NCM 103 - THERMOREGULATION - PALICPIC

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• Basal Metabolic Rate • Exercise / Shivering • Secretion of Thyroxine, epinephrine, and norepinephrine • Inflammation / Fever

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Factors affecting Heat Production (BMR)

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• Radiation • Conduction • Convection • Evaporation

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types of heat loss

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74 Terms

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• Basal Metabolic Rate • Exercise / Shivering • Secretion of Thyroxine, epinephrine, and norepinephrine • Inflammation / Fever

Factors affecting Heat Production (BMR)

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• Radiation • Conduction • Convection • Evaporation

types of heat loss

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Body Temperature

reflects the balance between the heat produced and the heat lost from the body: measured in heat units called degrees

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core temperature

surface temperature

2 types of body temperature

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core temp

Temperature of the deep tissues of the body (abdominal and pelvic cavity) Remains relatively constant

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surface temp

Temperature of the skin, subcutaneous tissue, and fat Rises and falls in response to the environment

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heat balance

the amount of heat produced by the body equals the amount of heat lost.

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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

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Muscle Activity

Including shivering increases the metabolic rate (affects heat production)

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Thyroxine Output

Increased thyroxine output increases the rate of cellular metabolism throughout the body

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Epinephrine, norepinephrine, and sympathetic stimulation / stress response

These hormones immediately increase the rate of cellular metabolism in many body tissues

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fever

Increases the cellular metabolic rate and thus increases the body's temperature further.

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radiationconduc

- transfer of heat from the surface of one object to the surface of another without contact between the two objects. (Example: Infrared rays)

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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

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convection

dispersion of heat by air currents

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evaporation

continuous vaporization of moisture from the respiratory fact and from the mucosa of the mouth and from the skin.

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insensible water loss

– continuous and unnoticed water loss

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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.

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age

exercise

stress

environment

diurnal variations

hormones

FACTORS AFFECTING BODY TEMPERATURE

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infant

- greatly influenced and must be protected from extreme temperature

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children

vary until puberty The younger they are, the more they are greatly influenced

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older adult

sensitive to extreme environmental temperature due to decreased thermoregulatory controls

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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.

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diurnal variations

Body temperatures normally change throughout the day, varying as much as 1 degree Celsius between early morning and late afternoon

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exercise

strenuous exercise increases body temperature if you have a sedentary lifestyle, less heat production

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hormones

more in women than men especially during ovulation due to progesterone secretion. Especially if women reach their menopausal stage or 40s

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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

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environment

extremes in environmental temperatures can affect the person's temperature regulatory systems

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36 to 37.5-degree Celsius (96.8 to 99.5-degree Fahrenheit)

Normal Body Temperature

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pyrexia

Body temperature above the usual range. o aka hyperthermia, and fever in laymen's term

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febrile

patient with fever

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afebrile

patient without fever

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intermittent fever

remittent fever

relapsing fever

constant fever

types of fever

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intermittent fever

body temperature alternates at regular intervals (ex. malaria)

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remittent fever

wide range of temperature fluctuations in different centigrade (mostly above normal) in a 24-hour period (Example: common colds or influenza)

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relapsing fever

short febrile periods of a few days with periods of 1-2 days of normal temperature.

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constant fever

body temperature fluctuates minimally but still above normal (Example: typhoid fever)

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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)

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heat exhaustion

result of excessive heat and dehydration. Signs - paleness, dizziness, nausea, vomiting, fainting and moderately increased temperature

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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

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fever spike

heat exhaustion

heat stroke

other types of fever

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  1. onset (cold of chill phase)

  2. course (plateau phase)

  3. defervescence (fever abatement/flush phase)

clinical manifestations or phases of fever

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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

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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

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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

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chill phase

help the client decrease heat loss

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flush phase

take measure to increase heat loss and decrease heat production

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hypothermia

Core body temperature below the lower limit of normal.

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induced

accidental

types of hypothermia

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• Excessive heat loss • Inadequate heat production to counteract heat loss • Impaired hypothalamic thermoregulation

3 Physiological Mechanisms:

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induced

deliberate lowering of the body temperature to decrease the need of oxygen by the body tissues like in surgeries

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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

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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.

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hypothermia

mild hypothermia

severe hypothermia

STAGES OF HYPOTHERMIA

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HYPOTHERMIA

involves removing the client from the cold environment and rewarming the client’s body.

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mild hypothermia

the body is rewarmed by applying blankets

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severe hypothermia

a hyperthermia blankets (an electronically controlled blanket that provides a specified temperature) is applied

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oral

rectal

axillary

tympanic membrane

skin/temporal artery

most common sites in assessing body temperature

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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

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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

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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.

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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

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skin/temporal artery

measured on the forehead; most useful but shows inconsistent reliability. Make sure na diri hiya sweaty

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mercury-in-glass thermometer

electronic thermometer

chemical disposable thermometer

temperature-sensitive tape

infrared thermometer

temporal artery thermometer

types of thermometer

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. 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.

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infrared thermometer

- sense the body heat in the form of infrared energy given off by a heat source

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temperature-sensitive tape

-It does not indicate the core temperature

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Chemical Disposable Thermometer

also used to measure body temperature. Chemical thermometers have a liquid crystal dots or bars that change color to indicate temperature

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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.

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Mercury-in-glass thermometer

traditional one and most common used thermometer however, it is hazardous due to exposure to mercury.

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basal thermometer

hypothermia thermometer

TWO TYPES OF SPECIAL ORAL THERMOMETER

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basal thermometer

is calibrated with 0.1°F intervals and is for fertility purposes, indicating the temperature rise that is associated with ovulation.

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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).

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