for patients with fever Care
human body temperature is constant, unlike cold-blooded animal, body temperature is unstable and varies depending on the ambient temperature.In a normal human body temperature is very slight variations depending on the time of day: in the morning the temperature of a healthy person is somewhat lower than in the evening.Also, higher temperatures in children than in adults, and it is higher in women during menstruation.This is due to the intensity of oxidation processes.Physiological body temperature fluctuations normally not exceed 1 ° C.The process of maintaining the stability of body temperature is called the regulators, it provides education and heat production by the body.With the development of the pathological process in the human body is a violation of thermoregulation, which manifests itself through fever.
Fever called adaptive reaction of the organism in response to various stimuli (bacteria, viruses, tissue decay, parasites).
Bacteria and emissions of waste products act as human thermoregulato
in response to viral infection produces interferon, the formation of which requires a lot of energy consumption and can only occur at a fever.
Allocate fever of infectious and non-infectious origin.The latter arise when absorption decay products of damaged tissues hemorrhage, the introduction of a foreign protein poisoning.
To measure temperature using a medical thermometer with graduations from 34 to 42 ° C.Measured temperature is usually in the armpit, at least in the inguinal crease, rectum, mouth.In the armpit should be inflammation because it results in a local temperature increase and distorts the actual body temperature.Before thermometry armpit dry wipe with a towel, because moisture will also affect the accuracy of temperature measurement.
well sanitized thermometer should be shaken to the mercury dropped below the scale.It was then placed in a temperature measuring point lower end.The patient should firmly press the thermometer to the body for 7-10 minutes.When the unconscious patient and excited hand must adhere to the nurse or carer (the same applies to young children).
obtained in the measurement of the temperature data is recorded as a nurse in the thermal sheet, and a doctor - in history.The sheet temperature thermometry data recorded in accordance with the measurement time, is obtained as a result of the line, which is called "temperature curve".The temperature curve is a graphic representation of the clinical course of the fever.
According to the degree of temperature rise are the following types of temperature curves: low-grade - no higher than 38 ° C, febrile - up to 39 ° C, high 39-40 ° C very high - above 40 ° C.
There are several species of fever height, duration, nature of the temperature fluctuations.
By the nature of variations in temperature, the following types:
• persistent fever (Jebris continua) - high, prolonged fever with daily fluctuations of temperature of 1 ° C.This type is characteristic of typhus and typhoid fever, lobar pneumonia;
• laxative fever (Jebris remittens) - fever with daily fluctuations in temperature of 1 ° C.Observed in suppurative disease, focal inflammation of the lungs;
• intermittent fever (Jebris intermittens) - fever occurs in malaria.Similarly with hectic.Increasing the temperature can last from one hour to several hours, repeated every 1-2 days depending on the type of agent;
• draining or hectic fever (Jebris hectica) - prolonged fever, with daily fluctuations in the 4-5 ° C and temperature drop to normal values.It is found in pulmonary tuberculosis, sepsis;
• perverse fever (Jebris inverse.) - Similar to the hectic fever.With this type of morning says the maximum temperature rise, and in the evening it is reduced to normal values.It is found in tuberculosis, and sepsis;
• atypical fever (Jebris irregularis) - this type is characterized by a fever of uncertain duration and wrong, a variety of daily temperature fluctuations.It occurs in many diseases;
• relapsing fever (Jebris reccurens) - fever is characterized by regular change of febrile and afebrile periods and lasts several days.wherein the temperature span may be up to 4-5 ° C.Characteristic for relapsing fever;
• undulating fever (Jebris undulans) - is caused by the change of periods of gradually increasing the temperature to high numbers and gradually reduce it to subfebrile or normal numbers.It occurs when brucellosis and chlamydia.
Care febrile patients is of great importance to facilitate the patient's condition, his recovery.In the process of care is important to work nurse, which in direct communication with the patient monitors the dynamics of his condition, says the appearance of new symptoms.A nurse conducts medical and hygienic measures, distributing drugs at a certain time and monitors their reception.The important role played by the reception and administration of drugs to the patient on the clock as a delay or missed reception result in the failure of the treatment process and recovery delay.Nurse heavy bedside need to know the symptoms of complications, life-threatening, to be able to see them in time to inform the doctor and to provide emergency aid.
To care for febrile patients need to be aware of the stages of the disease process.Steps can be easily determined by transient fever (malaria, flu) and it is difficult - if prolonged.
Each stage has its own symptoms and characteristics of the course, so the patient care at different stages of the febrile process has its own characteristics.
In the first stage the temperature increase heat production predominates over emissivity.This stage can last from several hours to several days.Objectively, it is manifested by headache, muscle pain, weakness, thirst, sometimes marked pallor of extremities.A quick rise in temperature is usually poorly tolerated by patients because of the shaking body chills.The patient should first warm: warm blanket to hide, to impose a warm heating pad (to avoid scalding hot water bottle should not be very hot, and contact with the body, for that it is better to wrap up in a towel), to give the patient to drink hot sweet tea, decoction of herbs.At this stage you need to monitor the condition of the patient, his organs and systems (to measure blood pressure, pulse, follow the diuresis).
In the second stage, the maximum temperature rise there is a relative balance between heat production and heat loss.This is the most sustained period of feverish process.Its duration can be from a few hours to several days.Stops the temperature rise, resulting in runs chills, decreased tremor in the muscles (hence the pain in them), decreased peripheral vascular spasm, there is hyperemia (redness) of the skin.
