Self Care: Fever/headache

Front 1

Quest

Back 1

quickly and accurately assess the patient

establish that the patient is an appropriate self care candidate

suggest appropriate self-care strategies

talk with the patient

Front 2

examples for fever

Back 2

how high is the fever, how long have you had it, how did you take your temperature, when did you notice the fever, did you get the flu shot

have you taken anything to treat?

what other medical conditions do you have?

can they be self treated

Front 3

SCHOLAR

Back 3

Symptoms

characteristics

history

onset

location

aggrevating factors

remitting factors

Front 4

MAC

Back 4

medications

allergies

conditions

Front 5

fever

Back 5

body temp higher than normal core temperature of 100 degrees F

Front 6

pathophysiology of fever

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core body temp controlled by hypothalamus and regulated by feedback system that involes information transmitted between thermoregulatory center in hypothalamus and thermosensitive neurons in skin and CNS

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causes

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etiology

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causes of fever

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microbial infections

response to drugs

vigorous activity

noninfectious pathogenic causes

Front 9

drug fever

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febrile response to administration of a drug

Front 10

drug fever temperature range

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98.9-109 degrees F

Front 11

what does drug fever cause

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maculospapular rash, relative bradycardia

Front 12

pyrogens

Back 12

fever producing substances activate body's host defenses increasing set point

Produce PGE2 (prostoglandin of the 2 series)

cause chills

Front 13

who tolerates fever well?

Back 13

children tolerate fever well, when they arenot acting themselves there is a problem, floppy baby syndrome

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piloerection

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goosebumps (cools down the system

Front 15

thermometers

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rectal, axillary, oral, temporal, tympanic

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if they start with one thermometer you...

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do not want to switch, keep it consistent

Front 17

when using a rectal thermometer, temperature of... is elevated

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100.4F, 1 inch insertion

preferred method for younger than 6 months

Front 18

oral temperature fever is considered above

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99.5F

not for children younger than 3yo

Front 19

tympanic temp is fever if above

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100F

senses infrared heat from blood vessels in the ear drum

Front 20

tympanic temperature is not for use

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in infants younger than 6 months because anatomy of the ear isn't fully developed

Front 21

tympanic temp is more accurate than

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axillary or oral

Front 22

temporal

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100.1, 100.3, 100.7

side of forehead over temporal artery, move across forehead

Front 23

temporal is

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more sensitive than tympanic but not better than rectal

Front 24

axillary

Back 24

for use under the armpit

Front 25

temperature greater than

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99.3 is considered fever, add 1 degree to obtain oral reading

Front 26

complications of fever: what to give for fluids

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low sugar, pedilyte over gatorade to reduce diharrea

Front 27

should see a peak reduction in up to...

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2 hours, first help in 30 minutes with tylenol or ibuprofen

Front 28

febrile seizures

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seizure with fever in infants/children who do not have intracranial infection, metabolic disturbance, defined cause

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most common in

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children with mental disorders, children at daycare, or hospital stay of more than 30 days as an infant

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peak age of febrile seizures is

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18-24 months of age

Front 31

what is recommended?

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antipyretics recommended to make child more comfortable but do not reduce risk of recurrent febrile seizures

Front 32

if the child has the history of febrile seizures, temp of 100, what do you do?

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how is the child acting, if he's fine just observe

Front 33

hyperpyrexia

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dehydration, delerium, seizures, coma, irreversible neuro/muscular damage more often

temperatures >106F, associated with hyperthermia

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fever of ... may be treated with antipretic and nonrx measures

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101, only treating if fever is greater than 101

Front 35

call pediatrician if rectal temp is

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104+, difficult to wake, irritable

Front 36

how quickly can a baby get dehydrated

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less than a day

Front 37

drugs: acetaminophen

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325mg to 1000mg every 4 to 6 hours

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ibuprofen

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200-400 every 4 to 6 hours

Front 39

naproxen

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220 q 8-12h

Front 40

aspirin

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not recommended

Front 41

before taking tylenol, ask about

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alcohol consumption

Front 42

pediatric acetaminophen dosage

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10-15mg/kg dose ever 4 to 6 hours (MAX 75mg/kg/day)

Front 43

ibuprofen pediatric dosage

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5 to 10mg/kg q6-8h (6 to 12 mo old)

