Asymptomatic hypothermia

[bioniclewoman]

I was told in report that this pt, who was in for ABX treatment of PNA, started having temps of 94.2 to 96.0 the day before, and was placed on a warming blanket. The 96.0 temp was obtained rectally, other temps oral and ax. I went in to do my assessment, took his temp and got 98.5 ax. I took him off the warmer, but left it in the room incase I needed it later. Later his temp was 95.3 ax. I noticed he had no covers on just a sheet and a small fan on him, and was eating ice chips. I turned the fan off and started to cover him up with blankets. He got mad and said he was not cold and he would be to hot with the blanket on. He was completly oriented. I came back later to recheck his temp and if was 94.6 ax. I told him I needed to put the warmer back under him and he refused, still eating ice and had his fan back on. I thought since he said he was fine that he was not in any danger, but the on coming nurse I gave report to freaked out that I had taken the warming blanket off.

Do pts with hypothermia usually feel fine? I thought they would be complaining of being cold, shivering, requesting warm blankets and hot tea.

[Ivanna_Nurse, BSN, RN]

Wonder if he's getting septic....

[ckh23, BSN, RN]

Everyone is different. He could have been going through a cold sepsis as well if he was getting IV ABX for pneumonia. As for the oncoming nurse, you just inform them (and document) that the patient refused the warming blanket and other interventions. If the oncoming nurse still has a problem I would simply tell them they can go explain it to the patient and force him to wear it. I would also recommend that it's not always about treating the numbers, but the patient.

[bioniclewoman]

He actually seemed like he was getting better. I had him for a few days after that and he was fine, still having low temps thou up until discharge.

[ckh23, BSN, RN]

Maybe that's just him.