Thermoregulation Exemplars

Thermoregulation

Priority: ABCs

• Airway, Breathing, Circulation

Lack of Maintaining Body Temperature

• The importance of maintaining body temperature is highlighted.

Factors Contributing to Hypothermia

• Skin to skin contact.
• Fans and wet conditions.
• Being by a window.
• Heat from mom.

Evaporation

• Evaporation can occur:
  • During birth or bathing from moisture on skin.
  • As a result of wet linens or clothes.
  • From insensible water loss.

Conduction

• Conduction occurs when the infant comes in contact with cold objects or surfaces such as:
  • A scale.
  • A circumcision restraint board.
  • Cold hands.
  • A stethoscope.

Convection

• Convection occurs when drafts come from open doors, air conditioning, or even air currents created by people moving about.
  • Blanket loose or off.
  • Open door to hall.
  • Air conditioner.

Radiation

• Heat is lost by radiation when the infant is near cold surfaces.
  • Heat is lost from the infant's body to the sides of the crib or incubator and to the outside walls and windows.

Special Considerations

• Preterm babies and infants under 6 months do not shiver.

Severe Concerns Related to Temperature

• Following of skin (likely referring to mottling or color changes).

Effects of Cold Stress

• Use of glucose leading to Hypoglycemia
• Use of $O_2$ leading to Hypoxemia
• Metabolism of brown fat leading to Increased production of acids and Metabolic acidosis
• Decreased body temperature and cold stress
• Evaporation, Conduction, Convection, Radiation
• Production of surfactant leading to Respiratory distress
• Displacement of bilirubin from albumin-binding sites, leading to Jaundice
• Vasoconstriction in Peripheral vessels and Pulmonary vessels, leading to Pale, cold, mottled skin and Return to fetal circulation patterns

Signs of Temperature Imbalance

• Poor latch feeding.
• Blueish discoloration.
• Dehydration.
• Skin temperature down.
• Weight loss.
• Lethargy.
• Poor weight gain.
• Irritability.

Interventions for Temperature Regulation

• Skin to skin contact.

Thermovitalsigns

• Skin to skin.

Temperature Measurement

• Normal is $37^\circ C$.
• Tegal (likely Tympanic) is the most accurate.

Fevers

• Tensile (likely referring to the body's ability to handle stress) almost all fevers are harmless.

Mechanisms to Combat Heat

• Perspiration.

Signs and Symptoms of Temperature Imbalance

• Brief Chills
• Sweating
• Warm
• Increased HR
• Dizziness
• Soreness in eyes
• Some symptoms of fever
• Loss of appetite
• Headache
• Increased heart rate
• Sweating
• Fatigue
• Depend on the pyrogen

Interventions

• Monitor
• Non-pharmacologic
  • Rest
  • Nutrition
  • Hydration

Addressing Pain, Discomfort, and Inflammation

Inflammation

• Inflammation of brain and swelling of liver.