Fever: causes, symptoms, measurement, classification & treatment
Fever can be defined as elevation of the body temperature more than usually by about 1-2 ° above the normal 98.6 degrees Fahrenheit (F) or 37 degrees Celsius (C). Fever is not a disease and is a symptom and it differs from hyperthermia.
Causes of fever:-
* Viral or bacterial Infections : influenza, common cold, Human immunodeficiency virus, malaria, infectious mononucleosis, or gastroenteritis, strep throat, pneumonia, flu and chickenpox, Endocarditis, Encephalitis and Meningitis Gastroenteritis (Stomach Flu), Melioidosis, Staph Infection (Staphylococcus Aureus) , Respiratory Syncytial Virus, and other infections causes fever.
* Various skin inflammations : boils, pimples, acne, or abscess cause fever.
* Immunological diseases : lupus erythematosus, sarcoidosis, inflammatory bowel diseases also cause fever.
* Tissue destruction : which can occur in hemolysis, surgery, infarction, crush syndrome, rhabdomyolysis, cerebral hemorrhage, etc cause fever.
* Drug fever : is directly caused by the drug, e.g. lamictal, progesterone, or chemotherapeutics causing tumor necrosis.
as an adverse reaction to drugs, e.g. antibiotics or sulfa drugs.
* After drug discontinuation, e.g. heroin or fentanyl withdrawal
Cancers : most commonly renal cancer and leukemia and lymphomas leads to fever as a first symptom.
* Metabolic disorders : gout or porphyria also causes fever.
* Thromboembolic processes : pulmonary embolism or deep venous thrombosis
Symptoms & Signs of fever:-
* Increase in body temperature more than 100.4 degrees F (38 degrees C) is main sign of fever.
* presence of chills due to increase in temperature of the body than the external environment is associated with fever.
* Increase in heart rate and muscle tone is the main symptom of fever.
* Shivering will be there.
* In severe cases of fever sometimes there will be presence of delirium and convulsions. Delirium and convulsions are usually seen in children.
* When there is rise in body temperature patient feels warm. If fever reduces the person may start to sweat.
* Severe cases of fever will be associated with some other symptoms at that time the patient has to meet the doctor immediately to treat fever.
Measurement of fever:-
The fever is measured using an instrument called thermometer. It contains mercury in it. The instrument is placed in different parts of the body and the temperature can be measured. There are varies types of thermometer are there. They are
* oral thermometer,
* axillary thermometer and
* anal thermometer.
If the temperature is taken in the anal region we have to subtract 1 degree from the total temperature because there is always high temperature in there.
If the temperature is measured in the oral region it is the normal there is no need of adding or subtraction.
When we are taking temperature in the axillary route we have to add 1 degree
classification of fever:-
fever is classified according to the grade of temperature, they are
* Low grade fever : approximately varies from 100.4-102.2 degrees of F
* Moderate fever : approximately varies from 102.2-104.0 degrees of F
* High grade fever : approximately varies from104.0-107.6 degrees of F
* Hyperpyrexia : is the maximum level that is more than the 107.6 degrees of F
advantages of fever:-
* According to some studies the fever is essential for the immune bodies to fight against the antigen of bacteria. it speeds up certain immunological reactions.
* Fever may be sometimes very essential in some extents because it cause unbearable environment for the pathogens.
* Fever is useful for the immunological bodies, it provides favorable environment for the white blood cells, so they will proliferate easily and can fight against the pathogens. There will be increased activity during fever.
Treatment for fever:-
* Fever is not treated essentially because it is a essential reaction of our body. So the fever needs only the symptomatic management. There will be so much of dehydration so the patient should be hydrated properly with intravenous fluids.
* During fever period the patient may be disoriented, so the patient needs psychological support to recover from fever, nurse should give psychological assurance that fever will be get reduced as soon as possible.
* The fever patient needs complete bed rest, and room should be well ventilated and provide an environment to sleep well.
* Feed the fever patient only with small, frequent diet, because there will be alteration in the bowel pattern and indigestion may occur.
* The immediate cause of the fever should be found and proper steps to be taken to reduce fever.
* There will be chances of hyponatremia, the patient is given sports’ drinks or intravenous administration of the electrolytes.
* If the fever is so high, cold bath or tepid sponge bath should be given.
* If the fever remains same the patient must take antipyretics like paracetamol or ibuprofen, Aspirin etc.
* The actual reason for fever should be find out and the cause should be treated immediately.