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temperature 1 Maintaining body temperature how does the body do this Heat production Basal metabolic rate Voluntary movement Shivering Heat loss Radiation.

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Presentation on theme: "temperature 1 Maintaining body temperature how does the body do this Heat production Basal metabolic rate Voluntary movement Shivering Heat loss Radiation."— Presentation transcript:

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2 temperature 1

3 Maintaining body temperature how does the body do this Heat production Basal metabolic rate Voluntary movement Shivering Heat loss Radiation Conduction Convection Evaporation – includes diaphoresis 2

4 Maintaining body temperature Heat production Basal metabolic rate Voluntary movement Shivering Heat loss Radiation Conduction Convection Evaporation – includes diaphoresis Water loss via respiration. 3

5 Body temperature Core temperature is the temperature of the internal environment of the body. This temperature is relatively constant. It is regulated by the hypothalamus – (Gk – hypo – below, thalamos – chamber.) The hypothalamus activates, controls and integrates the peripheral autonomic nervous system, endocrine processes, and many somatic functions like temperature, sleep and appetite. 4

6 Location of hypothalamus www.vivo.colostate.edu/.../hypopit/anatomy.html 5

7 Body temperature Core temperature is the temperature of the internal environment of the body This temperature is relatively constant. It is regulated by the hypothalamus The surface temperature is the temperature at the surface of the body The environmental temperature and blood circulation has a greater impact on this temperature The range of temperature is greater 6

8 Body temperature regulation 1.Sensory receptors – primarily the skin. 2.Hypothalamus – controls core temp. 3.Effector system – - prevents heat loss by – 1.Shivering 2.Peripheral constriction 3.Release of epinephrine – increases BMR. - Promotes heat loss by – 1.Sweating 2.Peripheral vasodilation 7

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10 Factors affecting body temperature Age – very young, elderly Exercise Hormonal level – ovulation Circadian rhythm – higher in the late afternoon, early evening Stress Environment Alteration in body function – infection, dehydration 9

11 Terms related to body temperature Normothermia – 36.1 – 37.2 Afebrile Fever Febrile Pyrexia Hyperthermia Rigor hypothermia 10

12 Grade Low grade fever Temperature Normal to 38 Possible cause Inflammatory response to mild infection, allergy, disturbance of body tissue by trauma, surgery, malignancy or thrombosis Moderate high grade temperature 38-40 C May be caused by wound, respiratory or UTI Hyperpyrexia > = to 40 C May be caused by bacteraemia, damage to the hypothalamus ore high environmental temperatures 11

13 Patterns of fever Sustained a constant body temperature continuously above 38 that demonstrates little fluctuation Intermittent fever spikes interspersed with usual temperature levels. Temperature returns to acceptable levels at least once in 24 hours. Remittent fever spikes and falls without a return to normal temperature levels Relapsing periods of febrile episodes interspersed with acceptable temperature values. Febrile episodes and periods of normothermia may be longer than 24 hours 12

14 S&S of fever ONSET Increased HR Increased RR Shivering – why? Pallor & cold skin – why? Patient c/o feeling cold ‘goose bumps’ Cessation of perspiration Rise in temperature 13

15 S&S of fever PROGRESSION Absence of shivering Skin feels warm to touch – forehead, cheeks. Increased P & RR Increased thirst Mild to severe degydration Drowsy, restless + / - delirium (if very high) Anorexia Malaise, weakness, ‘aches & pains’ 14

16 S&S of fever ABATEMENT Skin flushing, feels hot Sweating Decreased shivering Possible dehydration 15

17 Fever Flushing can occur on the face or over the entire body. 16

18 Hyperthermia – 38-41C Heatstroke Those at risk The very young the very old Cardiovascular disease, hypothyroidism,diabetes or alcoholism Medications (phenothiazine's, anticholinergic, diuretics, amphetamines and beta –adrenergic receptor antagonist Those who exercise or work strenuously - athlete, construction workers and farmers 17

19 Signs and symptoms Giddiness, confusion, delirium, excess thirst,nausea, muscle cramps, visual disturbances and even incontinence. 18

20 Hyperthermia - heatstroke Victims of heatstroke do not sweat because of severe electrolyte loss and hypothalamic malfunctions Heatstroke greater than 40.5 C produces tissue damage to the cells of all body organs. Vital signs may indicate temp greater than 41C, tachycardia, and hypotension. Temperatures above 41C can cause convulsions and a temperature of 43 C renders life unsustainable. Heat exhaustion occurs when profuse diaphoresis results in excess water and electrolyte loss 19

21 hypothermia Body temperature drops and mechanisms to increase heat production are ineffective Causes Environmental exposure Medication ( alter perception, cause heat loss through vasodilatation, inhibit heat generation eg panadol, alcohol) Metabolic conditions eg hypoglycemia and adrenal insufficiency Exposure of internal organs during surgery 20

22 hypothermia Core temperature Mild (33.1-36) Moderate (30.1 – 33) Severe (27 -30) Profound ( less than 27) To 35- shivering, loss of memory, depression and poor judgment 34.3 – cardiac dysrythmias, loss of consciousness, unresponsive to pain 21

23 hypothermia Frostbite- when the body is exposed to subnormal temperatures the ice crystals that form inside the cell can result in permanent circulatory and tissue damage. The area is white, waxy and firm to the touch) 22

24 Frostbite www.project-himalaya.com nl.savetibet.org 23

25 Conditions requiring frequent monitoring Patient’s condition affects their BMR Post operatively Critically ill patients Patients susceptible to infection Immuno compromised Those undergoing chemotherapy, radiation therapy or steroid therapy Patient has local or systemic infection Patients receiving a blood transfusion 24

26 Types of thermometers Tympanic Electronic Digital Disposable (not used in hospitals) 25

27 Contraindications/ cautions for oral temperature Children younger than 5 years Confused or combative patients Those that cannot close their mouth fully (injury, surgery) Unconscious patients or those prone to convulsions Mouth breathers Mouth infection Wait 15 minutes after patient smokes, drinks, eats Place thermometer in the sublingual pocket Leave insitu for 2 minutes with lips closed 26

28 Digital oral thermometer 27 guardian.co.uk

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31 Contradictions/ cautions for rectal temperature Don’t use this route if patient has rectal or perineal injuries or surgery A rectum full of soft faeces may cause an inaccurate reading (lower) This site is least used (because of its intrusive nature) but it is more accurate than the others though there is lag time with febrile states. Lubricate and insert (at least 4 cm) gently Don’t leave patient unattended and ensure that patient doesn’t move Leave insitu for 2 minutes 30

32 Cautions and /contraindications for tympanic temperature Remove hearing aids Don’t use the ear that the patient has been lying on Most commonly used site Wax buildup may lower temperature Otitis media may increase temperature The tip of the thermometer has to fit snugly and point to the tympanic membrane to read accurately 31

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36 Contraindications and cautions for axilla temperature Area must be dry and clean There must be contact with both skin surfaces The thermometer may have to be helped in position The least accurate site (surface temperature) The thermometer must be insitu for 5 minutes 35


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