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NCP on Fever (Pyrexia) – Complete Nursing Care Plan (File-Ready)
Ye article exam-oriented aur practical file-ready format me likha gaya hai — GNM/B.Sc Nursing students ke liye. Har section ko aap directly print karke apni practical file me paste kar sakte ho. Maine is post me additional explanation, rationales aur evaluation points bhi add kiye hain taaki word count ~2000 words complete ho aur Google/Readers dono ko value mile.
Introduction — Fever (Pyrexia) kya hai?
Fever (pyrexia) body temperature ka normal daily range se upar jaana hai. Ye body ka protective response hota hai jo infection, inflammation, tissue injury ya heat exposure ke response me activate hota hai. Nursing point of view se fever ko evaluate karna aur complications ko prevent karna equally important hai.
Definitions & Normal Range
| Parameter | Range / Meaning |
|---|---|
| Normal oral temperature | 36.5°C – 37.5°C |
| Low grade fever | 37.6°C – 38.0°C |
| Moderate fever | 38.1°C – 40.0°C |
| High grade / hyperpyrexia | > 40.0°C (medical emergency possible) |
Common Causes of Fever
Fever ka aasan classification cause ke according kar sakte hain:
- Infectious: Bacterial (pneumonia, UTI, typhoid), Viral (influenza, dengue), Parasitic (malaria).
- Non-infectious: Inflammatory diseases (rheumatoid arthritis), malignancy, drug reactions, heat stroke.
- Physiologic: Immunization reaction, post-operative inflammation.
Nursing Assessment — What to record
Assessment is the foundation. Check and document clearly:
- History: onset, pattern (continuous/intermittent), associated symptoms (rigors, headache, rash, cough, dysuria), travel history, recent immunization, medication history.
- Vital signs: temperature method (oral/axillary/tympanic/rectal), pulse, respiration, blood pressure, SpO₂.
- Fluid status: mucous membranes, skin turgor, urine output.
- Systemic exam: chest (breath sounds), abdomen (tenderness), skin (rashes, petechiae), neurological (confusion, neck stiffness).
- Investigations ordered: CBC, blood culture (before antibiotics), urine R/M & culture, chest X-ray, malaria smear/rapid test, dengue NS1/IgM, CRP, others as indicated.
Common Nursing Diagnoses (NANDA style)
- Hyperthermia related to infectious process as evidenced by elevated body temperature and chills.
- Risk for fluid volume deficit related to excessive diaphoresis and decreased oral intake.
- Acute pain related to headache, myalgia and chills.
- Imbalanced nutrition: less than body requirements related to anorexia.
- Fatigue related to increased metabolic demand and prolonged fever.
Goals / Expected Outcomes
Short-term:
- Patient’s temperature will return to normal range (36.5–37.5°C) within 24–48 hours.
- Hydration status will be maintained (urine output ≥ 0.5 mL/kg/hr).
- Patient will report increased comfort and decreased headache.
Long-term:
- Underlying cause will be diagnosed and treated appropriately.
- No complications (seizure, dehydration, organ dysfunction) will occur.
Nursing Interventions with Rationales (Detailed & File-Ready)
Intervention 1 — Monitor temperature & observe pattern
Action: Measure temperature Q2–4H (specify method) and chart pattern (continuous, remittent, intermittent, relapsing).
Rationale: Fever pattern suggests likely cause (eg. malaria cyclical fever) and helps evaluate response to therapy. Accurate charting helps doctor decide interventions.
Intervention 2 — Tepid sponging and environmental measures
Action: Tepid sponge with lukewarm water; remove excess blankets; ensure simple light clothing; maintain room ventilation; use fan if tolerated.
Rationale: Promotes evaporative heat loss and reduces fever discomfort. Avoid cold water or ice packs which can cause shivering and raise metabolic heat.
Intervention 3 — Antipyretic administration as prescribed
Action: Give paracetamol (dose & route per order), record time and response.
Rationale: Antipyretics act on hypothalamic set point to reduce fever; timely dosing prevents fever spikes and complications in vulnerable patients (children, elderly).
Intervention 4 — Maintain hydration & electrolyte balance
Action: Encourage frequent small sips of ORS, boiled water, juices, coconut water; start IV fluids (NS/RL) if oral intake inadequate or signs of dehydration present.
Rationale: Fever increases insensible water loss via sweating and respiratory loss; replacement prevents hypovolemia, electrolyte imbalance and renal compromise.
Intervention 5 — Comfort, pain relief & supportive care
Action: Administer analgesics as prescribed for myalgia/headache; ensure restful environment; provide mouth care if dehydrated.
Rationale: Reducing pain and discomfort improves compliance with oral fluids and rest, aiding recovery.
Intervention 6 — Infection control & isolation (as required)
Action: Follow standard precautions: hand hygiene, masks if respiratory symptoms, disposable tissues, dedicated utensils; isolate if disease highly contagious.
Rationale: Prevents transmission within hospital/community — essential for infections like influenza, measles, varicella.
Intervention 7 — Administer antibiotics/antivirals after cultures
Action: Ensure blood cultures are taken before starting antibiotics; administer antimicrobials per sensitivity and physician order.
Rationale: Empirical treatment may be necessary in severe cases; however cultures before antibiotics improve chances of targeted therapy and reduce resistance risk.
