Introduction
A fever, also called hyperthermia, is a temporary increase in body temperature, often due to an illness. Having a fever is a sign that something out of the ordinary is going on in the body.
A fever may be uncomfortable for an adult but usually isn’t a cause for concern unless it reaches 103 F (39.4 C) or higher. A slightly elevated temperature may indicate a severe infection for infants and toddlers.
Fevers generally go away within a few days. Several over-the-counter medications lower a fever, but sometimes it’s better left untreated. Fever seems to play a vital role in helping the body fight off a number of infections.
This blog post discusses about fever, its symptoms, nursing care plans and interventions with some examples .As you follow along, remember that our qualified writers are always ready to help in any of your nursing assignments. All you need to do is place an order with us!
Disclaimer: The information presented in this article is not medical advice; it is meant to act as a quick guide to nursing students for learning purposes only and should not be applied without an approved physician’s consent. Please consult a registered doctor in case you’re looking for medical advice.
Symptoms of Fever
A person has a fever when the temperature rises above its normal range. What’s normal for one person may be a little higher or lower than the average normal temperature of 98.6 F (37 C).
Depending on what’s causing the fever, additional fever signs and symptoms may include:
- Sweating
- Chills and shivering
- Headache
- Muscle aches
- Loss of appetite
- Irritability
- Dehydration
- General weakness
Children between the ages of 6 months and 5 years might experience febrile seizures. About a third of the children who have one febrile seizure will have another one, most commonly within the next 12 months.
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Taking a temperature
To take a temperature, you can choose from several types of thermometers, including oral, rectal, ear (tympanic), and forehead (temporal artery) thermometers.
Oral and rectal thermometers generally provide the most accurate measurement of core body temperature. Ear or forehead thermometers, although convenient, provide less precise temperature measurements.
In infants, doctors generally recommend taking a temperature with a rectal thermometer.
When reporting a temperature to your or your child’s doctor, give the reading and explain how the temperature was taken.
Causes of Fever
Fever occurs when an area in the brain called the hypothalamus shifts the set point of the normal body temperature upward. When this happens, a person may feel chilled and add layers of clothing or wrap up in a blanket or may shiver to generate more body heat, eventually resulting in an elevated body temperature.
Normal body temperature varies throughout the day — it’s lower in the morning and higher in the late afternoon and evening. Although most people consider 98.6 F (37 C) normal, the body temperature can vary by a degree or more — from about 97 F (36.1 C) to 99 F (37.2 C) — and still be considered normal.
Fever or elevated body temperature might be caused by:
- A virus
- A bacterial infection
- Heat exhaustion
- Certain inflammatory conditions such as rheumatoid arthritis — inflammation of the lining of your joints (synovium)
- A malignant tumor
- Some medications, such as antibiotics and drugs, treat high blood pressure or seizures.
- Some immunizations, such as diphtheria, tetanus, and acellular pertussis (DTaP), or pneumococcal vaccine
Complications of Fever
Children between the ages of 6 months and 5 years may experience fever-induced convulsions (febrile seizures), which usually involve loss of consciousness and shaking of limbs on both sides of the body. Although alarming for parents, most febrile seizures cause no lasting effects.
If a seizure occurs:
- Lay the child on his or her side or stomach on the floor or ground
- Remove any sharp objects that are near the child
- Loosen tight clothing
- Hold the child to prevent injury
- Don’t place anything in the child’s mouth or try to stop the seizure
Prevention of Fever
Fever can be prevented by reducing exposure to infectious diseases. Here are some tips that can help:
Wash hands often and teach the children to do the same, especially before eating, after using the toilet, after spending time in a crowd or around someone who’s sick, after petting animals, and during travel on public transportation.
Show the children how to wash their hands thoroughly, covering each hand’s front and back with soap and rinsing completely under running water.
Carry hand sanitizer with you for times when you don’t have access to soap and water.
Try to avoid touching the nose, mouth, or eyes, as these are the main ways that viruses and bacteria can enter the body and cause infection.
Cover your mouth when you cough and your nose when you sneeze and teach your children to do likewise. Whenever possible, turn away from others when coughing or sneezing to avoid passing germs along to them.
Avoid sharing cups, water bottles, and utensils with children.
