Hyperthermia NCP
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maeca101Hyperthermia NCP
Uploaded by
maeca101Caberte, Mae Lyn M.
BSN 3-F Group 20
Patient’s Name: AJG
Medical Diagnosis: acute gastritis t/c UTI
Nursing Diagnosis: hyperthermia r/t present infection as evidenced by increased WBC in CBC result
Short Term Goal: At the end of shift, the patient’s temperature will lower to 37 °
Long Term Goal: At the end of hospitalization, the patient’s core temperature will be in normal range.
Cues Problem Scientific Rationale Nsg. Interventions Rationale Evaluation
O> received pt. awake Hyperthermia A fever occurs when the -provide surface cooling by -to promote heat loss by Goal met. Patient’s body
>not in cardiopulmonary body sets the core means of undressing, cool radiation, conduction, temperature lowered to
distress temperature to a higher environment, tepid sponge convection and 36.8° C. No reoccurrence
>skin warm to touch temperature, through the bath, local ice packs evaporation, especially in of fever was noted.
>febrile action of the pre-optic especially in groin and areas of high blood flow
region of the anterior axillae
hypothalamus. For
>temp: 38.1 example, in response to a -administer medication -to treat underlying cause
HR: 139 bacterial or viral infection, such as antibiotics as
RR 29 the body will raise its ordered
temperature, much like
raising the temperature -administer replacement -to support circulating
setting on a thermostat. fluids and electrolytes volume and tissue
perfusion
SOURCE: Wikipedia.org
-note sweating as body -evaporation is decreased
attempts to increase heat by environmental factors
loss of high humidity and high
ambient temperature
-maintain in bed rest -to reduce metabolic
demands/ oxygen
consumption
