Fever is generally a temperature of 100.4 F (38 C) or higher; the route used affects the reading.
Before you read
Test yourself first: 4 questions
Question 1 of 4
A nurse is caring for an older adult with pneumonia. Which atypical presentation is most common in older adults with this infection?
Answer: A. Older adults with pneumonia often present atypically, with new or worsening confusion and decreased functional ability rather than the classic high fever and productive cough. Recognizing confusion as a possible sign of infection in older adults supports early treatment. A high spiking fever is less reliably present.
Question 2 of 4
A client with cirrhosis is on a fluid restriction for dilutional hyponatremia and ascites. Which nursing action best evaluates the effectiveness of fluid management?
Answer: A. Daily weights at the same time on the same scale provide the most accurate, objective measure of fluid status; a 1 kg gain roughly equals 1 liter of retained fluid. Abdominal girth and intake/output complement this, but daily weight is the single best indicator of fluid retention or loss in ascites. Skin turgor and appetite are unreliable here.
Question 3 of 4
A client at 31 weeks gestation is placed on modified bed rest at home for preterm labor management. Which nursing teaching point about activity and safety is most appropriate?
Answer: A. Prolonged bed rest increases the risk of venous thromboembolism and muscle deconditioning, so clients are taught to perform gentle leg and ankle exercises, change positions, and stay hydrated. Strict immobility without movement of the legs raises clot risk.
Question 4 of 4
A client is being discharged after outpatient surgery. Which statement by the client indicates a need for further teaching?
Answer: B. A client should not drive home or be alone for the first 24 hours after general anesthesia or sedation because of lingering effects on judgment and coordination; planning to drive home indicates a need for more teaching. Reporting a fever, having a ride and a caregiver, and resting are correct understandings.
Keep the streak going with more questions like these, each with a full rationale.
What is pediatric fever management?
Management focuses on the child's comfort and hydration, not on normalizing the number. Key principle: a fever in an infant under 3 months is a medical emergency requiring immediate evaluation, regardless of how well the baby appears.
Key points to remember
- Fever is generally a temperature of 100.4 F (38 C) or higher; the route used affects the reading.
- Any fever in an infant under 3 months (rectal temp 100.4 F or higher) is a red flag requiring urgent medical evaluation.
- Antipyretics are dosed by weight: acetaminophen every 4-6 hours and ibuprofen (only for children over 6 months) every 6-8 hours.
- Aspirin is contraindicated in children due to the risk of Reye syndrome.
- Febrile seizures are usually benign, brief, and self-limited, most common between 6 months and 5 years.
- Fever increases fluid losses, so maintaining hydration is a priority.
Nursing priorities
- Measure temperature with an age-appropriate, accurate method and document the route.
- Administer weight-based antipyretics for comfort and reassess effect.
- Encourage frequent fluids and monitor intake/output and hydration status.
- Dress the child lightly and keep the room comfortable; avoid bundling.
- Assess overall appearance, activity, and signs of serious infection rather than fixating on the number.
Labs & values
Patient teaching
- Use a weight-based dose with the device that comes with the medication; do not dose by age alone.
- Offer fluids often and watch for dehydration: fewer wet diapers, dry mouth, no tears.
- Do not alternate or double up antipyretics without provider guidance, and never use aspirin.
- Seek care for a fever in a baby under 3 months, a fever over 5 days, or a child who appears very ill, difficult to wake, or has trouble breathing.
Red flags: report now
- Fever in an infant under 3 months requires immediate evaluation for serious infection (sepsis, meningitis).
- Never give aspirin to a child or teen with a febrile/viral illness (Reye syndrome risk).
- Stiff neck, petechial or purpuric rash, lethargy, difficulty breathing, or a seizure lasting over 5 minutes is an emergency.
- Do not sponge a child with cold water or alcohol; it causes shivering, vasoconstriction, and toxicity.
References
Clinical references for this topic
