Treating fever with acetaminophen - page 2

by Vespertinas 5,787 Views | 28 Comments

I believe that a little fever is a good thing. My understanding is that it's our bodies' response in an effort to actually kill the offending organism. When patients have a fever, I'm cautious to immediately respond with... Read More


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    It used to be that when she received her temps back before I was done charting, and she start to medicate with Tylenol, I would feel like I haven't done my job properly.

    Now, I just shake my head and suggest that maybe they need to take a shirt off. Our unit is incredibly hot almost all year around, and with our little old people, wearing nine layers of clothes, all it takes is some cold juice and removing a few layers.

    I don't hesitate to put someone on the 72 hour monitoring report if I have concerns for them. Most of the time, it turns out that it really isn't anything and I get asked if it really is necessary to chart on them, and then there are those times when I am glad I did it.

    And as always, you need to treat the patient, and not the machines. That may sound a little cavalier, but it is something that I learned as a Paramedic, and it has always served me well.
    joanna73 likes this.
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    I still think of my uncle who had his PhD in Pharmaceutical Science and said all the time how useless Tylenol was. Though I guess if you have a patient that can't take Aspirin or an NSAID it has it's moments. I still am not completely sure about it's efficacy though.

    Besides that...a little fever is good. I do work with Oncology patients though and when you have neutropenic issues you can't mess around, but for my two small kids I don't medicate unless it is above 101 or they can't sleep, etc.
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    I, too, think that a little fever is a good thing, as long as they are not uncomfortable (I work in LTC). We have a lot of residents who are one the max daily dose of tylenol for pain management, so I get pretty concerned when they spike a temp; am I being paranoid in this?
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    No, I don't think you are being paranoid about it. It would be a good idea to take it to the physician, or even your NM, or DON, to try to come up with a better plan. Maybe their pain management needs to be tweaked.
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    I've done so, but so many docs don't want a pt to become "addicted" to narcs or don't want to be perceived as the doc who dopes up their pts. I know a lot of nurses who feel this way as well, so sometime I think that I am the odd ball on it, but there are so few pleasures in a LTC setting...why should someone have to live in pain?

    My other concern is the potential of "masking" a sign of infection...some folks don't look or sound like they have pneumonia and the only clue is an elevated temp...but if they are on temp suppression via lots of tylenol...that concerns me, but maybe I don't understand the drug's method of action properly.

    Quote from ClearBlueOctoberSky
    No, I don't think you are being paranoid about it. It would be a good idea to take it to the physician, or even your NM, or DON, to try to come up with a better plan. Maybe their pain management needs to be tweaked.
    DeLanaHarvickWannabe likes this.
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    I always ask the patient. If there is an order I ask the patient if they are comfortable, educate them that a "little fever" is a good thing and give them the option if they want the medication or not. Most patients that I have encountered typically will live with it during the day, but prefer to be comfortable at night.
    Vespertinas likes this.
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    38.5 is considered a fever with most of the docs on my floor. We usually medicate for anything over that and have an order for such. If someone is postop I will have them use their IS an usually their fever will be gone.
    Altra likes this.
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    I'm also of the opinion that a low-grade temp is a good thing. I typically won't medicate for a temperature unless it's over 101 or my kid is feeling uncomfortable at the time. Typically, she doesn't start feeling uncomfortable with a fever until she gets to about 102 or so. I am still a student nurse, but as a parent, I tend to look at comfort and temperature, in that order.

    If I'm looking to suppress the fever, because I need to keep metabolic demand to a minimum, then I'm going to most likely medicate much earlier than I would otherwise.
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    I'm pretty stubborn about medicating fevers as far as myself is concerned. I believe a fever is the body's way of fighting infection, and unless I go above 104 degrees, I don't take meds. For patients though? Anything above 100.4 I treat, especially peds. I don't think it's needed, but I'm going to cover my butt and give them their Tylenol/Motrin.
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    Quote from catlvr
    I've done so, but so many docs don't want a pt to become "addicted" to narcs or don't want to be perceived as the doc who dopes up their pts. I know a lot of nurses who feel this way as well, so sometime I think that I am the odd ball on it, but there are so few pleasures in a LTC setting...why should someone have to live in pain?

    My other concern is the potential of "masking" a sign of infection...some folks don't look or sound like they have pneumonia and the only clue is an elevated temp...but if they are on temp suppression via lots of tylenol...that concerns me, but maybe I don't understand the drug's method of action properly.
    I think when our patients are on scheduled Tylenol, you might get a masking of a fever. I feel that it happened to me last week with a patient that has a habit of going septic very quickly. He wasn't running a fever on my shift, but it started to go up on the oncoming shift. However, because of the way that he was acting, I had already procured orders for stat labs and a UA. We had also been really encouraging fluids all morning.

    It is where your assessment skills come in and how well you know your residents. If they are not acting right, then investigate.


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