Reasons NOT to give APAP for fever?

[NocturneNrse]

I've heard of the pre blood culture holding of the apap.. but are there other instances when you would not give tylenol?

Would you only give tylenol for a low grade fever IF the patient felt the fever uncomfortable?

Thanks all.. = )

[applewhitern, BSN, RN]

I have had doctors tell us to not give tylenol unless the temp is 103. But unfortunately, most patients want it if a temp is 99! Many patients just don't understand that an elevated temp is not necessarily a bad thing, and a lot of family members will freak out over a temp. I was told the same thing about the bacteria "being more active and will grow out better" if the cultures are drawn while the temp is up, but on the other hand, I have had lab techs tell me this is not true. That didn't help a bit, did it?

[Esme12, ASN, BSN, RN]

There are theories out there that not giving APAP until the Temp on >101 allows the bodies natural inflammatory response to activate. That a temp isn't really a "temp"until greater than 101F the build up in inflammatory response of a healthy immune system. Not giving APAP until cultures were complete was an old practice and no longer valid as more research has shown the administration of Tylenol had no bearing on the presence of bacteria.

The administration of antibiotics however, need to be withheld until cultures are complete.

[MattNurse, MSN, RN]

APAP = N-acetyl-p-aminophenol the chemical name for trade name tylenol and generic name acetaminophen

[wooh, BSN, RN]

I have had doctors tell us to not give tylenol unless the temp is 103. But unfortunately, most patients want it if a temp is 99!

Ugh, it doesn't help that our techs like to tell parents that their kid has a fever if their temp is 37.6...

[OKNurse2be]

As a mom, I get a lot of conflicting signals over this exact issue. I got practically yelled at by a telephone triage nurse for calling 100.3 a fever. However, when I take them to the ER, they give acetaminophen if the temperature is as low as 99.5. Generally speaking I will not medicate my children till they are at least at 101, unless the fever is accompanied by pain, like in an ear infection. I am more likely to give acetaminophen at bedtime to help them sleep if they have a fever, and then withhold during the day when I can monitor better how their temp is along with other sx. Adults I think react differently to fevers than children. My kids can be at 104 and be bouncing off the walls while at that temp I feel like I am dying. Thankfully I don't get sick like that often.

[Stephalump]

As a mom, I get a lot of conflicting signals over this exact issue. I got practically yelled at by a telephone triage nurse for calling 100.3 a fever. However, when I take them to the ER, they give acetaminophen if the temperature is as low as 99.5. Generally speaking I will not medicate my children till they are at least at 101, unless the fever is accompanied by pain, like in an ear infection. I am more likely to give acetaminophen at bedtime to help them sleep if they have a fever, and then withhold during the day when I can monitor better how their temp is along with other sx. Adults I think react differently to fevers than children. My kids can be at 104 and be bouncing off the walls while at that temp I feel like I am dying. Thankfully I don't get sick like that often.

I'm the same way. I like to let a fever play out, but if it's accompanied by complete misery or dehydration is an issue, I'll go ahead and give it.

My youngest does get Tylenol immediately when his temp is 99 or above because he has complex febrile seizures. My aversion to fever reducers backfired there - the first fever he ever had, I let play out, and he ended up in the ICU. Go mom

As far as the difference between adults and children, I've been told by a few pediatricians that normal children can withstand much higher temps than adults for some reason or another. I'm sure someone here can shed light on that one :)

[rnlately]

no, tylenol has no effect of the actual bacteria that may or may not exist in the blood stream when collecting cultures.

Tylenol is an antipyretic and combats the effect of the bacteria and the bodies response to the insult to it.

Tylenol does not kill, diminish of affect the actual bacteria in any way in the blood stream and does NOT, NOT affect blood cultures.

Giving Tylenol and lowering the bodies temperature and ability to fight infection does affect the over all outcomes though and is not given by my hospital until a temp hits 103. Allow the body to fight....

Exactly; give the body time to correct itself. Many times I will have a CNA, nursing student, family member come to me frantically stating "so and so's temp is 99.9" and then wonder why I'm not knocking myself out trying to give Tylenol. I have no problem explaining it to them though...lol.