Hypothermia in Newborn/Fever in Child
Heat Regulation in Newborns
1. Heat Loss 2. Thermogenesis
Pharmacological interventions
Acetaminophen Nonsteroidal Anti-inflammatory Drugs (NSAIDs) AVOID Aspirin --> risk of Reye's syndrome
Most effective intervention for a fever........
Antipyretics -Acetaminophen -NSAIDs -NOT aspirin
Next to establishing respirations and adequate circulation, heat regulation is the most critical to the newborn's survival
Next to establishing respirations and adequate circulation, heat regulation is the most critical to the newborn's survival
An elevated temperature, most frequently from ________, but occasionally from hyperthermia, is one of the most _____________ symptoms of illness found in ______________.
fever, common, children.
Brown Fat
located in the superficial deposits
Thermoregulation
the maintenance of balance between heat loss and heat production
Clinical Management/Goal of Care
to maintain a neutral thermal environment for the neonate in which heat balance is maintained
Factors that influence heat loss include
-temperature & humidity of the air -flow and velocity of the air -temperature of surfaces in contact with and around the infant
Risk Factors (Hypothermia in Newborn)
-thin layer of subcutaneous fat -blood vessels are close to surface of skin -changes in temp (environment) can affect the blood temperature -larger surface-to-body weight ratio
Most effective intervention for hyperthermia.....
(antipyretics are of no value) Cooling Measures are used on the skin to help reduce the core temperature
Clinical Management of Elevated Temperature (Fever)
****** RELIEVE DISCOMFORT***** -remain hydrated -rest -pharmacological interventions -environmental interventions (only after pharmacological)
**Hypothermia is a common and dangerous problem in the newborn **
**Hypothermia is a common and dangerous problem in the newborn **
Cold Stress
-imposes metabolic and physiologic demands on all infants, regardless of gestational age and condition -respiratory rate increases -O2 consumption and energy are diverted from making normal brain and cardiac function and growth consequence: hypoglycemia
Physical Benefits of Fever
-increased WBC activity -increased interferon production and effectiveness -antibody production -some enhancement of antibiotic effects
Clinical Manifestations/Assessment (Newborn)
-muscle activity increases (NOT shivering) -increased crying -restlessness -cool skin -acrocyanosis (on extremities) -position of flexion -metabolic activity increases resulting in increased oxygen demand
The ability to concentrate urine is fully attained by about _____________ months of age
3
At birth, a small quantity of urine is usually present in full-term infant, many newborns void. (This is important to note)
At birth, a small quantity of urine is usually present in full-term infant, many newborns void. (This is important to note)
Clinical Manifestations/Assessments (Child)
elevated temperature shivering vasoconstriction warm, flushed skin diaphoresis feeling cold increased heart rate increased muscle tone (stiffness)
Risk Factors (Fever in Child)
infection from pyrogen (bacteria, virus) susceptibility of host (immunocomprised, endogenous source, autoimmune disorder, disease)
How do newborns lose heat through.... Convection Radiation Evaporation Conduction & interventions
loss of heat through air currents (keep infant away from window, put a cap on baby's head) emit heat from skin surface to air (warming light/incubator) evaporation of moisture from the skin surface (make sure baby is dried right away, quick baths, check water temp) transfer of heat through direct contact (kangaroo care, place blankets on surfaces where infant will rest)
Nonshivering Thermogenesis
metabolism of brown fat and then by increased metabolic activity in brain, heart, and liver
Goal of treating a fever
relief of discomfort