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Altered Body Temperature: Submitted To: Mrs - Ipsita Sahoo Submitted By: Krushna Priya Nayak Msc. Nursing (First Year)
Altered Body Temperature: Submitted To: Mrs - Ipsita Sahoo Submitted By: Krushna Priya Nayak Msc. Nursing (First Year)
Submitted To :
Mrs.Ipsita Sahoo
Submitted By:
Krushna priya Nayak
MSc. Nursing (First year)
Outlines of the topic
• Temperature : Definition, Types, Thermoregulation, Factors affecting
• Summary
• Conclusion
• Bibliography
Definition
• Body temperature is the degree of hotness or coldness of a body or
environment
• It is somatic sensation of heat or cold. It is the degree of or the
intensity of heat of a body in relation to external environment.
• The body temperature is the difference between the amount of heat
produced by body processes and the amount of heat lost to the
external environment.
• Body temperature = Heat produced – Heat lost
Types of temperature
• Core temperature : It is the temperature of internal body tissues
below the skin and sub-cutaneous tissues. The science of
measurements are rectum, tympanic membrane, esophagus,
pulmonary artery, urinary bladder.
Types of temperature
• Surface body Temperature : It refers to body temperature at the
surface i.e. of the skin and sub-cutaneous tissues. The sites of
measurement are skin, axillae and oral.
• Oral :
• Rectal :
• Axillary :
Physiology of Thermoregulation
• It is regulated by the physiological and behavioral mechanism in
number of ways
a) Neural control
b) Vascular control
c) Skin in temperature regulation
d) Behavioral control
Factors affecting body temperature
• Age
• Exercise
• Hormonal level
• Stress
• Circadian rhythm
• Environment
Fever
• Fever is an elevation of body temperature that exceeds normally daily
variation and occurs in conjunction with an increase in hypothalamic
set point for e.g.
Causes of Fever
• Hot environment
• Excessive exercise
• Neurogenic factor like injury to hypothalamus
• Dehydration after excessive diuresis
• As an undesired side effect of a therapeutic drug
• Chemical substances i.e. caffeine and cocaine directly injected into the
blood stream
• Severe hemorrhage.
• Infectious disease and inflammation.
Classification of Fever
• Intermittent fever : Temperature curve returns to normal during a day
and reaches its peak in the evening. E.g. Septicemia
• Remittent fever: The temperature fluctuates but does not return to
normal. E.g. TB, viral disease
• Sustained fever : The temperature remains continuously elevated
above and demonstrate little fluctuation.
• Relapsing fever : The periods of fever are interspersed with period of
normal temperature. E.g. Malaria.
Chronology of events required for Induction
of Fever
Infection, Microbial Heat production ,
Fever
toxins, immune Heat Conservation
reaction
Elevated
Monocytes thermoregulatory
macrophages, Microbial set point
Endothelial cells Toxins
PGE2
Pyrogenic
Circulation Hypothalamus
cytokines
Grades of Fever
• Low grade fever :
• Hyperpyrexia :
Sign and Symptoms
• Flushed face
• Hot dry skin
• Anorexia
• Headache
• Nausea and Vomiting
• Constipation
• Body aches
• Scant highly coloured urine
• Increase Heartrate, respiratory rate and depth
• Shivering : Pale cold skin, Cyanotic nail beds
Hyperthermia
• It is elevated body temperature due to failed thermoregulation that
occurs when a body produces or absorbs more heat than it dissipates.
• Temperature range -
Causes
• Heat stroke : Prolonged exposure to sun or high environmental
temperature. These condition causes heat stroke – a dangerous heat
emergency with a high mortality rate.
• Drug induced hyperthermia : Due to increase use of psychotropic
drugs. E.g. Monoamine oxidizes inhibitors, tricycle antidepressants,
cocaine
• Endocrinopathy : Thyrotoxicosis and pheochromocytoma can lead to
increase thermogenesis.
• Central nervous system damage : cerebral hemorrhage, epileptics,
hypothalamic injury can cause hyperthermia.
Diagnostic Findings
• History talking
• Physical examination
• Laboratory tests
1. Clinical Pathology
2. Chemistry
3. Microbiology
4. Radiology
Medical Management
• Acetaminophen : Adult – 325 to 650 mg PO q 4 to 6 hrs
Children – 10 to 15 mg/kg body weight q 4 to 6 hrs
• If neutropenia and vital sign instability, then empirical therapy with fluroquinolone and
piperacillin is given
1. Mild hypothermia :
2. Moderate Hypothermia :
3. Severe Hypothermia :
Causes
• Exposure to the cold environment in winter season
• Occupational exposure that extensive exposure to cold for e.g. hunters, sailors
and climbers
• Sepsis
Risk factor for hypothermia
• Age : Elderly, Neonates.
• Outdoor exposure : Occupational, sports related, inadequate clothing
• Drug and intoxicants : Ethanol, phenothiazines, barbiturates,
anaesthetics
• Endocrine related : Hypoglycaemia, Hypothyroidism, adrenal
insufficiency
• Multisystem : Malnutrition, sepsis, shock, renal failure, burns and a
dermatologic disorder
• Immobility
Sign and Symptom
• Rewarding
• Supportive care
Rewarming
Active Passive
o The application of outside heat to raise the body temperature o It involves the use of blankets to cover body and head to trap heat being lost
• Warm blanket
• Heat packs
• Warm water immersion
• Immobility
• Third degree frost bite : Haemorrhagic vesicles due to micro vasculature injury which
further leads to cyanosis.
• Forth degree frost bite : Damage in sub-cuticular, muscular and osseous tissue
Symptoms
• The injure area is white or mottled blue white, waxy and firm to the touch
• The patient should be simulated with orally administrated hot fluids such
as tea and coffee.