I have a patient who has been 100% afebrile during the day. At HS he says he's chilled (but has no temp). So I bring him a warm blanket, which he hides under. Several hours later, he has a 102-103 degree temp. He's done this two nights in a row.
Normally, I wouldn't question this--but this particular patient has a long, sordid history (including MANY years in a federal prison). I really wonder if he's learned some tricks to make it appear that he's sicker than he is.
Specializes in Med/Surge, Psych, LTC, Home Health.
I just have to second everything said. Don't think anyone can purposefully spike a temp like that unless they drink something really hot before you take their temp.
The first thing that did come to mind though, was perhaps some sort of "mind over matter" type of trick. LIke, some people become really good at willing their bodies to do things like that.
in some instances here we have pt's c FUO..i even had a kid once had a bit of garlic crushed, inserted to his orifice which produced fake fever..lol but in this case, the pt may have this "somatic" fever of something (i have seen this dx once, with a pedia, he is always fine but his temp spikes up everytime he is stressed out) or having some infection. i think TB produces low-grade fever and chills at noc.
*shrugs* anything can happen in a man's body lol..
Lol. I take my temps every morning. Near the end of my cycle, when I hope my temps are high (indicating pregnancy) I cover myself with so many blankets that I can barely breathe. And yet, my temps remain low (indicating no pregnancy).
So no, I can personally attest....adding a warm blanket will not produce a fever-no matter how hard you try.
Like a PP said, it's probably the chills before the fever that your pt is experiencing. Whenever a pt asks me for a warm blanket, I always checck their temp first.
What about encouraging IS use (10 per hour, Q 1 hour) while he is chilling. And, no warm blankets at nocs. You have obviously discovered a trend.
NurseCard, ADN
2,850 Posts
I just have to second everything said. Don't think anyone can purposefully spike a temp like that unless they drink something really hot before you take their temp.
The first thing that did come to mind though, was perhaps some sort of "mind over matter" type of trick. LIke, some people become really good at willing their bodies to do things like that.
*shrugs* I dunno.