“Fever Evaluation and Early Recognition” by Kramer

The majority of hospitalized patients complain of fever from time to time. Fever is defined “as a temperature greater than the normal body temperature, usually higher than 38 0C” (Kramer, 2010, p. 20). In most cases, fever indicates an underlying problem. Initially, nurses had to decide whether to treat the fever or deal with the underlying condition first. This decision depended on the state and nature of the patient at the time. However, this article refutes this perception by noting that every case of fever should be examined independently to establish its cause before embarking on any form of treatment. This move will save lives because treating fever without establishing its cause can lead to unnecessary deaths. Hypothermia underscores a state where body temperatures go below the normal levels, but this situation can be used to manage fever in neurological disorders or cardiac arrest. The article gives thorough details on the steps that should be followed when handling fever among hospitalized patients. Therefore, fever management can be used to prevent sepsis at its early stage, but the process required thorough knowledge as explored in this article.

This article is of significant use in the nursing practice. Firstly, after reading this article, nurses will understand why fever should not be treated before establishing its cause. According to Kramer (2010), every patient showing signs of fever should be investigated to establish the cause of the condition for proper medication. Kramer (2010) indicates, “Critical thinking skills and assessment of overall systems, invasive lines, medications, indwelling drainage catheters, pain, incision(s), vital signs, and pulse oximetry must be done prior to treatment with antipyretics, cold washcloths, ice packs, and hyperthermia units” (p. 21). Therefore, with this knowledge, the nursing practice is enhanced to address its core mission of saving lives. Conventionally, the majority of nurses assume that fever is a dangerous sign, and thus they rush into addressing it without establishing its cause. This unthoughtful move can cost people’s lives especially for patients with critical underlying conditions.

The article gives a physician-driven guideline, which incorporates the different causes of sepsis and infection. This move is novel because such guides have been lacking in the nursing practice. The given guidelines in the article are “a product of systematic review, rigorous quantitative scientific research, meta-analysis, and collaboration from various specialties such as obstetrics, pulmonary medicine, infectious diseases, internal medicine, neurology, oncology, surgery, and critical care” (Kramer, 2010, p. 21). This combination of different health care fields in the management of fever will assist nurses in dealing with different kinds of patients.

In addition, the article links evidence-based practice with the management of fever. This information is important because earlier versions linked EBP with the general nursing practice. The article summarizes the NGC guidelines to be used in treating fever in hospitalized patients. Therefore, it becomes easy for nurses to have a general overview of the set guidelines, which improves service delivery and care outcomes. Additionally, the article outlines how nurses can collaborate with physicians, which enhances problem solving coupled with patient care outcomes. Finally, the article gives a collection of the available literature and requirements on handling fever amongst hospitalized patients. Therefore, this information gives nurses a clear picture on the direction that the nursing practice is taking concerning the management of fever amongst patients.


Kramer, L. (2010). Evidence-based practice: fever evaluation and early recognition of Systemic inflammatory response syndrome in critical care patients. Dimensions of Critical Care Nursing, 29(1), 20-28.

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