Treating fever with acetaminophen - page 2

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... Read More

  1. Visit  ClearBlueOctoberSky profile page
    0
    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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  3. Visit  catlvr profile page
    1
    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.
  4. Visit  Jory profile page
    1
    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.
  5. Visit  PediLove2147 profile page
    1
    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.
  6. Visit  akulahawkRN profile page
    0
    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.
  7. Visit  Racer15 profile page
    0
    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.
  8. Visit  ClearBlueOctoberSky profile page
    0
    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.
  9. Visit  Altra profile page
    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.
  10. Visit  TerpGal02 profile page
    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.
  11. Visit  applewhitern profile page
    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.
  12. Visit  turnforthenurseRN profile page
    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."
  13. Visit  jadelpn profile page
    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.
  14. Visit  jadelpn profile page
    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.


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