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Is there any truth to this?

Posted

Specializes in Critical Care; Cardiac; Professional Development. Has 10 years experience.

I sometimes have people insist they are feverish when they aren't based on what they state their baseline temp is. "Well, I usually am 96.5 so YOU may not think 98.6 is a fever but for me it is". I have only ever had females make this type of statement and to be honest it has always been a patient who is difficult to care for in other ways. I do not want to dismiss it out off hand but my gut reaction is pretty much an inward eye roll. Is there any basis for this claim that anyone knows of?

People who insist this don't understand that temperatures can range throughout the day for an individual. Unless they also complain about feeling feverish or having symptoms I'd just document their statement and move along.

xoemmylouox, ASN, RN

Has 13 years experience.

I know your frustration. I hear about the high 99.1 fever all of the time.. I try to provide education, but it falls on deaf ears or the patients argue with me.

IrishIzCPNP, MSN, RN, APRN, NP

Specializes in Pediatrics, High-Risk L&D, Antepartum, L. Has 13 years experience.

Unless there's a real issue..."fevers" aren't an issue anyway so nod and move on. I'm "that person" to some degree because I rarely get a fever. I will feel ill and "feverish" but no significant temp. I even had surgery for a severe infection...no fever. So in my mind...I don't care about a fever but how somebody is feeling for most people.

CodeteamB

Specializes in Emergency. Has 5+ years experience.

Nope, no truth! However, watch out for the septic elderly person with a LOW temp. That one can happen.

I generally will not let this one go. Time for some pt education!

I get people with "special" vital signs all the time. I will always take the time to explain that while their BP is *always* 160/90, there is not going to be any physiological ill effect from the fact that it has been 120/80 for the last 6 hours.

I agree, this is usually brought up by a patient who spends way too much time in hospital, or a visitor who is way too far up in grandpa's business. I think it comes from the fact that they feel awful and sick and we are telling them "everything looks good." This provides zero validation of how they are feeling internally, and they want to staff to know that they are sick (whether they really are or not).

In the ER we see this a lot from people in the WR during triage or reassess, as a ploy to get into a bed quicker as well ;).

FWIW, I happen to be one of those annoying people who normally runs a low temp. I'm healthy as a horse, rarely get sick, certainly don't complain about it if I am, and would rather stay at home and quietly bleed to death than ever be admitted to a hospital, so I'm not some whiny hypochondriac. However, my temp v. rarely fluctuates unless/until I'm really sick, and a temp of 99.1 actually does represent a significant elevation for me (a fever). Feel free to roll your eyes ...

Esme12, ASN, BSN, RN

Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma. Has 41 years experience.

I'll bet if you asked those annoying patients (mostly female) that they also went through infertility and monitoring the temp is, or was, one of the first things they were told to do even before getting OOB was to take their temp, track it and record it...so yes they KNOW their temp is 96.5! So then yes they probably feel like crap at 99.5......just like you feel like crap if your temp is 101.5.

We all inwardly roll our eyes but that doesn't make them any less sick or have less valid complaints. AND it is true a person who is septic can have a lower temp

macawake, MSN

Has 13 years experience.

I believe that we should always combine the reading (in this case the thermometer) with what symtoms we can observe/assess and what the patient reports. I think that baseline temperature does matter. We know that body temperature varies due to many factors. Age, gender, time of day, medication, insomnia, physical fitness and the menstrual cycle. (The elderly typically have a much lower baseline temperature.)

If we dismiss a person who has an elevated temperature compared to their baseline temp, but that doesn't fall in the range that we consider febrile we might miss an infection.

Time for a change to assess and evaluate bo... [int J Nurs Pract. 2009] - PubMed - NCBI

What is the evidence base for the assessment and evaluation of body temperature? | Practice | Nursing Times

applewhitern, BSN, RN

Specializes in ICU. Has 30 years experience.

I doubt there is any "basis" for the claim of an elevated temp, other than the patient says so. In these days of customer service, probably best to just humor them, rather than try to teach them. OK, I'm being sarcastic here, but actually I have had a doctor walk into a room and validate what the patient said about their temp, just as I had got through trying to teach them!

Do you also roll your eyes when an athletic person says their pulse is usually in the 50s? When someone says their blood pressure usually runs 70s/50s?

Is it really THAT out of the ordinary for someone's baseline vital signs to be below "normal"?

blondy2061h, MSN, RN

Specializes in Oncology. Has 15 years experience.

