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Care of patient with altered body temperature

Care of patient with altered body temperatureDeblina Roy M.Sc. Nursing 1st year

Definition of body temperatureBody temperature is the heat of the body.-- reflects the balance between the amount of heat produced by body processes the amount of heat lost to the external environment

Definition of body temperaturecore temperature : temperature of deep tissues (cranium, thorax, abdominal and pelvic cavity ), relatively constant Surface temperature :the temperature of the skin, the subcutaneous and the fat tissue , fluctuates from 36 to 38

Heat productionHeat is produced in the body through metabolism. The main heat production organs of the body are liver and skeletal muscles.Heat production occurs during rest, voluntary movements, involuntary shivering, and nonshivering thermogenesis(brown adipose).

Heat lossHeat is lost through physical mode. The main heat loss part of the body is skin. (70%) (R29%,elimination1%)RadiationConductionConvectionEvaporation

Regulation of Body Temperature Neural and Vascular Control Behavioral Control

Neural and Vascular ControlT regulation center :the hypothalamus , controls body temperature the same way a thermostat works in the home (reflex arc)the anterior hypothalamus controls heat loss Via sweating, vasodilation, inhibition of heat production the posterior hypothalamus controls heat production via muscle shivering , heat conservation by vasoconstriction of surface blood vessels

9Normal Blood Temperature(37 )Factors whichincrease metabolic rate or Environmental temperatureIncreased blood temperatureabove level at which thermostatin hypothalamus is set (37 )Stimulated thermal receptorsOf heat-dissipating center in hypothalamus, initiatingimpulses that lead toIncreased sweatsecretionDilation of skin blood vesselsIncreased heat Loss by radiation Increased heatLoss by evaporationDecreased bloodtemperature(to or toward)

Heat loss mechanisms to maintain normal body temperature

Behavioral control of body temperatureenvironmental temperature fall: add clothing move to a warmer place raise the thermostat setting increase muscular activity by running sit with arms and legs tightly wrapped together

Behavioral control of temperatureThe ability of a person to control body temperature depends on the degree of temperature extreme the persons ability to sense feeling comfortable or uncomfortable--infants, older adults thought processes or emotions--depression the persons ability to remove or add clothes infants, children

Average Temperature and Normal Range of Adult site average temperature normal range oral 37 36.3-37.2 rectal 37.5 36.5-37.7 axillary 36.5 36.0-37.0

Factors Affecting Body Temperature Measurement siteCircadian rhythms : drops between 2 and 6 AM peaks between 1 and 6PMAge: With age,T tends to fall . infancy: temperature regulation is labile aging: control mechanisms deteriorate

Factors Affecting Body TemperatureStress: Stimulate sympathetic nervous system -- epinephrine and norepinephrine production , -- metabolic activity heat production --TEnvironment: the extent of exposure, air temperature and humidity the presence of convection currents Ingestion of hot/cold liquids Smoking: increase body temperature

Fever or HyperthermiaA body temperature above the usual range is called fever. A true fever results from an alteration in the hypothalamic set point. Pyrogens such as bacteria and virus cause a rise in body temperature. Fever is an important defense mechanism.

Fever process and manifestationFever-chill phase: heat production>heat loss; experience tiredness, paleness, dryness, chills, shivers, and feels cold (2 patterns)plateau phase : heat production=heat loss; warm , dry, R , P , headache, faint.fever break phase: heat production41 >105.8

Patterns of Feveris the modality of a temperature curve. differ depending on the causative pyrogen. The increase or decrease in the amount of pyrogens results in fever spikes and declines at different times of the day. The duration and degree of fever depends on the pyrogens strength and the ability of the individual to respond. ----serve a diagnostic purpose.

20Patterns of Fever

Constant Fever Remittent Fever Intermittent fever Irregular Fever

Constant Feversustains between 39~40demonstrates little fluctuation of less than 1 within 24 hours. ( pneumonia , typhoid)

Remittent Feverhas great fluctuation above the normal with more than 1 in 24 hours and cannot return to normal temperature level. (septicemia , rheumatic fever)

Intermittent feverfluctuates greatly in 24 hours, may suddenly rise above the normal then suddenly fall to or below the normal alternates regularly between a period of fever and a period of normal temperature levels (malaria, tuberculosis)

Irregular Feverirregularity alternates between a period of fever and a period of normal temperature values. ( influenza , cancer)

Hypothermia A body temperature below the lower limit of normal 35 is called hypothermia Heat loss during prolonged exposure to cold overwhelms the bodys ability to produce heatcausing hypothermiaHypothermia may be intentionally induced during surgical procedures to reduce metabolic demand and the bodys need for oxygen

Classification of Hypothermia Mild 33.1-36 91.5-96.8Moderate 30.0-33 86.1-91.4Severe 27-30 80.6-86.0Profound

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