature
heat stroke
Generally exercising in hot weather, have warm, flushed skin and often do not sweat. Temperature of 41.1 degree Celsius (106-degree Fahrenheit). Signs – delirious, unconscious, having seizures
fever spike
heat exhaustion
heat stroke
other types of fever
onset (cold of chill phase)
course (plateau phase)
defervescence (fever abatement/flush phase)
clinical manifestations or phases of fever
Onset (Cold or Chill Phase)
new set point of body temperature. o Increased HR. RR and depth o Shivering o Pallid, cold skin o Complaints of feeling cold o Cyanotic nail beds o "Gooseflesh" appearance of the skin o Cessation of sweating
Course (Plateau Phase)
new set point of core temperature, the person feels neither cold or hot and no longer experiences chills. o Absence of chills o Skin that feels warm o Photosensitivity o Glassy eyed appearance o Increased PR and RR o Increased thirst o Mild to severe dehydration o Drowsiness, restlessness, delirium, or convulsions o Herpetic lesions of the mouth o Loss of appetite (if fever is prolonged) o Malaise, weakness, and aching muscles
Defervescence (Fever Abatement / Flush Phase)
when the cause of high temperature is suddenly removed so the hypothalamus now attempts to lower the body temperature. o Skin that appears flushed and feels warm due to vasodilation o Sweating o Decreased shivering o Possible dehydration
chill phase
help the client decrease heat loss
flush phase
take measure to increase heat loss and decrease heat production
hypothermia
Core body temperature below the lower limit of normal.
induced
accidental
types of hypothermia
• Excessive heat loss • Inadequate heat production to counteract heat loss • Impaired hypothalamic thermoregulation
3 Physiological Mechanisms:
induced
deliberate lowering of the body temperature to decrease the need of oxygen by the body tissues like in surgeries
accidental
can occur as a result of: o Exposure to a cold environment o Immersion in cold water o Lack of adequate clothing, sheller, or heat
frostbite
-If skin and underlying tissue is damage by freezing cold this results in frostbite. Frostbite most commonly occurs in hands, feet, nose, and ears.
hypothermia
mild hypothermia
severe hypothermia
STAGES OF HYPOTHERMIA
HYPOTHERMIA
involves removing the client from the cold environment and rewarming the client’s body.
mild hypothermia
the body is rewarmed by applying blankets
severe hypothermia
a hyperthermia blankets (an electronically controlled blanket that provides a specified temperature) is applied
oral
rectal
axillary
tympanic membrane
skin/temporal artery
most common sites in assessing body temperature
oral
wait for 30 mins if the client had cold or warm food and drinks or just had smoke. Under the tongue, either side of the frenulum
rectal
said to be very accurate in checking temperature but contraindicated for those undergoing rectal surgery, diarrhea, disease of the rectum, immunosuppressed, clotting disorder, hemorrhoids. Insert ½ or an silver tip
axillary
preferred in newborns because its accessible and safe: lower than rectal; if readings are elevated, the nurse must recheck in other sites. Center of the axilla, or an silver tip dapat aada ha center it axilla.
tympanic membrane
frequent site for estimating core body temperature tends to be imprecise (lower) if the probe fits too loosely in the ear canal. For adults is up and back, and for babies is down and back. To follow the contour
skin/temporal artery
measured on the forehead; most useful but shows inconsistent reliability. Make sure na diri hiya sweaty
mercury-in-glass thermometer
electronic thermometer
chemical disposable thermometer
temperature-sensitive tape
infrared thermometer
temporal artery thermometer
types of thermometer
. Temporal artery thermometer
determine temperature using a scanning infrared thermometer that compares the artery of the forehead to the temperature in the room and calculates the heat balance to approximate the core temperature of the blood in the pulmonary artery. This is also a kind of your infrared which is use for your arterial or your temporal artery, like what I said forehead or the back of your ears.
infrared thermometer
- sense the body heat in the form of infrared energy given off by a heat source
temperature-sensitive tape
-It does not indicate the core temperature
Chemical Disposable Thermometer
also used to measure body temperature. Chemical thermometers have a liquid crystal dots or bars that change color to indicate temperature
Electronic Thermometers
- can provide a reading in only 2 to 60 seconds, depending on the model. The equipment consists of an electronic base, a probe, and a probe cover. Models have different circuit and probe for oral and rectal measurement.
Mercury-in-glass thermometer
traditional one and most common used thermometer however, it is hazardous due to exposure to mercury.
basal thermometer
hypothermia thermometer
TWO TYPES OF SPECIAL ORAL THERMOMETER
basal thermometer
is calibrated with 0.1°F intervals and is for fertility purposes, indicating the temperature rise that is associated with ovulation.
hypothermia thermometer
- have a greater low range than everyday thermometers, usually measuring temperatures from 27.2 °C to 42.2 °C (81 °F to 108 °F).