You have people who's bp is 70/50 all the time? Walking around with no radial pulse?

xstarsfallingx

Specializes in Peds. Has 2 years experience.

In regards to monitoring ovulation, an early morning basal temp before you get out of bed is much different than what it is later in the day. I personally run 96.6 as a basal, but if you checked me any other time after being up I am back to normal 98.1-98.6. If a woman is basing their "norm" on basal temps then they are severely incorrect. As for fevers, evidence is growing regarding whether it is necessary to even treat them unless there is patient discomfort or unless they are high. Personally, if a patient is 99.5 and I am told they normally "run low" but they are awake and ambulating and functioning just fine, I am by no means humoring them and treating that fever. I would educate on the body's defense, the benefits of low grade fevers, and to give me a call if they begin to feel uncomfortable in any way. Now, if they were admitted for a significant reason related to fevers then my approach would be much different.

Nurse SMS, MSN, RN

Specializes in Critical Care; Cardiac; Professional Development. Has 10 years experience.

Do you also roll your eyes when an athletic person says their pulse is usually in the 50s? When someone says their blood pressure usually runs 70s/50s?

Is it really THAT out of the ordinary for someone's baseline vital signs to be below "normal"?

Nope, I don't. Nor do I for a low basal temp as a norm. If you read the original post, what I said was that those who want me to treat 98.6 as a fever have made me wonder if there is any scientific basis for considering that a fever, because it often comes from an individual who is difficult to care for and therefore triggers a reaction in me that may not be warranted. I would hate a gut reaction to dramatics to cause me to miss something. Pretty sure self evaluation is a good thing.

I appreciate those who took my question seriously.

blondy2061h, MSN, RN

Specializes in Oncology. Has 15 years experience.

Do you also roll your eyes when an athletic person says their pulse is usually in the 50s? When someone says their blood pressure usually runs 70s/50s?

Is it really THAT out of the ordinary for someone's baseline vital signs to be below "normal"?

So should we start anti-hypertensives in these people when their BP is 110/70? Push Adenosine if their heart rate hits 90?

Esme12, ASN, BSN, RN

Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma. Has 41 years experience.

In regards to monitoring ovulation, an early morning basal temp before you get out of bed is much different than what it is later in the day. I personally run 96.6 as a basal, but if you checked me any other time after being up I am back to normal 98.1-98.6. If a woman is basing their "norm" on basal temps then they are severely incorrect. As for fevers, evidence is growing regarding whether it is necessary to even treat them unless there is patient discomfort or unless they are high. Personally, if a patient is 99.5 and I am told they normally "run low" but they are awake and ambulating and functioning just fine, I am by no means humoring them and treating that fever. I would educate on the body's defense, the benefits of low grade fevers, and to give me a call if they begin to feel uncomfortable in any way. Now, if they were admitted for a significant reason related to fevers then my approach would be much different.
I didn't say they were correct......all I was giving a reason on why they may say it......I agree that all temps should not be treated. I am just saying to consider the patients perspective and while you may not treat it you can moderate your answer to help them feel better while education them about the appropriate treatment for their present situation.

Even though we nurses think we roll our eye inside our heads....trust me .....it can be seen.

You have people who's bp is 70/50 all the time? Walking around with no radial pulse?

My husband has a radial pulse, but it is really low. He is a runner and I have never known his pulse rate to be above 45. When he did an exercise tolerance test his pulse would not get above 50 even. So while I may not treat him with a pulse of 90, I would be somewhat worried.

twinmommy+2, ADN, BSN, MSN

Specializes in ED. Has 16 years experience.

Sorry Esme, my ED patients come in to the VA, mostly male, usually with wives coming along saying they've had a fever, 99.8 temporal, with the response of "they are always 96.8" so this is a fever. They may feel like crud but its typically not that bad.

Morainey, BSN, RN

Specializes in Orthopedic, LTC, STR, Med-Surg, Tele.

I sometimes have people insist they are feverish when they aren't based on what they state their baseline temp is. "Well, I usually am 96.5 so YOU may not think 98.6 is a fever but for me it is". I have only ever had females make this type of statement and to be honest it has always been a patient who is difficult to care for in other ways. I do not want to dismiss it out off hand but my gut reaction is pretty much an inward eye roll. Is there any basis for this claim that anyone knows of?

I have DEFINITELY had patients tell me this before. Yes, they are female now that I think about it. I always want to say, I'm not calling the doctor if your temperature is 98.6 when you "usually run 95.5!" I tell them we'll keep an eye on it, mainly to be nice.