Treating fever with acetaminophen

  1. 1
    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 acetaminophen. I believe it's best used when the patient experiences symptom-related discomfort . If the patient isn't at all disturbed by his fever (when A&O), I feel like it's not worth interrupting a perfectly decent immune process.

    This gives me problems when I handoff a patient to an RN who asks, "well did you give APAP for the fever?" I don't feel as though they want to sit there and listen to my stance on fevers but I also don't want to seem as though I'm being irresponsible.

    Am I wrong? Should I be automatically treating?
    kiszi likes this.

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  2. 28 Comments...

  3. 3
    I would tend to agree with you however you have to do what your policy says
  4. 2
    The NP that I work with closely has a stance to medicate at 100.5 or above. I agree. I think a little fever is a good thing, especially when there are no s/s or no voiced discomfort associated with the low grade fever. There is a nurse that relieves me though, that will medicate if they have a fever of 99.

    I personally think there are other things that will affect temperature, other than infection. Do they just need a little fluid, is the room too warm and they are wearing nine layers of clothes, have they been in bed and just need to get up and breathe a little better? (I would say deep breathing, but I work with the dementia population. Trying explaining THAT concept to my LOCP.)
    joanna73 and loriangel14 like this.
  5. 0
    I mean despite a clear parameter that states for fever >xx degrees. ...I know

    But I still want thoughts on the physiology behind this.
  6. 7
    I agree that for most people with mild to even moderate illnesses, a little fever is beneficial (as opposed to a higher fever that can cause brain damage). But you have to weigh the benefits of a little fever with the additional metabolic demand this places on someone. In ICU we're not very tolerant of fevers, mainly because we're trying to reduce metabolic demand as much as possible.
    bebbercorn, tewdles, Meriwhen, and 4 others like this.
  7. 1
    Quote from MunoRN
    I agree that for most people with mild to even moderate illnesses, a little fever is beneficial (as opposed to a higher fever that can cause brain damage). But you have to weigh the benefits of a little fever with the additional metabolic demand this places on someone. In ICU we're not very tolerant of fevers, mainly because we're trying to reduce metabolic demand as much as possible.
    This.
    bebbercorn likes this.
  8. 3
    Quote from ClearBlueOctoberSky
    The NP that I work with closely has a stance to medicate at 100.5 or above. I agree. I think a little fever is a good thing, especially when there are no s/s or no voiced discomfort associated with the low grade fever. There is a nurse that relieves me though, that will medicate if they have a fever of 99.
    My, I think that nurse would keep me on enough Tylenol to kill off a major organ, as 99 is not unusual for me at all....and I don't start feeling "feverish" until I'm 101. or higher.

    I don't believe in medicating for a "fever" unless the patient actually feels uncomfortable. Otherwise, fluids, rest, and monitoring. That's for me and my own family, though.....and whenever I've had the leeway to medicate floor patients with PRNs as I've seen fit. Have another set of orders to medicate at X degrees? Gotta do it.
  9. 1
    I agree that a low grade fever should not always be medicated. Take off a layer of blannkets, fluids, sponge them off a little, reassess.

    However, this depends on the client population and the condition of your patient. Geriatric patients can and will go downhill quickly with no medical intervention. If one of my geriatric patients has a fever of 38.1, I'm going to give them tylenol in addition to the basic interventions I mentioned. I would also check the rest of their vitals and look to see when their last BM was.

    So it depends.
    Ir15hd4nc3r_RN likes this.
  10. 1
    Quote from RNsRWe
    My, I think that nurse would keep me on enough Tylenol to kill off a major organ, as 99 is not unusual for me at all....and I don't start feeling "feverish" until I'm 101. or higher.

    I don't believe in medicating for a "fever" unless the patient actually feels uncomfortable. Otherwise, fluids, rest, and monitoring. That's for me and my own family, though.....and whenever I've had the leeway to medicate floor patients with PRNs as I've seen fit. Have another set of orders to medicate at X degrees? Gotta do it.
    We were taught in school that a fever is 100.4 (my employers have all had the same parameter) and above anyway, so 100.5 IS a low grade fever. I'd never think to treat a temperature of 99 unless the patient had been having fevers and looked like they were on their way up again. We do treat 100.4 and above though.
    Ir15hd4nc3r_RN likes this.
  11. 5
    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."
    RNsRWe, poppycat, joanna73, and 2 others like this.


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