{
  "name": "Hyperthermia (Fever)",
  "slug": "hyperthermia",
  "url": "https://nursingplex.com/care-plans/hyperthermia",
  "category": "Basic Nursing & General Care Plans",
  "summary": "Elevated core temperature from infection, heat exposure or drug reaction; treated with cooling, fluids and cause-directed therapy.",
  "nursing_diagnoses": [
    "Hyperthermia",
    "Deficient fluid volume",
    "Risk for imbalanced body temperature"
  ],
  "overview": [
    "Hyperthermia is a core temperature above the normal range caused either by a raised hypothalamic set point (fever from infection or inflammation) or by failure of heat dissipation (heat exhaustion, heat stroke, malignant hyperthermia, thyroid storm, anticholinergic and serotonergic drug reactions).",
    "The distinction matters: fever responds to antipyretics because the set point is elevated, while heat stroke and drug-induced hyperthermia do not and require active external cooling plus removal of the trigger. Untreated core temperatures above 40 °C cause protein denaturation, rhabdomyolysis, seizures and multi-organ failure.",
    "Nursing care combines continuous core temperature monitoring, cooling that avoids shivering, aggressive fluid replacement and treatment of the underlying cause."
  ],
  "key_facts": [
    {
      "label": "Heat stroke",
      "text": "Core temperature above 40 °C with altered mental status is a medical emergency; cool first, transport second."
    },
    {
      "label": "Shivering",
      "text": "Shivering generates heat and defeats cooling — cool gradually and treat shivering as ordered."
    },
    {
      "label": "Malignant hyperthermia",
      "text": "Occurs after volatile anesthetics or succinylcholine; treated with dantrolene and immediate cooling."
    },
    {
      "label": "Antipyretics",
      "text": "Effective for infectious fever, useless for environmental or drug-induced hyperthermia."
    }
  ],
  "nursing_priorities": [
    "Determine whether the elevation is fever or a heat-dissipation failure.",
    "Lower core temperature safely and monitor continuously.",
    "Restore fluid and electrolyte balance.",
    "Treat the underlying cause — infection, drug, environment or endocrine crisis.",
    "Prevent complications: seizures, rhabdomyolysis, arrhythmia, organ injury."
  ],
  "assessment": {
    "subjective": [
      "Reports of feeling hot, flushed or chilled",
      "Complaints of headache, weakness, dizziness or nausea",
      "History of heat exposure, exertion, recent anesthesia or new medications",
      "Reports of muscle cramps or thirst"
    ],
    "objective": [
      "Core temperature above normal on rectal, esophageal or bladder measurement",
      "Flushed, hot skin; sweating in heat exhaustion but often dry skin in heat stroke",
      "Tachycardia, tachypnea and hypotension",
      "Altered mental status, seizures or ataxia",
      "Dark urine, elevated CK, or oliguria suggesting rhabdomyolysis"
    ],
    "related_factors": [
      "Infection, sepsis or inflammatory disease",
      "High ambient temperature, humidity or strenuous exertion",
      "Dehydration and impaired sweating",
      "Medications: anticholinergics, antipsychotics, stimulants, serotonergic drugs, anesthetics",
      "Extremes of age and chronic illness limiting thermoregulation"
    ]
  },
  "goals": [
    "The client's core temperature will return toward normal within the prescribed timeframe.",
    "The client will maintain stable vital signs and mental status.",
    "The client will maintain adequate urine output and fluid balance.",
    "The client will verbalize measures to prevent recurrence."
  ],
  "interventions": [
    {
      "title": "Monitor",
      "points": [
        "Measure core temperature continuously with a rectal, esophageal or bladder probe in severe cases.",
        "Monitor heart rate, blood pressure, respirations, SpO2 and mental status frequently.",
        "Track intake, output, urine color and daily weight.",
        "Review CK, electrolytes, renal function and coagulation for rhabdomyolysis and DIC."
      ]
    },
    {
      "title": "Cooling measures",
      "points": [
        "Remove excess clothing, lower room temperature and apply cool compresses to groin, axillae and neck.",
        "Use evaporative cooling (tepid mist plus fan) or a cooling blanket for heat stroke.",
        "Stop active cooling around 38–38.5 °C to prevent overshoot hypothermia.",
        "Treat shivering promptly as ordered because it raises heat production.",
        "Give antipyretics for infectious fever only; they do not help environmental hyperthermia."
      ]
    },
    {
      "title": "Fluids and cause-directed care",
      "points": [
        "Administer IV isotonic fluids as ordered to correct dehydration and protect renal function.",
        "Obtain cultures before antibiotics when infection is suspected.",
        "Discontinue causative medications and prepare dantrolene for malignant hyperthermia.",
        "Provide oxygen and seizure precautions as needed."
      ]
    }
  ],
  "patient_teaching": [
    "Teach hydration and activity limits in hot weather, especially for children and older adults.",
    "Advise never leaving anyone in a parked vehicle.",
    "Explain when a fever should be reported: above 38.5 °C persisting, with stiff neck, rash or confusion.",
    "Review correct antipyretic dosing and the risk of duplicate acetaminophen products."
  ]
}