Essay on Science

This essay has a total of 1048 words and 7 pages.


The Purpose of this paper is to review the fever protocol used in the consulting nurse
office as compared to the protocol suggested by the nursing research articles. In the
consulting nurse office, we use a protocol for fever in which we assess the symptoms of
patients who call us and we triage then with the protocol. The first thing we do is make
sure they are not in need of emergency medical attention, then we go over their symptoms
carefully to make sure they can safely take care of themselves at home. If we find they
are not in need of immediate medical care, we give them home care instructions. One of the
instructions is to give Tylenol or Motrin for any fever above 100 F. According to the
research articles, treating a fever is not always in the patientís best interest. Fever
has beneficial effects on the body and should only be treated in a certain population of

The paper will also discuss the physiological, Pathophysiological, behavioral and
experiential responses to the phenomena of fever.

Background of the Protocol

A company named Access Health supplies the fever protocol used by the consulting nurse
office. The company sells nursing call centers software that they use to triage patientís
symptoms. They arenít used to diagnose, only to help the patient receive the level of care
needed according to their symptoms. Physicians give the nurses permission to use these
protocols to lessen the amount of calls they have to take care of. The fever protocol is
divided into sections.

The first section is emergent in which the symptoms are so severe they need to call 911 or
go to an ER. In the fever protocol you would send a person with a temperature over 104 F
to the ER. If the had a decreased level of consciousness you would instruct them to call
911. The second section is called urgent within four hours, in this section if a patient
has had a recent surgery or procedure or have a serious medical condition such as diabetes
or sickle cell and have a fever above 102 they should go to the ER or to their doctorís
office. The third section is called urgent within twenty-four hours. These patients can
call for an appointment with their doctor within the next twenty- four hours for symptoms
of a fever above 100 with no improvement with home care. The next section called
non-urgent, those symptoms can be cared for at home such as a fever that goes down with
Tylenol. The last section is called watchful waiting, which usually requires the patient
just to be aware of worsening symptoms and to call back if they occur. If we triage the
patient and feel they can safely take care of themselves at home, we give them home care
that is in the fever protocol. We instruct them to rest, drink fluids and take Tylenol or
Motrin for a fever above 100. We encourage them to continue to take the meds until their
symptoms are gone.

Human Reponses

One of the physiologic responses to fever is increased heart rate. When a person has a
fever, their metabolism increases up to seven percent for each degree increase above
normal. The heart rate rises about ten beats per minute for each degree above normal.
(Morgan 1990).

Delirium is a pathophysiologic response that can occur with fever. It usually happens if the fever is over 104.

Delirium occurs when the body has a rapid rise in temperature that doesnít trigger the
compensatory cooling mechanisms. This phenomena can start a positive feedback situation in
which there is an increased metabolic response to stimulate heat production. This
response can continue to raise body temperature. (Rowsey 1997).

Review of the Study
The study: Pathophysiology of Fever, Part 2: Relooking at Cooling Interventions by P.
Rowsey was reviewed for this paper. The research in this study found that treatment of
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