Fever question

[MissChloe]

If someone's normal body temperature is 96.8-97, is 98.5 then a fever since it's elevated, or is it not a fever because it's still around "normal?"

[MandE4and1]

I think it would depend on the age and mood even. Body temperature can also fluctuate throughout the day and night and even throughout the week atleast 1.0 degrees. It also increases after you eat and when you are sleeping. I don't think I would worry about a temperature that is only a slight higher like a degree but if it kept rising then that is cause for concern. It also depends on where you are taking it.

[Bug Out, BSN]

A 1 degree movement of temp is so insignificant that I don't pay much attention to them. Like mentioned before, time of day, time of menstrual cycle, age, sex, eating, mechanical variability, different people taking the temp, different placement of probe in mouth etc can all effect temp with a 1 degree shift.

I would not classify a slight increase in temp as a "fever" but I would maybe monitor it to see if it is trending up.

[VickyRN, MSN, DNP, RN]

Depends also on the client population. For a frail elder whose normal body temp is often lower than what is considered "normal" in the younger adult population, any elevation may signal an acute infection. The elderly (especially the "old-old" - those 85 years of age and above) often present atypically with illness, especially acute infections. Their immune system is impaired, due to the effects of aging, and so one may not see a drastically elevated temp or increased WBC. One may see instead a change in level of consciousness, confusion, anorexia, a slight elevation in temperature, or malaise. All the while, the person is battling a raging infection (such as a UTI or pneumonia).

[SolaireSolstice, BSN, RN]

Never mind, misread the question.

[CT Pixie, BSN, RN]

Depends also on the client population. For a frail elder whose normal body temp is often lower than what is considered "normal" in the younger adult population, any elevation may signal an acute infection. The elderly (especially the "old-old" - those 85 years of age and above) often present atypically with illness, especially acute infections. Their immune system is impaired, due to the effects of aging, and so one may not see a drastically elevated temp or increased WBC. One may see instead a change in level of consciousness, confusion, anorexia, a slight elevation in temperature, or malaise. All the while, the person is battling a raging infection (such as a UTI or pneumonia).

I've been working with the elderly for years and have always heard that the elderly don't present with the "normal" s/s of an illness ie:UTI such as a fever, the biggest "signal" is often confusion. But I always thought, if their normal temp range is say high 96-mid 97 range and they start acting "off" such as slight confusion and malaise, we check their temps..its 98.7 or so, we always say they aren't running a temp. A few days out, they get a U/A and we see a raging UTI..so in my eyes, they indeed were running a temp for their body even though it wasn't a temp for "normal" average aged people. So maybe they DO get the typical expected fever w/UTI but since their fever isn't what we would consider for a normal, healthy average aged person, we don't think of it as such.

Maybe we (people who work w/geriatrics) should re-think what we would consider a temp on our residents. Maybe take a look at the temps for a few shifts (to take into account time of day, sleeping, etc) and check against the BASELINE temps for that person. If their normal temps run high 96's-low 97's..and now they are running temps in the high 98's and low 99's ALONG with some confusion..sounds like an infection setting in..

I guess what I'm saying is, I personally think *and know there are those that disagree* that even though the normal body temp is 98.6 and its not really considered an abnormal temp, In most adults, an oral temperature above 100F or a rectal or ear temperature above 101F is the reading, (so an increase of approx 1.4 degrees for an oral temp) a person who's normal temp is 97.6 starts getting readings of 99 range for THEM it is an abnormal temp reading just as if someone who's normal temp is 98.6 starts getting readings of 100.

[MissChloe]

CT_pixie, that really answered my question. Thank you! I know that it's not considered to be "a temperature," but I'm glad to know that about 1.4-1.5 above normal COULD be considered a temperature FOR THAT PATIENT.

[DolceVita, ADN, BSN, RN]

Excellent points.