NR602 Week 5: Homework- MyEvaluations Log

Fever is among the most frequent causes of pediatric office visits in primary care. Although fever is frequently a benign component of sickness and is common in youngsters, the child’s medical history must be carefully examined. The condition of the kid may require more than a standard exam in some circumstances. In this session, some basic evaluation ideas are covered, however it should be noted that monitoring, regulating, and understanding the function of fever in children are still developing fields. To ensure that the entire immunological response from vaccines may occur, it is no longer advised to use an over-the-counter fever reducer prior to immunizations (Prymula et al., 2009). Below are some areas to consider in evaluating fever in a primary care setting in infants and children.

There are a few definitions of fever, but the most widely accepted parameter is 100.4°F or 38°C rectal (Hay, Levin, Deterding, & Abzug, 2018). However, the AAP notes that normal fever in children can range from 97 to 100.4 degrees (Sullivan & Farrar, 2011). The methods with which temperature can be evaluated vary and mercury thermometers should not be used.

Below are some important points about accurately measuring pediatric temperatures.

(Craig, Lancaster, Taylor, Williamson, & Smyth, 2002; Society of Pediatric Nurses, 2007; Sullivan & Farrar, 2011)

Fever is not an illness, but a manifestation of changes in the body that occur most frequently as a systemic response to fight foreign material. In the body, endogenous pyrogens cause the hypothalamus to reset internal temperature regulation to a higher point. Fever aids in arresting invader reproduction and causes increased neutrophil and T-lymphocyte production (Hay et al., 2018; Sullivan & Farrar, 2011). The range of causes of fever is broad, from neurological disease and malignancies to common infections and even medications. Although it may cause discomfort in the child, there is some data to support that fever may even help in building immunity and in speeding up recovery from an illness (Sullivan & Farrar, 2011). No evidence to date supports the idea that teething causes fever above 38.4°C (Hay et al., 2018).

Below is a list of considerations in evaluating any infant or child with fever.

(Hay et al., 2018; Sullivan & Farrar, 2011)

Additional workup is needed in children without an obvious exam finding who are younger than 3 months of age, have a fever for longer than 72 hours, have a very high fever, or have a reoccurring fever for more than 7 days . In these cases, a CBC, urinalysis, and anterior/posterior/lateral chest radiograph should be considered.NR602 Week 5: Homework- MyEvaluations Log

Fever can be a frightening experience for parents. Proper anticipatory guidance should be a routine part of well-child care, as well as sick visits. This includes how to measure temperature accurately, when to use over-the-counter medications, and when to call the healthcare provider’s office. Reminding the parents of the goals of care and offering parents information on when and how to properly treat a fever (particularly with a sick child) can help ease a parent’s concerns. Oftentimes, parents need to know how to help their child feel better. These suggestions can be of benefit and assist the parents as well.

Prescriptions Writing – Practice

(Hay et al., 2018; Sullivan & Farrar, 2011)

Week 5: References