OIA1014 FEVER MANAGEMENT

What is fever?

An elevation of body temperature above the normal circadian range due to pyrogens.

What is the normal body temperature range?

36.5°C to 37.7°C depending on time and conditions.

How does rectal temperature compare to oral temperature?

Rectal temperature is approximately 0.6°C higher.

What are the categories of fever based on temperature?

Low-grade: 37.3–38.0°C

Moderate-grade: 38.1–39.0°C

High-grade: 39.1–41.0°C

Hyperthermia: >41.0°C.

What are pyrogens?

Substances that induce fever, classified as exogenous (e.g., microbial toxins) or endogenous (e.g., interleukins).

How do endogenous pyrogens cause fever?

They stimulate the hypothalamus to increase the body's temperature set point.

What physiological effects occur with a 1°C increase in body temperature?

Increases in oxygen consumption (13%), caloric requirements, and fluid needs.

What are common accompaniments of fever?

Back pain, myalgias, arthralgias, chills, sweats, and somnolence.

What is rigor, and when does it occur?

Severe shivering with goosebumps, common in bacterial and protozoal infections.

What temperature can cause febrile seizures in children?

Above 40°C, particularly in children under five years old.

What laboratory tests are used for fever diagnosis?

Urinalysis, ESR, CBC, blood cultures, and chest X-rays.

What is Fever of Unknown Origin (FUO)?

A fever >38.3°C lasting over 3 weeks without a definitive diagnosis despite 1 week of investigation.

What are common causes of FUO?

Infections (30–40%), malignancies (20–30%), and autoimmune diseases (10–20%).

What are common drugs used to treat fever?

Paracetamol, NSAIDs (e.g., ibuprofen, diclofenac), and aspirin.

Why is aspirin contraindicated in children?

It may cause Reye’s syndrome, a rare but serious condition.

What is the adult dosage of paracetamol for fever?

500 mg to 1,000 mg every 4–6 hours, with a maximum of 4 g/day.

How is paracetamol dosed for children?

10–15 mg/kg per dose, not exceeding 4 doses or 4 g/day.

What are non-pharmacological methods to manage fever?

Rest, hydration, tepid sponging (add wet cloth), and external cooling measures like fans.

Why is hydration important during fever?

To compensate for increased fluid loss and metabolic demand.

At what temperature does fever require emergency treatment in newborns?

Above 38°C.

What symptoms with fever indicate the need for immediate medical attention?

Severe headache, neck stiffness, mental confusion, or severe throat swelling.

What causes heat stroke?

Overheating due to high environmental temperatures or exertion.

What are the symptoms of heat stroke?

Temperature >39.4°C, confusion, seizures, dry skin, and rapid heart rate.

How can heat stroke be managed while waiting for medical help?

Spray the body with water and use fans to promote cooling.

What are common risk factors for heat stroke?

Age >65 years, cardiovascular conditions, and use of diuretics or antidepressants.

Why is fever management critical in pregnant women?

To reduce metabolic stress and protect fetal development.

How would you calculate a paracetamol dose for a 12 kg child?

Dose = 10 mg × 12 kg = 120 mg per dose, given 4 times daily.

What advice would you give to a caregiver about paracetamol syrup?

Administer 5 mL of 120 mg/5 mL syrup 4 times daily.

What risks are associated with fever during the first trimester of pregnancy?

Increased risk of neural tube defects in the fetus.

Why is fever management important?

To alleviate discomfort, prevent complications, and address underlying causes promptly.