Intervention 8 — Nutrition support
Action: Offer light, high-calorie, high-protein soft foods (khichdi, soups, milk) and small frequent meals; consider supplementation if anorexia persists.
Rationale: Fever increases metabolic demand; adequate nutrition supports immune function and tissue repair.
Monitoring & Evaluation — What to record
- Temperature trend (time, method, value)
- Vitals every 4 hourly or as ordered
- Fluid balance: I/O chart, urine colour & specific gravity
- Response to antipyretics: time to defervescence
- Signs of complications: hypotension, tachypnea, altered consciousness, bleeding
- Lab follow-up: CBC, cultures, electrolytes
Potential Complications to watch for
- Seizures (febrile seizures in children)
- Severe dehydration and renal failure
- Sepsis / septic shock
- Delirium / encephalopathy (in elderly)
- Electrolyte disturbances (hyponatremia, hypokalemia)
3 File-Ready NCPs — Copy & Paste into your file
NCP 1 — Hyperthermia related to infection
ASSESSMENT:
Subjective: "Mujhe bukhar aur sar dard ho raha hai."
Objective: Oral temp 39.2°C; pulse 110/min; warm flushed skin; rigors.
NURSING DIAGNOSIS:
Hyperthermia related to infectious process as evidenced by elevated temp and chills.
GOALS:
Temp will return to 36.5-37.5°C within 24-48 hours.
Patient will report reduced discomfort.
INTERVENTIONS:
1. Measure temp Q2 hourly and chart.
2. Tepid sponging every 30-60 min until temp reduces.
3. Administer paracetamol 15 mg/kg (child) or 500-1000 mg adult as per order.
4. Keep clothing light; maintain cool room.
5. Monitor for signs of sepsis or complications.
EVALUATION:
Temperature stable; patient reports comfort; no complications observed.
NCP 2 — Risk for fluid volume deficit related to diaphoresis
ASSESSMENT:
Subjective: "Main bohot pyaasa hoon."
Objective: Dry mucous membranes; urine output 200 mL/8 hr; weight loss 0.8 kg in 24 hr.
NURSING DIAGNOSIS:
Risk for fluid volume deficit related to excessive sweating and reduced intake.
GOALS:
Maintain urine output ≥0.5 mL/kg/hr.
Prevent signs of hypovolemia.
INTERVENTIONS:
1. Encourage frequent sips of ORS/juices.
2. Start IV NS 0.9% as per physician order for rehydration.
3. Monitor I&O, daily weights and vital signs.
4. Replace ongoing fluid losses (measure stool/vomit losses).
5. Educate patient on oral rehydration importance.
EVALUATION:
Urine output adequate; vitals stable; patient hydrated.
NCP 3 — Knowledge deficit regarding fever management
ASSESSMENT:
Subjective: Patient says "I don't know when to give meds or how to care at home."
Objective: Patient/family unaware of antipyretic timing, hydration measures.
NURSING DIAGNOSIS:
Knowledge deficit regarding fever management in home setting.
GOALS:
Patient/family will demonstrate correct antipyretic dosing and fluid measures.
INTERVENTIONS:
1. Teach antipyretic dosing schedule and precautions.
2. Demonstrate how to prepare ORS and encourage frequent fluids.
3. Provide written instructions in local language.
4. Advise on danger signs (persistent high fever, breathlessness).
EVALUATION:
Patient/family demonstrates correct knowledge; verbalizes warning signs.
Patient Education — Key Points to Teach
- Take full prescribed medications; do not stop antibiotics early.
- Use paracetamol for fever; avoid aspirin/ibuprofen in certain infections without doctor advice.
- Increase fluid intake — ORS, soups, coconut water.
- Wear light clothes, rest and avoid overcrowded places.
- Seek immediate care for warning signs: breathing difficulty, persistent vomiting, confusion, seizures, decreased urine output.
Documentation — Practical Template
DATE/TIME: ____________
ASSESSMENT: Temp: ____°C (method); Pulse: ____; RR: ____; BP: ____; SpO2: ____%
INTERVENTIONS: (e.g., Paracetamol 500 mg PO at 10:00; Tepid sponge at 10:15)
RESPONSE: (e.g., Temp decreased to 38.1°C after 2 hours)
PATIENT TEACHING: (Topics covered)
EVALUATION/PLAN: (Continue/Change care)
SIGNATURE:
Exam & Viva Tips (For Nursing Students)
- Always mention method of temperature measurement (oral/axillary/rectal) and normal values.
- Explain rationale for tepid sponging vs cold sponge (avoid shivering).
- Memorize 3 danger signs to tell the examiner (eg. seizures, altered consciousness, oliguria).
- Give one practical nursing priority first (eg. obtain cultures BEFORE antibiotics in suspect sepsis).
Conclusion
Fever (pyrexia) ek common but potentially serious clinical sign hai. Effective nursing care combines accurate assessment, timely interventions (antipyretics, fluids, environmental measures), monitoring for complications and patient education. Yeh file-ready NCPs, monitoring templates aur exam tips aapki practical file aur ward duties me directly use ho sakte hain. Agar chaho to main is post ka PDF, AMP version ya dark theme HTML bhi bana ke de sakta ho — reply batao kaunsa format chahiye.
 – Assessment, Diagnosis, Goals, Interventions, Rationale, Evaluation){kind=link}
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