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22 Cards in this Set
- Front
- Back
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What is the "practical definition" of a fever?
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temperature of 38 (100.4) and up
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What is the most reliable way to take a temperature?
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Rectal
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When are rectal temps the ONLY way to go?
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for the first three months
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Difference between Fever and Hyperthermia?
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Fever is well regulated by body, not dangerous, and rarely exceeds 41 (105ish)
Hyperthermia is dysregulated and very dangerous |
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Benefits of Fever?
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Helps fight infection
Adaptive Immunity is more potent at high temp Viral and Bacterial Replicaction decreases Ag processing enhanced |
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Disadvantages of Fever
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Inc Metabolic Rate
Inc O2 consumption Inc CO2 production Inc demands on CV and Pulm systems Uncomfortable Can-->febrile convulsions in 6mo-5yr kids |
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Dangers of high temps?
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Above 42 is BAD and almost always hyperthermia and not fever
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Symptomatic Rx of Fevers?
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Antipyretics for discomfort
Acetaminophen and Ibuprofen are = Aspirin is BAD for kids |
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Causes of Fevers
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Infectious Disease (most common)
Non-Infectious Inflammatory Disease Malignancies Other (drug fever) |
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Typical Viral Infections causing Fever?
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Rotavirus (GE)
Enterovirus (GE, viral meningitis) Influenza virus Respiratory Syncytial Virus (bronchiolitis) |
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Other viruses...
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Herpes
Varicella Adenovirus Coxsackievirus EBV |
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What are the types of serious bacterial infection?
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Bacteremia
Bacterial meningitis Bacterial pneumonia Cellulits Osteomyelitis Bacterial GE Septic Arthritis UTI/pyelonephritis |
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Other Focal (not as serious) bacterial infections leading to fever?
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Pharyngitis
OM Lymphadenitis Impetigo Sinusitis |
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What is the most important element of the History for Dx fever?
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Age of Pt
it alters the Dx and Rx |
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What else is important to the Hx?
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Sx's (resp, GI)
Duration Behaviors (feeding, irritable) Exposures (siblings, etc) Previous Illnesses Birth History (mom fever, GBS, STD's) |
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Key parts of physical of febrile infant?
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Visual Inspection
Vitals |
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Keys to Lab of febrile munchkin?
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CBC w/ Diff (for leukocytosis, etc)
Blood culture (bacteremia) Urinalysis w/ culture Lumbar Puncture Stool Examination Chest X-ray Metabolic Profile Throat culture |
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Why is proper Dx and Rx of fever so important in neonates and infants?
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B/c Fever is often the only Sx
B/c incidence of serious bacterial infection is higher in infants<3mo than at any other time of childhood |
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Guidelines Based on Age:
Neonates (0-28d) |
Admit to Hospital for Full Sepsis Eval if >38
CBC w/ diff Blood Culture Urinalysis w/ culture Lumbar Puncture +/- others Empiric Antibiotics |
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Guidelines Based on Age:
Infants (1-3months) who is ill appearing w/ temp over 38.5 |
Ill-appearing + temp over 38.5-->
Full Eval of blood, urine, CSF Admit Empiric AB's |
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Guidelines Based on Age:
Infant, 1-3 months, well-appearing w/ temp over 38.5 |
CBC
Blood Culture Urinalysis w/ culture Depending on risk, maybe go home, maybe admit, empirics, and lumbar poke |
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Guidelines Based on Age:
3-36 months |
Temperature must be over 39
Incomplete Immunization-->CBC, blood and urine culture Possibly puncture and empirics |
