Fever 101
Interventions
Ddx
Paging NP ___
100

What are some ways to measure body temperature?

rectal

oral

axillary

temporal

tympanic

tactile (subjective)

100

What is the first-line antipyretic recommended for a child with a fever?

Acetaminophen (Tylenol)

Source: UpToDate, 2023

100

What common viral infection is associated with a rash and high fever in toddlers, often appearing after the fever breaks?

Roseola

- followed by the appearance of a rash once the fever breaks, characterized by a few discrete popular erythematous lesions confined to the anterior chest and abdomen

Source: El-Radhi, 2018

100

Assess for signs of hyperthermia.

flushed face, weakness, rash, respiratory distress, tachycardia, malaise, headache, and irritability, monitor for sweating, hot and dry skin

200

What is considered "normal temperature"? (give a range)

97F (36.1C) and 99.3F (37.4C)

AAP considers a temperature above 100.4F (38C) as a sign of a fever.

Source: American Academy of Pediatrics, 2022

200

List some ways to treat fever at home

Provide your child with fluids

Dress your child lightly to help keep them cool 

Sponge with lukewarm water 

Check temperature every 4 hours in the day

200

The Pt has a low-grade fever, runny nose, and minimal rhinorrhea. What common viral infection primarily affects the upper respiratory tract?

viral rhinitis or the common cold

Source: Thomas, 2023

200

State some questions you would ask for in a fever visit.

OLDCARTS, duh! (HPI)

ROS

PMH, FHx, PSH

How and when fever is being measured.

Impact on functioning/ADLs.

Medications and allergies.

300

What is the recommended method to measure temperature in our 2yo Pt?

Rectal (rec for under 4 years of age)

Source: American Academy of Pediatrics, 2022

300

What NOT to do at home when treating for fever?

1. Do not use aspirin to treat (Reye syndrome is a serious illness that affects the liver and brain).

2. Do not use cold water (can cause shivering and increase your child's temperature).

3. Never apply rubbing alcohol (rubbing alcohol can be absorbed into the skin or inhaled, causing serious conditions such as a coma).

Source: El-Radhi, 2018

300

What is the potential complication of untreated urinary tract infection (UTI) in toddlers?

Kidney damage

Untreated UTIs in toddlers can potentially lead to kidney damage. The infection may ascend from the lower urinary tract to the kidneys, causing pyelonephritis.

Source: El-Radhi, 2018

300

How would you address the parent's concern about the rash on our Pt's chest?

Explain that rashes are common with viral infections, and it may resolve as the illness improves.

400

Name the 3 different fever categories and its duration

1. acute: less than 7 days

2. sub-acute: up to 2 weeks

3. chronic or persistent: greater than 2 weeks

Source: Netmeds, 2020

400

High fevers in young children can cause ____ and what to worry about

Seizures.

- Occurs in children btwn 6mo and 5yrs w/ a temp >100.4F (38C). 

- A FHx of febrile seizures increases risk.

- Having one episode increases the risk of having another febrile seizure.

Source: Leung, 2018

400

Koplik (tiny-whitish spots in the buccal mucosa) can be found with what diagnosis?

Measles (prodromal phase)

Symptoms like abrupt high fever, sneezing, dry cough, and conjunctivitis, align with the initial pre-exanthem stage of measles, resembling a common cold. As measles progresses, the characteristic rash appears.

Source: El-Radhi, 2018

400

If the child develops respiratory distress during the visit, what immediate actions would you take?

Assess airway, breathing, and circulation (ABCs)

Consider oxygen support and prompt referral to emergency services

500

Describe some behavioral responses to fever

Cognitive changes (ranging from mild difficulty concentrating to delirium).

Wearing or covering w/ additional layers to keep warm d/t chills.

Decreased activity.

Fatigue/malaise.

Decreased oral intake.

500

In the case of our 2 yo Pt with fever, what role does parent education play in preventing OTC medication errors?

Parents should be educated on proper dosing based on the child's weight, understanding the difference between formulations (ex. infant vs. children's), and avoiding double-dosing by combining multiple medications with similar ingredients.

Source: American Academy of Pediatrics, 2022

500

What respiratory syncytial virus (RSV) precautionary measures would you recommend for a 2 yo with fever and respiratory symptoms?

Isolation precautions to prevent the spread of the virus.

RSV is highly contagious, especially in young children. Isolation precautions, including proper hand hygiene, wearing masks, and maintaining distance from other individuals, are essential to prevent the spread of RSV.

500

Name some red flags (concerns) for a fever exam

rigors

very high temp

hypotension

oliguria

CNS abnormalities (change from baseline)

cardiorespiratory compromise

new, significant cardiac murmurs

petechial eruption

significant leukocytosis or leukopenia

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