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silly little question

Nurses   (2,890 Views 15 Comments)
by sweetieann sweetieann (Member)

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I know there's a few different variables to consider (age, baseline, etc).....but what temperature were you taught constitutes a fever? We were taught in school that, generally, a "fever" is considered any temp OVER 101. As in, 101 would still be "normal." I personally always considered over 100 to be a temp.....what's correct? At what temp would you call the Dr.?

Thanks!

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colleennurse has 8 years experience as a ASN, RN and specializes in post-op.

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I think it can vary from facility to facility, but where I work usually 38.5 (101.3) or greater is when we would call the doctor or pa and get blood cultures. Sometimes depending on the doc it is 38.3 (100.94).

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Some places have guidelines and protocols with standing orders, like if a temp is over 99.9 or something, then give Tylenol and recheck. The facility I work at does not, so whenever someone has temp that is high, which personally i consider 99.9 or above, I get a rectal temp and check that, then if that's high, then I call the doc, and the first thing they usually say is to get a UA/C&S and a CBC.

Hope this helps!

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Lacie is a BSN, RN and specializes in jack of all trades.

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99.9 was considered "low grade temp" which we just monitored with no treatment, and notify doctor if 101 or above followed by tylenol. Usually followed with CBC and blood cultures. This was the same with children and adults both.

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MrChicagoRN has 30 years experience as a RN and specializes in Leadership, Psych, HomeCare, Amb. Care.

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Remember that body temp is circadian, so time of day can influence whether one is "febrile" or not.

Plus a low grade elevation indicates the body's defenses are at work.

In amulatory & homecare, I'd generally suggest anything less than 101 or so be left to it's own defenses unless also feeling malaise, achy, etc

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We have heard above 100.5 is a "fever". However trends are important and as a student I will report to the nurse a temp that has risen suddenly for apparnet reason of over a degree if this is a patient who has been running the same temp for awhile. (particularly if they have a foley or are a post op). It could be the start of something. Also I ask how the patinet feels because if they are uncomfortable some tylenol probably should be given, maybe remove some blankets, turn the heat in the room down etc...

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jmgrn65 has 16 years experience as a RN and specializes in cardiac/critical care/ informatics.

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we usually think greater than 101 surgical unit below is usually an indicator of inflamation the patient needs to his c&db and their Icentive spirometer.

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esrun00 has 22 years experience and specializes in cardiac, oncology.

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I know there's a few different variables to consider (age, baseline, etc).....but what temperature were you taught constitutes a fever? We were taught in school that, generally, a "fever" is considered any temp OVER 101. As in, 101 would still be "normal." I personally always considered over 100 to be a temp.....what's correct? At what temp would you call the Dr.?

Thanks!

And different types of patients matters, like weakened immune systems. When one of my cancer patients has a new temp of 100.5 or greater we call. And they are instructed when they go home, it is very important to call with a temp >100.4 or chills with or without fever. A person who is neutropenic won't always have a fever with an infection.

This probably won't help answer your question, just something to think about.

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Roy Fokker is a BSN, RN and specializes in ER/Trauma.

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we usually think greater than 101 surgical unit below is usually an indicator of inflamation the patient needs to his c&db and their Icentive spirometer.
At my facility we use centigrade (and also Kgs. Don't ask :rolleyes: )

Most post-op standing orders state 350/650 mg Tylenol for temp > 38.0

Some of the gen surgery docs will be POed if you disturb them for temps

First line of defense? C & DB and I/S. Encourage ambulation/activity if possible.

Second line - Sometimes something as silly as extra blankets can drive someone's temp up and keep it there. Medicate with anti-pyretic.

Third line - persistent temp. Call doc... most will order CBC + Blood cultures times two. If using a central/PICC line, some docs will use different parameters for the blood draw to see if the line is causing the infection.

cheers,

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Pepper The Cat has 33 years experience as a BSN, RN and specializes in Gerontology.

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38.5 celcius. (which I believe is approx 101 F). Anything below that should just be monitored. Some nurses I work with panic at 37.5 (apporx 99.5 F)! Its hard to convince them that they are doing more harm than good by giving tylenol at that temp.

Also - if you use tympanic thermometers (sorry spelling bad tonight) becareful - if a pt has been lying on the ear, the temp can be artificially raised - similar to what a cup of coffee can do to an oral temp!

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crissrn27 has 8 years experience as a RN and specializes in nursery, L and D.

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We do cbc-d and bc with temp of over 100.5. I had a period of time that I ran a constant 99.5-100 temp, and the docs charted "low-grade" fever everytime. And did a horde of test. So, I guess it depends on the pt and doc. Also, geriatric pt, immunosuppressed pt, etc, might not even run a fever when they are septic. Soooo, just gotta look at the whole picture and not the "numbers" so much.

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clee1 has 9 years experience and specializes in Hospice, Med/Surg, ICU, ER.

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We have heard above 100.5 is a "fever". However trends are important and as a student I will report to the nurse a temp that has risen suddenly for apparnet reason of over a degree if this is a patient who has been running the same temp for awhile. (particularly if they have a foley or are a post op). It could be the start of something. Also I ask how the patinet feels because if they are uncomfortable some tylenol probably should be given, maybe remove some blankets, turn the heat in the room down etc...

:yeahthat:

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