11.9
Métodos para reducir la fiebre.
Los signos y síntomas de la fiebre incluyen piel caliente y seca, cara enrojecida, sed, dolores musculares, anorexia, dolor de cabeza, taquicardia, ta…
La selección de un tratamiento adecuado para reducir la fiebre depende de determinar primero la causa.
Los medicamentos como los antipiréticos inducen la pérdida de calor, mientras que los corticosteroides interfieren con la respuesta hipotalámica y restablecen el punto de ajuste elevado.
Si la fiebre se debe a una infección bacteriana, se recetan antibióticos para ayudar a combatir los pirógenos que causan la fiebre.
Por el contrario, si la fiebre se debe a una infección viral, se puede tratar de manera no farmacológica, ya que los virus tienen una vida corta.
Si una persona experimenta una alergia a un medicamento o una reacción de hipersensibilidad, puede experimentar fiebre y sarpullido o prurito. Las intervenciones incluyen la interrupción de la medicación, el tratamiento del deterioro de la integridad de la piel y la educación sobre alérgenos.
El golpe de calor requiere tratamientos de emergencia, como la administración de líquidos intravenosos y la irrigación del estómago y el intestino inferior con soluciones frías según lo recetado.
Los métodos no farmacológicos para reducir la fiebre incluyen la esponja tibia, la aplicación de compresas de hielo en las axilas y las áreas de la ingle, ventiladores oscilantes y mantas de hipotermia.
Aunque estas técnicas fomentan una mayor pérdida de calor, las enfermeras deben asegurarse de que no causen escalofríos.
View the full transcript and gain access to JoVE Core videos
Q1: How do antipyretics reduce fever?
Antipyretics such as acetaminophen and ibuprofen induce heat loss by lowering body temperature. These nonsteroidal anti-inflammatory drugs work by affecting the body's temperature regulation system. Antipyretics are commonly used to manage fever caused by viral infections or when other pharmacological methods are not appropriate for the patient.
Q2: Why is identifying the cause of fever important before treatment?
Determining the fever's cause guides appropriate treatment selection. Bacterial infections require antibiotics to destroy pyrogenic bacteria, while viral fevers can be managed non-pharmacologically since viruses have short lifespans. Drug hypersensitivity reactions need medication discontinuation and skin care. Proper diagnosis ensures effective intervention and prevents unnecessary or harmful treatments.
Q3: What nonpharmacological methods reduce fever through heat loss?
Nonpharmacological fever reduction uses evaporation, conduction, convection, and radiation. Methods include tepid sponge baths, applying ice packs to axillae and groin areas, oscillating fans, and hypothermia blankets with refrigerated solutions. These techniques encourage heat loss but must avoid inducing shivering, which would promote additional heat production instead of reduction.
Q4: How do corticosteroids differ from antipyretics in treating fever?
Corticosteroids work by interfering with the hypothalamic response and resetting the raised set-point of body temperature. Unlike antipyretics that induce heat loss, corticosteroids modify the central temperature regulation mechanism itself. This different mechanism makes them useful in specific fever cases where the hypothalamic set-point needs adjustment rather than simple heat dissipation.
Q5: What emergency treatments are used for heatstroke?
Heatstroke requires immediate medical intervention including relocating the patient to a cooler area, removing excess clothing, and applying cold damp cloths. Emergency treatments involve administering intravenous fluids, irrigating the stomach and lower bowel with cold solutions, and using oscillating fans to enhance convective heat loss. Hypothermia blankets may also be applied to rapidly reduce dangerous body temperature.
Q6: How should nurses manage fever caused by drug hypersensitivity reactions?
Drug hypersensitivity fever presents with rash or pruritus symptoms. Treatment involves immediately discontinuing the offending medication, treating any impaired skin integrity from the allergic reaction, and providing allergen education to the patient and family. Antipyretics may be used to manage fever symptoms while the underlying allergic response resolves after medication withdrawal.
Q7: Why must nurses prevent shivering during nonpharmacological fever reduction?
Shivering generates additional body heat through muscle contractions, which counteracts fever reduction efforts. While tepid sponging, ice packs, and fans encourage heat loss through evaporation and convection, shivering would promote heat production instead. Nurses must monitor patients carefully during nonpharmacological interventions to ensure comfort and prevent involuntary muscle contractions that undermine cooling effectiveness.