Fever is characterized by an elevation of temperature, usually 37.5 C and above. Fever can be an early sign of infection, as the body attempts to eliminate the bacteria/virus by rising the body's temperature. This is common among children and postoperative patients. And as a nurse, we will need to devise a nursing care plan that will help patients' temperature to return to normal.
Situation: As the nurse, you saw Anna wearing a jacket, pajama, socks and is curled inside a blanket. Upon taking her temperature, you found out that it is above normal: 38C.
Here's a sample nursing care plan for fever.
- Skin warm to touch
- Temperature: 38 C
- Alteration in body temperature related to inappropriate clothing
- Within the shift, the patient will maintain core temperature within normal range
- Assess patient for any signs of convulsions
- Assess for signs of dehydration
- Monitor Vital Signs especially temperature
- Note presence of sweating as the body attempts to increase heat loss by evaporation, conduction and diffusion
- Instruct patient to wear loose clothes to promote heat loss
- Render Tepid Sponge Bath (TSB)
- Administer medications as ordered
- Goal met.
- Seen patient wearing loose clothing
- Temparature: 37.4 C