How high is to high!?

  1. I am a student of Practical Nursing due to graduate in June. I have a question about fevers in pediatric patients (two year old)
    If a child this age developes a fever of 103 degrees F (axillary) and keeps climbing, as soon as the Tylenol wears off, shouldnt this be cause for alarm? I spoke with a DR. and he said that in viral infections fevers of 104 and 105 arent uncommon and that you would just give Tylenol and spongebaths. I am about half way thru Peds in school and I though that fevers over 101.4 in infants and young children were a cause for concern. I would greatly appreciate input re: this because I have decided to write my theory paper on this subject THANKS!!!
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  2. 6 Comments

  3. by   nur20
    OK, i'm assuming, (assuming,mind you) that all test have been done and he/she knows what this diagnosis really is,virul/bacteria etc. then i will agree that if the problem is being treated the fever may continue for a few days,breaking soon, however if this is a guessing game, then treating the fever is treating a symptom not the problem. Fever is not a diagnosis unless it is FUO (fever of unknown origin) and they are still exploring
  4. by   nursedawn67
    Myself at 104 and not budging to come down with what I can do (sponge bath, tylenol or motrin), I was taking my children in to see a doctor. I was afraid of febrile seizures.
  5. by   nursedawn67
    Originally posted by Jennipherlynn
    I have decided to write my theory paper on this subject THANKS!!!

    I would love to see what become of this topic/theory paper. Will you let us know how things turn out?
  6. by   Jennipherlynn
    Thank you for your responces and yes I will let you know how the paper turns out Febrile sezures was the first thing i thought of to, any one know what temp these usually occur? As far as a FUO that is pretty much what I was referring to sorry should have added that. I have heard that in FUO a spinal tap is done but if there is no evedence of IICP or of nuchal ridigity, why would they do that? ( havnt had neuro yet, start it in two weeks) thanks again!
  7. by   rck213
    Lumbar punctures are done routinely on infants with a fever, infants being neonates, usually under 3 months of age. This is part of a "septic workup" including a cath urine or sp tap and bloodwork.

    Neonates with fever are a concern, older infants, toddlers and children can tolerate fevers up to 105 with illnesses. Most of the time it is viral, of course we look at other symptoms but if there is no strep or ear infection and the child acts fine when the tylenol kicks in things just have to run their course. Motrin is used in those over 6 months if the tylenol doesn't bring the fever down.
    Febrile seizures do not happen in every child with a fever, those who have had hx of febrile seizure are more closely watched when they have had a fever and we try to keep a tighter control on rapid temp changes.
  8. by   PediRN
    I was told once by a peds oncologist that fevers are a good thing in otherwise healthy children; it confirms that the child's immune system is working properly, and its a sign that the body is doing a good job at fighting the infection.
    FYI, high fever (>104) generally points to viral illness, not bacterial, hence, antibiotics are not necessary.

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