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Treatments of Fever/Hyperthermia
Fever is usually associated with physical discomfort, and most people feel better when a fever is treated. But depending on your age, physical condition, and the underlying cause of your fever, you may or may not require medical treatment for the fever alone. Many experts believe that fever is a natural bodily defense against infection. There are also many non-infectious causes of fever.
Treatments vary depending on the cause of the fever. For example, antibiotics would be used for a bacterial infection such as strep throat.
The most common treatments for fever include over-the-counter drugs such as acetaminophen and nonsteroidal anti-inflammatory drugs such as ibuprofen and naproxen. Children and teens should not take aspirin because it’s linked to a condition called Reye’s syndrome.
Ways to lower a fever at home include:
- Drinking a lot of clear liquids such as water, broth, and juices or a rehydration drink
- Taking a lukewarm bath
- Resting
- Keeping yourself cool with lightweight clothing and bed coverings
Nursing Assessment and Rationales for Fever/Hyperthermia
Assessment is necessary to identify potential problems that may have led to hyperthermia and name any episode during nursing care.
1. Assess for signs of hyperthermia.
Assess for hyperthermia signs and symptoms, including flushed face, weakness, rash, respiratory distress, tachycardia, malaise, headache, and irritability. Monitor for reports of sweating, hot and dry skin, or being too warm.
2. Assess for signs of dehydration as a result of hyperthermia.
Look for signs of dehydration, including thirst, furrowed tongue, dry lips, dry oral membranes, poor skin turgor, decreased urine output, increased concentration of urine, and weak, fast pulse.
3. Monitor the patient’s heart rate and blood pressure.
HR and BP increase as hyperthermia progresses.
4. Identify the triggering factors for hyperthermia and review the client’s history, diagnosis, or procedures.
Understanding the changes in temperature or the cause of hyperthermia will help guide the treatment and nursing interventions.
5. Determine age and weight.
Extremes of age or weight increase the risk of the inability to control body temperature. The elderly are prone to hyperthermia because of the physiologic changes related to aging, the presence of chronic diseases, and the use of polypharmacy.
6. Accurately measure and document the client’s temperature every hour or as frequently as indicated or when there is a change in the client’s condition.
Using a consistent temperature measurement method, site, and device will help make accurate treatment decisions and assess trends in temperature. Use two modes of temperature monitoring if necessary. All non-invasive methods to measure body temperature have accuracy and precision variances unique to each type and method compared to core temperature methods. Note that the difference in temperatures between core temperature measurement and other non-invasive methods is considered to be 0.
7. Monitor fluid intake and urine output. If the patient is unconscious, central venous or pulmonary artery pressure should be measured to monitor fluid status.
Fluid resuscitation may be required to correct dehydration. The significantly dehydrated patient can no longer sweat, which is necessary for evaporative cooling.
Nursing Care Plans for Fever Based on Diagnosis
Nursing Care Plan 1: Diagnosis – Hyperthermia/Fever related to upper respiratory tract infection (URTI)
Evidenced by a temperature of 38.5 degrees Celsius, rapid and shallow breathing, flushed skin, profuse sweating, and weak pulse.
Desired Outcome
Within 4 hours of nursing interventions, the patient will have a stabilized temperature within the normal range.
| Interventions | Rationales |
| Assess the patient’s vital signs at least every 4 hours. | To assist in creating an accurate diagnosis and monitor the effectiveness of medical treatment, particularly the antibiotics and fever-reducing drugs (e.g., Paracetamol) administered. |
| Remove excessive clothing, blankets, and linens. Adjust the room temperature. | To regulate the environment’s temperature and make it more comfortable for the patient. |
| Administer the prescribed antibiotic and antipyretic medications. | Use the antibiotic to treat a bacterial infection, which is the underlying cause of the patient’s hyperthermia. Use the fever-reducing medication to stimulate the hypothalamus and normalize the body temperature. |
| Offer a tepid sponge bath. | To facilitate the body in cooling down and to provide comfort. |
| Elevate the head of the bed. | Head elevation helps improve the expansion of the lungs, enabling the patient to breathe more effectively. |
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Nursing Care Plan 2: Diagnosis – Hyperthermia/ Fever related to surgical wound infection
Evidenced by a temperature of 38.0 degrees Celsius, pus draining from the wound, shivering chills, and profuse sweating.
Desired Outcome
Within 4 hours of nursing interventions, the patient will have a stabilized temperature within the normal range and no signs of surgical wound infection.
