A Child with fever 102°F which action is contraindicated?

Appeared in: NORCET 2 -2021 (Shift-2)

Explanation

Cold sponging is contraindicated for fever management in children.
It causes rapid skin cooling, leading to peripheral vasoconstriction, which traps heat in the body's core.
This action also induces shivering, an involuntary muscle activity that generates more heat, paradoxically increasing the core body temperature.
The procedure is uncomfortable and distressing for the child.

Option A: Providing IV fluids is an appropriate intervention, not a contraindication.
Option B: Covering with a light blanket is a recommended comfort measure.
Option C: Checking the temperature regularly is a standard and essential part of monitoring a febrile child.

Visual 1: Flowchart: Step-by-step guide for managing fever in a child, highlighting the administration of antipyretics, hydration, and comfort measures, while explicitly marking cold sponging as a 'Do Not Do' step.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Management of fever (hyperpyrexia) in pediatric patients as background academic context rather than a clinical decision trigger.
A core nursing responsibility is to manage fever using evidence-based practices that prioritize patient safety and comfort.
Avoiding outdated and harmful practices like cold sponging is critical to prevent iatrogenic complications such as a paradoxical rise in core temperature and patient distress.
Nurses must educate parents and caregivers about appropriate fever management at home, including correct antipyretic dosing, hydration, and when to seek medical attention.

How to Approach the Question

First, identify the keyword 'contraindicated' in the question stem. This tells you to look for the action that is harmful or should not be performed.
Next, analyze the clinical situation: a child with a 102°F fever. Recall the physiological principles of thermoregulation.
Evaluate each option based on standard pediatric nursing guidelines for fever management.
Option A (IV fluid): Consider if hydration is important during fever. Yes, it is.
Option B (Light blanket): Consider the risk of shivering vs. overheating. A light blanket prevents shivering without overheating.
Option C (Temp check): Consider the need for monitoring. Yes, it's essential.

Concept Tested & Keywords

Concept Tested: Management of fever (hyperpyrexia) in pediatric patients.
Stem keywords: Child, fever, 102°F, action, contraindicated
Lead-in keywords: contraindicated
Clinical cues: Fever of 102°F indicates a moderate to high-grade fever in a child, requiring appropriate intervention.
Negative lead-in flag: contraindicated

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Practise the full NORCET 2 -2021 (Shift-2)

Attempt every question from this paper in a timed mock, then review the full solution for each one.