Front 44

naproxen

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not recommended under 12 years

Front 45

all antipyretics decrease

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PGE2 by inhibiting COX enzyme

Front 46

ibuprofen has max temp reduction at

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2 hours, same for acetaminophen

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acetaminophen is metabolized

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in liver to inactive glucuronic and sulfuric acid conjugates

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inbuprofen metabolized

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in the liver

Front 49

NSAIDs relieve pain via

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peripheral inhibition of cyclooxygenase and subsequent inhibition of prostaglandin syntehsis

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aspirin works by

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inhibiting prostaglandin synthesis from arachidonic acid by inhibitinng both isoforms of COX enzyme

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ibuprofen vs apap in reducing fever after single dose

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ibuprofen marginally superior to APAP

Front 52

Fever pearls work in

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30 to 60 minutes and begin to work

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do not use antipyretics longer than

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3 days without evaluation of underlying cause

Front 54

max dose of apap

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3 grams a day otc

Front 55

acetaminophen contraindications

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liver, regular or high alcohol consumption

Front 56

ibuprofen

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history of GI bleed, epptic ulcer disease

Front 57

approximately .... percent of headache are not associated with underlying illness

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90 percent

Front 58

self treatable headaches (3)

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tension type

diagnosed migrane

sinus headache

Front 59

tension type

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stress headaches

episodic

chronic is greater than 15 days per month

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impact of tension type

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lack of concentration, inability to study, cannot go to work

Front 61

micrane: with/without aura

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flashing lights, ringing, stars, poor vision

Front 62

triggers of migrane:

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dehydration, stresss, not enough sleep, certain foods, lack of caffeine, white walls

Front 63

sinus headache presents in patients with

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acute sinusitis

Front 64

treatment of sinus headache

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pseudaphed, phenelephrine and an NSAID

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medication overuse headache

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rebound effect after withdrawal of analgesic

greater than 3 days per week for several weeks would cause trouble

Front 66

treatment of medication overuse headache

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taper therapy, may need to go on a prescritpion if withdrawal headaches are too much

Front 67

tension type

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bilateral, varies from diffuse ache to tight pressing pain (mild to disabling)

onset is gradual

usually resolved in less than a day

Front 68

migrane

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unilateral usuall, aura, sudden onset, may last hours to day

Front 69

sinus headache pain in the

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face, forehead. periorbital area

Front 70

if the patient bends down, do they

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feel pain?

Front 71

sinus headaches can last

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for days because it's fighting a bacterial or viral infection

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treatment: tension headache

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acetaminophen, NSAIDs, salicylates

Front 73

nonpharmacological treatment of tension type

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stretch and strengthen neck and head muscles

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migraane

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nutritional strategies, sometimes magnesium supplementation, stress reduction

Front 75

acetaminohen pears

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2 tabs q6h, max 6/day

Front 76

capsules can be opened into a spoonful of...

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yogurt applesauce

Front 77

maximum alcohol use with acetaminophen

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not more than 3 alcoholic beverages a day

Front 78

tylenol overdose

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activated charcoal within 1 hour

acetylcysteine within 8 hours

refer

Front 79

NSAID onset time and durtion

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30 minutes, lasts 6 to 8 hours

Front 80

NSAIDS and acetaminophen

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1 baby aspirin 1 hour before nsaid, or 8 hours after nsaid

Front 81

NSAIDS have an increased

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cardiovascular risk

Front 82

FDA for CV patients

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FDA says 10 days under medical supervision

Front 83

salicylates dosage

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4 to 6 grams/day for antiinflammatory effects

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salicylism

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mild salicylate intoxication

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salicylates are avoided

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in patients with GI risks

Front 86

when do you stop asa before tests/surgery

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3 to 7 days beforehand

Front 87

RAYE's syndrome

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avoid use in less than 16 years old, rare disorder in childhood, characterized by symptoms of encephalitis combined with evidence of liver failure

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Special populations by age

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children less than 8yo, refer to md

Front 89

children greater than 2 yo may use acetaminophen or ibuprofen

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12 years old

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may use naproxen

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15 years old

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may use aspirin

Front 92

pregnancy and lactation

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acetaminophen is fine

nsaid contraindicated during third trimester

aspirin avoid use

Front 93

which is avoided in breastfeeding

Back 93

aspirin