Name: Nikko P.

Dajao Year and Section: 2-A

A case of baby Jahzanara C. Limbaga, 2 months and 8 day-old, female sought consultation along with her mother at Saint Anthony Mother and Child Hospital, Basak, Cebu City, for the second time, as a follow-up check up because of her intermittent fever as shown by recurring fever episodes for 3 days separated by times of normal temperature. During these three days, she experienced fevers with temperatures of 38.9C, 38.3C, that were followed by normal temperatures. She also manifests coughs for 3 days, and colds for four days. Her latest temperature is 36.6 degrees Celsius. Intermittent fever or Periodic fever is intermittently elevated temperature (>38C, 100.4F) and returns to baseline and to normal. Examples are: 1) PFPA Syndrome: fever ever 3-4 weeks (most common in children age < 5 years); 2) Relapsing Fever: every 2-3 weeks; 3) Malaria: fever every other or every third day; 4) Rat Bite Fever: every three to five days; 5) Hodgkins Disease: Pel-Ebstein Fever; and 6) Cyclic Neutropenia: fever every 3 weeks (associated with mucosal ulcer). (Source: Family Practice Notebook, 2010. Accessed on June 22, 2011 at http://www.fpnotebook.com/id/exam/fvr.htm) Other types of intermittent fever are: 1) Quotidian fever, with a periodicity of 24 hours, typical of Malaria; 2) Tertian fever (48 hour periodicity), typical of Malaria; 3) Quartan fever (72 hour periodicity), typical of Plasmodium malariae. Intermittent fever is commonly called Fever and Ague, or Chills and Fever. As the name implies, the fever is not constant, as in the continual fevers, but intermits, so that in its career there are well-marked periods of absence of febrile symptoms. It is a fever characterized by a succession of attacks, with equal intervals and intermissions, that are complete, but irregular, owing to the paroxysms being of uncertain duration. By interval is meant the time from the beginning of one paroxysm to the beginning of the next, and by intermission the period of time between the close of one parosysm to the beginning of the next. The length of the interval determines the the variety of ague. When the interval is twenty-four hours, it is called quotidian; thirty-six hours, tertian; and when seventy-two hours, it is called quartan. These varieties duplicate, and are then called double quotidian, etc. (Source: Statosphere, 2009. Intermittent Fever. Accessed on June 22, 2011 at http://chestofbooks.com/health/herbs/O-Phelps-Brown/TheComplete-Herbalist/Intermittent-Fever.html) Nursing interventions in dealing with patients with intermittent fever include: monitoring vital signs, assess skin color and temperature, monitor WBC, Hct and other pertinent records (elevated WBC levels indicates presence of infection; elevated Hct indicates dehydration), remove excess blankets when the client feels warm; provide extra warmth when patient feels chilled, inform SO to provide adequate fluids, provide TSB (Tepid Sponge Bath) if ordered, provide cool, circulating environment, administer antipyretics as ordered, and promote rest. (Source: NursingFile.com, 2009. Nursing Interventions for Fever. Accessed on June 22, 2011 at http://nursingfile.com/nursingcare-plan/nursing-interventions/nursing-interventions-for-fever.html)