Day-to-Day Care


Home Treatment:  Fever Intervention





Fever is one of the most common symptoms of illness.  A person is said to be having fever if his body temperature rises above the normal range which is between 36oC to 37.2oC.  Since each individual's temperature range varies, generally, a reading above  37.2oC measured in the mouth is considered febrile.  In adults, fever is usually not dangerous unless it measures 39oC or higher.


Most fevers are self-limiting and usually go away in a relatively short time, usually within a few days.  In fact, moderate fever (not higher than 38oC) has beneficial effects as the body adapts itself through normal physiological mechanism  which strengthen the immune system.  Hence, aggressively treating all fevers can actually interferes with the body's immune response.


A person who has fever often has other medical problems.  The caregiver must be able to consider how the problems interact.  The signs and symptoms often help to identify the underlying causes.  However, if you do not know why the person is having fever, it is best not to try to lower his temperature which may only mask the symptoms and make it harder to determine the cause.


To learn more about fever and temperature taking, please refer to Day-to-Day Care Observation: Temperature.



Nursing a Person with Fever


A complete nursing intervention of a person with fever need to focus on 4 areas:


1. Decrease Body Heat Production:

Advise the person to take a complete rest to minimise unnecessary energy expenditure which may increases body temperature.

Anticipate the person's needs and keep things within reach to avoid activity on his part.

Inform the person of his condition and treatment to reduce apprehension and anxiety.


2. Promote Body Heat Lost:

Dress the person with lightweight clothing.

Keep the person cool by providing a fan or nurse him in air-conditioner room.

Sponge the person with tepid water.

Take a cool bath if necessary.

Increase fluid intake if the person has no fluid restriction.  Fluid can be in the form of water, iced drinks, ice-blocks, jelly, juices, or whatever he will drink.

Severe anti-fever medicine (paracetamol eg. Panadol) if the temperature reaches at least 39oC for adults.


Note:  Avoid shivering in the attempt to cool the body because this involves muscular activity that increases heat production.


3. Monitor and Maintain Body Functions:

Take temperature readings every 4 to 6 hourly.  Pulse, respirations and blood pressure should also be monitored in high fever as these vial signs may indicate complications.  An increase temperature is usually accompany with increase respiration and heart rates.

The person behavioral changes such as confusion, restless, or disorientation should be noted in high fever.

Check the state of hydration since fever tends to be very debilitating and dehydrating.  Learn more about dehydration in the topic Day-to-Day Care, Observation: Fluid Balance.

Fluid intake should be increased to replace fluids lost through insensible water loss and sweating.  The inclusion of soups is recommended because of their sodium content.

Provide measures to stimulate appetite and offer well-balanced meals to meet increased metabolic needs.  Learn more on how to encourage eating in the topic Day-to-Day Care, General: Assist in Meals.


4. Promote Comfort:

Provide oral hygiene to keep the mouth and lips moist.

If the person is lying on bed, frequent changing of position and linen help to reduce discomfort.

Frequent changing of clothes is also necessary because of increased sweating.

Severe paracetamol such as Panadol if the person has headache.

Use a lightweight blanket if the person feels cold or is shivering.


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Care During a Chill


A chill is an attack of shivering and a feeling of coldness, often accompanied by a rapid rise in body temperature.  If the person experiences a chill at the onset of the fever:

Offer extra blankets and raise the room temperature to keep the person warm during chills. Remove blankets when the person feels warm.

Provide extra fluids to replace fluid lost through increased metabolism.

As soon as the chill is over, reduce covers to prevent loss of body fluid and sodium by excessive sweating.

Assess onset and duration of chill. Take temperature immediately after episode.




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