Patients in this stage complain of headache, weakness, dry mouth, feeling of fever.There have been rapid heartbeat (tachycardia), rapid breathing (tachypnea), there may be a decrease in blood pressure - hypotension.
At this stage, metabolic disorders.In the body, begin to degrade carbohydrates, fats, proteins, at the same time in connection with a reduction in the digestion and absorption is reduced intake of nutrients.All this leads to depletion of the body.Patients lose weight.At this stage, much attention should be paid to the state of the cardiovascular system in a timely manner to prescribe drugs for the deceleration pulse, hypotension maintain blood pressure at a normal level.Patients should be fortified excessive drinking, taking antipyretics.
In the third stage at lower temperature heat production decreases, the heat transfer is increased.Temperature decrease could be due to lysis type - it is a slow, prolonged drop in temperature, but the type of crisis or when the temperature decreases rapidly within a few hours.
critical temperature decrease heavily tolerated due to the fact that there are symptoms of acute heart failure.
There are three stages of feverish process:
• temperature rise stage;
• Stage a maximum temperature rise,
• temperature reduction step.
sharp drop in temperature below the normal level occurs with deterioration of general condition of the patient.Patients have weakness, thirst, fever may reappear.The skin is pale, cold sweat acts, decreases blood pressure, pulse quickens, but becomes small, soft, frequent breathing.Develops collapse.
At congenial critical temperature reduction in the patient noted increased sweating, breathing and pulse are stored in the normal feverish excitement passes, the patient falls asleep.
severity for a period of feverish process depends on the disease that caused the fever, the general state of the organism, the functional state of the nervous, endocrine, cardiovascular system of the patient, intensity of oxidative processes.
At higher temperatures there is a metabolic disorder in the body.Violated the water-salt balance, increases fat metabolism, increases the excretion of nitrogen in urine, increased blood sugar, it is often observed glycosuria.When fever occurs quickening heart rate of 10 beats per minute at a temperature increase of 1 ° C.Also according to the increase of temperature and heart rate, shortness of breath occurs.
Temperature rise reflects the state of the organism reactivity, its ability to fight infection.But it is not always possible to regard as a fever favorable for the body of the patient process.Excessive temperature rise, as well as the reduction of its lower than normal, always difficult tolerated and has an adverse effect on the body, so in the treatment of fever requires an individual approach to each patient.
Patients with fever require special attention and care.In different periods of feverish process of patient care has its own characteristics.When hyperthermia patient need to provide rest, bed rest.The patient should be warm shelter when necessary (when potryasyvayuschem chills) warm heaters.It needs to drink hot sweet tea.During the period of maximum temperature rise as a result of excitation of the central nervous system of the patient possible improper conduct: he can jump out of the room, jump out of the windows, etc.Such patients require constant monitoring nurse.It should monitor the heart rate, blood pressure level.With the deterioration of the patient sentry nurse should immediately inform your doctor.
At high temperature figures, its large fluctuations during the long process of feverish patient severely depleted.To keep the body of the patient, replenish energy costs, increasing its resistance must be in the patient's diet include a high-calorie, high-protein and digestible food in a liquid or semi-liquid form.The patient can feed chicken broth with mashed vegetables, cereals.During the rise in temperature in the patient's appetite is reduced, so it is necessary to feed the sick often but in small portions.When hyperthermia in the body of the patient accumulate toxic products, which have a damaging effect on the body's cells.For the excretion of toxic substances to the patient must be abundant, fortified drink, you can give the patient
fruit and berry juices, fruit drinks, mineral water without gas (for the prevention of flatulence).The diet of the patient is restricted salt intake.During this period, the patient says dry mouth, may appear small sores (aphthous stomatitis), cracks in the corners of the mouth.To facilitate the state nurse must lubricate the oral cavity of the patient furatsilina solution (nitrofurazone), ulcers treated with 3% hydrogen peroxide solution, cracks lubricated with sterile liquid paraffin or any fat cream.If too high, the temperature of the patient may experience a sharp headache, to reduce it to the forehead put an ice pack or cold compress.To do this in cold water (preferably on ice), moisten a piece of folded in several layers of absorbent tissue, slightly wring out and put on the forehead.After 3-5 minutes, it is replaced by another, and so can be continued for one hour.Sometimes water is added acetic acid.as sponging with cool water is used to reduce fever.For the prevention of complications of the cardiovascular system can be cleaned area of large blood vessels, heart vodka.A nurse has to make sure that the patient is not freezing that in the House there was no drafts, noise.
nurse must care for the skin of the patient, to carry out prevention of bedsores.If constipation is enema.Often staged cleansing enema helps to reduce the temperature and the normalization of the patient's condition.In severe fever patient physiological functions must perform in bed in the vessel.
At the critical temperature decreases a patient develops acute cardiovascular failure, which shows sharp decline in blood pressure, increased heart rate, breathing, sweating, pale skin becomes cold.This condition requires immediate medical care.A nurse should immediately inform your doctor and quickly carry out his purpose.The patient is administered drugs that increase blood pressure, caffeine, adrenaline.In this state, he should change underwear and bed linen, it must be warm, to hot drink.
critical temperature drop occurs in lobar pneumonia, malaria, influenza.
lytic When the temperature drops (slowly, gradually) the patient's condition is usually not impaired.There is a little sweating, weakness, the patient can go to sleep.Sleep in this case - the best medicine!