Hi all, I'm new to allnurses.com, and a new nurse working nights on a med-surg floor with only 2 months experience. I was hoping to get some advice. I had a patient who was admitted with pneumonia yesterday morning and had a temp of 100 on admission. Around midnight when I started he was up to 103. All other VS stable, being treated with IV antibiotics, and doc had ordered blood culture on his admission, awaiting results. He was c/o a headache, so my thought was to give him Percocet as was ordered prn for pain and that would bring his temp down. I went to one of my colleagues, as I am still on orientation, and explained the situation and my reasoning. She advised me not to wake the doc for his temp bc he was running temps when he came in, cultures were ordered, and standing order for perc. This made sense to me-as a temp w/ pneumonia is expected and really what else could he have ordered? I administered the perc and his temp was down to 101 within an hour. I know everyone has different practices about calling a doc in the middle of the night, but I just wanted to get some feedback on whether this should warrant a call to the MD. Pt was comfortable, not diaphoretic, taking PO fluids. Any feedback is appreciated.
Specializes in Spinal Cord injuries, Emergency+EMS.
there has been some really good advice given in this thread
assess the patient and look at trends of observations
what has their temperature done in the last day or so, what are their observations like compared to the last day or so
consider the interventions you have open to you based on the existing care plan and your organisational policies -
as has been suggested Paracetamol or some of the NSAIDs are an option for reducing the fever
as are other non pharmacolgical interventions - how is the bed made ( strike a balance between controlling shivering and not adding to the heat- it's no good just having a sheet over the patient if they are shivering and heating themselves up when a light cover might stop that and make the patient more comfortable
what is happening fluid balance wise - is the patient dry ? what is their urine output like ...
ZippyGBR, BSN, RN
1,038 Posts
there has been some really good advice given in this thread
assess the patient and look at trends of observations
what has their temperature done in the last day or so, what are their observations like compared to the last day or so
consider the interventions you have open to you based on the existing care plan and your organisational policies -
as has been suggested Paracetamol or some of the NSAIDs are an option for reducing the fever
as are other non pharmacolgical interventions - how is the bed made ( strike a balance between controlling shivering and not adding to the heat- it's no good just having a sheet over the patient if they are shivering and heating themselves up when a light cover might stop that and make the patient more comfortable
what is happening fluid balance wise - is the patient dry ? what is their urine output like ...
is there a window open or a fan going?