Treating fever with acetaminophen

Nurses Medications

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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?

I mean despite a clear parameter that states for fever >xx degrees. :unsure: ...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.

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.

Specializes in Oncology, Med-Surg.

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.

And Tylenol is a medication, therefore, needs an order--standing protocol or individual MD order.

Specializes in Critical Care.
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.

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