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Fever Management Essay

1076 words - 5 pages

MANAGEMENT OF THE CHILD WITH FEVER Aim To manage the symptoms of fever so as to reduce the child's discomfort. Key points 1. Fever is a sign of illness/inflammation. Uncomplicated fever is relatively harmless, and is fact an important immunologic defence mechanism 2. The cause of the fever should be the focus of treatment. Indications to intervene 1. The intervention has the potential to increase the child’s comfort level (or decrease their discomfort). 2. The purpose of intervening can be clearly identified. 3. Reduction of parental anxiety could arise from the intervention. 4. Any harm that might result from intervening (e.g. increased discomfort or risk of liver damage) has been balanced ...view middle of the document...

3. Consider bathing the child. If there is high environmental temperatures and/or humidity, or in situations where there is a need for immediate temperature reduction, Where the child has a history of febrile convulsions, providing the parent with the opportunity to give physical care by bathing a child who enjoys it is considered to be appropriate While the evidence suggests that there is minimal clinical benefit from routine sponging in temperate climates, some children actually enjoy a bath, particularly when given by their parents. 4. In febrile children with temperatures less than 41°C, consider offering one dose of paracetamol 10-15mg/kg2. Nurses and parents need to be mindful of other medications in use by the child, which may contain paracetamol - to ensure the total dose per day is accurately estimated. Extreme caution should be used if administering paracetamol to young children who are dehydrated and/or malnourished. Children who are fasting may also be at risk. Evidence suggests that paracetamol should be used selectively and with caution to treat fever in otherwise healthy children. Despite its comparative safety, its routine sustained administration is not supported. An upper limit of 60mg/kg/day is recommended. The most serious side effect of paracetamol overuse has been reported to be hepatotoxicity. It has been suggested that the child at risk of liver toxicity is most likely to be under two years, to be sick (especially dehydrated), and receiving four hourly panadol (90mg/kg/day or greater) for more than one day. Research has also demonstrated that repeated therapy at recommended doses can result in drug accumulation and that cases of serious liver damage have occurred in children receiving doses of around 150mg/ kg/day when taken for one to four days. 5. Take the child's temperature one hour after implementing care One hour after intervening the temperature can be expected to have fallen between 0.55°C - 0.75°C following a bath and between 0.8°C - 1.1°C following the administration of paracetamol. References Watts R, Robertson J, Thomas G and Review Panel, 2001. The Nursing Management of Fever in Children - Systematic Review No 14 Adelaide: The Joanna Briggs Institute for Evidence Based Nursing & Midwifery: Canadian...

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