Peds test 1 - CHILDHEALTHMAINTENANCE HYPERPREXIA

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CHILD HEALTH MAINTENANCE  HYPERPREXIA An elevation of body temperature above the normal daily variation Elevation in set point o Set point: temperature around which body temperature is regulated Above 38C or 100.4F Overview Body’s natural physiological response to infection = raise body temp over 99.7  (37.6C) Natural defense to o Fight infection o Kill viruses o Kill bacteria  Beneficial effects of a mild, low grade fever o Might be untreated by Dr or RN because lets body naturally fight infection Fever in Children Common and usually not dangerous Most kids 4-6 fevers in first 2 years of life Parents are scared and concerned because think fever can lead to o Seizure (3-4% in all children), brain damage, death Patho Hypothalamus: body’s thermostat o Conserves of dissipates heat o Relays and receives input to the thermostat to increase of decrease heat  production Infection o Microorganisms invade body o Endogenous pyrogens are released into blood stream and cause  increase in bodies set point  Triggers release of prostaglandins  Blood diverted from extremities to move central vessels Increase in core temperature o Hypothalamus increased heat production until core temperature reaches  new set point 
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Etiology Infection, dehydration, exercise, neurologic disorders, malignancy, CHF, trauma,  drugs (asa), increase in environmental temperatures, immunizations (give  acetaminophen before leaving clinic)  FEVER MANGEMENT Goal = relief of discomfort! Pharmacologic Antipyretics Admin for comfort and to decrease set point  o Administrate for temps > 102 o Newborns up to 6-7 weeks >100-100.4 Acetaminophen (DOC) o DOSE 10-15 mg/kg/dose q 4-6 hrs no more than 5 times in 24 hrs o Forms Comes in many forms, so be able to educate about because  acetamin poisoning is common among children  Need to know what family has at home Suppository (feverall) o Medication not equally distributed-cut vertically Acetaminophen in other products Tylenol cold, Tylenol flu, Tylenol sore throat etc… o You CANNOT give one of these if child has already  had a dose of Tylenol Aspirin o DOSE 10-15 mg/kg/dose PO or PR q 4-6 hrs 4 grains/24 hrs = max dose Rarely given to children Associated with aspirin use in children with influenza,  chicken pox, Reye syndrome Rare cases give for anti-platelet therapy NSAIDS (ibuprofin/motrin)  o Non-prescriptive and approved for fever reduction in kids 6 mos o DOSE
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Based on initial temperature level T < 102.6F (39.2C) = 5 mg/kg q 6-8 hrs T >102.6F (39.2C) = 10 mg/kg q 6-8 hrs 40 mg/kg/day= max dose
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Peds test 1 - CHILDHEALTHMAINTENANCE HYPERPREXIA

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