In addition to the nursing interventions mentioned previously, here are some possible actions related to this particular nursing diagnosis:
| Interventions | Rationales |
| Perform a proper surgical wound cleaning and dressing change on a daily basis. | To perform appropriate wound care and aid in the healing process against the infection that has triggered the fever. |
| Inform the surgical doctor regarding the signs of surgical wound infection and inquire about the need to use antipyretic and antibiotic drugs. | Use the antibiotic to treat a bacterial infection, which is the underlying cause of the patient’s hyperthermia. Use the fever-reducing medication to stimulate the hypothalamus and normalize the body temperature. |
| Start intravenous therapy as prescribed. Encourage oral fluid intake if recommended postoperatively. | Hyperthermia can lead to dehydration. |
Nursing Care Plan 3: Diagnosis – Alteration in comfort related to Fever/Hyperthermia.
Desired Outcome
Within 4 hours of nursing interventions, the patient will have a stabilized temperature within the normal range and will verbalize feeling more comfortable.
| Interventions | Rationales |
| Remove excessive clothing, blankets, and linens. Adjust the room temperature. | To regulate the temperature of the environment and make it more comfortable for the patient. |
| Administer the prescribed antibiotic/ antiviral or antiparasitic and antipyretic medications. | Use the antibiotic/antiviral/antiparasitic drug to treat the infection, which is the underlying cause of the patient’s hyperthermia. Use the fever-reducing medication to stimulate the hypothalamus and normalize the body temperature. |
| Offer a tepid sponge bath. | To facilitate the body in cooling down and to provide comfort. |
| Elevate the head of the bed. | Head elevation helps improve the expansion of the lungs, enabling the patient to breathe more effectively. |
| Offer a cooling blanket to the patient. | To facilitate the body in cooling down and to provide comfort. |
Nursing Care Plan 4: Diagnosis –Fluid Volume Deficit related to dehydration due to fever
Evidenced by a temperature of 39.0 degrees Celsius, skin turgidity, dark yellow urine output, profuse sweating, and blood pressure of 89/58.
Desired Outcome
Within 48 hours of nursing interventions, the patient will have a stabilized temperature within the normal range and will verbalize feeling more comfortable.
In addition to the nursing interventions mentioned previously, here are some possible actions related to this particular nursing diagnosis:
| Interventions | Rationales |
| Commence a fluid balance chart, monitoring the input and output of the patient. | To monitor patient’s fluid volume accurately and effectiveness of actions to reverse dehydration. |
| Start intravenous therapy as prescribed. Encourage oral fluid intake. | To replenish the fluids lost from profuse sweating and to promote better blood circulation around the body. |
| Educate the patient (or guardian) on how to fill out a fluid balance chart at the bedside. | To help the patient or the guardian take ownership of the patient’s care, encourage them to drink more fluids as needed, or report any changes to the nursing team. |
| Monitor patient’s serum electrolytes and recommend electrolyte replacement therapy (oral or IV) to the physician as needed. | Sodium is one of the important electrolytes that are lost when a person is sweating. Hyponatremia or low serum sodium level may cause brain swelling. |
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Nursing Care Plan 5: Diagnosis –Fever/Hyperthermia related to possible catheter-associated UTI
Evidenced by a temperature of 38.7 degrees Celsius, cloudy urine, pain in the lower back, positive urine dipstick, and profuse sweating.
In addition to the nursing interventions mentioned previously, here are some possible actions related to this particular nursing diagnosis:
| Interventions | Rationales |
| Collect a urine sample and send it to the lab for urinalysis and culture. | To confirm the medical diagnosis of urinary tract infection and determine the underlying bacteria that caused it. |
| Change the urinary catheter. | To remove the contaminated catheter and replace it with a new one that is fit for purpose. |
| Perform regular catheter care properly. | Regular catheter care is required to ensure that there is no recurrence of infection. This involves proper documentation to show that it is done frequently. |
questions
What is the nursing care plan for fever?
Adjust the room temperature.To regulate the temperature of the environment and make it more comfortable for the patient.Administer the prescribed antibiotic and anti-pyretic medications. Use the antibiotic to treat bacterial infection, which is the underlying cause of the patient’s hyperthermia.
How will you manage a patient suffering from fever?
making sure the room temperature where the person is resting is comfortable. taking a regular bath or a sponge bath using lukewarm water. taking acetaminophen (Tylenol) or ibuprofen (Advil) drinking plenty of fluids.
