Treating fever with acetaminophen - page 3

by Vespertinas

5,457 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


  1. 0
    Only temps of > 38 get medicated at my hospital. In the ER we get lots of kiddos at 37.1 - 38 ... but we nurses (AND the docs) firmly educate family about why we're not medicating.
  2. 0
    I am in the a little fever is a good thing camp. We usually don't get fevers where I work (inpt psych) but for myself I won't take Tylenol unless I'm really uncomfortable.
  3. 0
    I have worked with a doctor who would not let us give acetaminophen unless the temp. was >103. I have also worked with a doctor who would only let us give one, 325 mg acetaminophen instead of 2. Most doctors, however, will want us to repeat blood cultures for a spike in temp of >101.
  4. 0
    I agree, I think a little fever is a good thing.

    Most of the time docs will write parameters for Tylenol...to give if fever is >/101.5. Other times they don't, the order just reads "PRN pain/fever."
  5. 0
    Quote from Vespertinas
    I mean despite a clear parameter that states for fever >xx degrees. ...I know

    But I still want thoughts on the physiology behind this.
    If there are clear parameters, and/or MD orders, doesn't matter what your thought on the physiology is. You need to follow the order and treat.
    If the PATIENT'S thought process is that they do not want to treat a low grade fever, they can certainly decline to take the med, however, you need to follow the parameters of the order.
  6. 0
    Quote from wooh
    We've had parents lately that are DEMANDING around the clock tylenol on their child. "He woke up, he needs tylenol!" Sadly, since our customer satisfaction surveys will come back before the kid needs a liver transplant, we're obliging.

    Working with kids, where the numbers can vary widely from kid to kid and even on one kid from minute to minute, I've learned to look at the patient more than the numbers. 37.6 but breathing fast and looks miserable will get tylenol before 38.5 and feeling fine. Unless we're looking at seizure-inducing kind of fevers, I don't tend to treat "fever" but rather the "discomfort that comes with a fever."
    BUT some do have parameters for "not to exceed xx in 24 hours" and if the child is that feverish, then a discussion with the MD about an alternate needs to be added, like ibuprofen.
    And the parents educated, as some really have not a clue about how damaging too much Tylenol can be. I swear they think that it is like chocolate syrup or something.
  7. 1
    It really depeends on your patients condition. When I was in oncology/HIV, we medicated at 99.5. These patients, like many ICU patients, can't tolerate the metabolic demands that come with fever.
    jadelpn likes this.
  8. 0
    And Tylenol is a medication, therefore, needs an order--standing protocol or individual MD order.
  9. 2
    Quote from jadelpn
    If there are clear parameters, and/or MD orders, doesn't matter what your thought on the physiology is. You need to follow the order and treat.
    If the PATIENT'S thought process is that they do not want to treat a low grade fever, they can certainly decline to take the med, however, you need to follow the parameters of the order.
    I hope I read that wrong, but a Nurse should never, ever, give a medication just because they have an order to do so. If a Nurse doesn't understand the purpose of a med then they need to clarify that, if they don't agree with the necessity of a med then they need to pursue that. This is an important part of the checks and balance system that protects the patient and provides good care through a double-approval system. If a Nurse's only role was to give a medication because it says to do so (a single approval system), we could get someone off the street and train them in less than a day to that, but a Nurse's responsibility is much more complex.
    Vespertinas and Susie2310 like this.


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