NORCET -2 (shift-2): A Child with fever 102°F which action is contraindicated?

NORCET -2 (shift-2)

Child Health Nursing (Pediatrics)

Easy

Appeared in: NORCET -2 (shift-2)

Explanation

Cold sponging is contraindicated in the management of simple fever as it can induce shivering.
Shivering is the body's mechanism to generate heat, which paradoxically increases the core body temperature, defeating the purpose of the intervention.
Cold application also causes peripheral vasoconstriction, which traps heat within the body by reducing blood flow to the skin surface.
This method causes significant discomfort and distress to the child.

Option A: Providing IV fluids is often a necessary intervention for a febrile child.
Option B: Covering with a light blanket is an appropriate comfort measure.
Option C: Checking the temperature regularly is a standard part of fever management.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Management of pediatric fever and contraindicated nursing actions as background academic context rather than a clinical decision trigger.
A key nursing responsibility in pediatric care is 'fever phobia' education for parents. Nurses must teach that fever is a natural immune response and that the goal is the child's comfort, not just normalizing the number on the thermometer.
Nurses must differentiate between fever (a regulated rise in temperature due to infection/inflammation) and hyperthermia (e.g., heatstroke), where the body's temperature regulation fails. While cold sponging is wrong for fever, aggressive external cooling is essential for hyperthermia.
What if the child had a history of febrile seizures? The priority would still be antipyretics and hydration. While the urgency to control the fever is higher, cold sponging remains contraindicated as the resulting shivering could still increase core temperature and does not prevent seizures more effectively than medication.

How to Approach the Question

First, identify the core of the question: it asks for a 'contraindicated' action, meaning something that should NOT be done.
Analyze the clinical situation: a child with a moderate fever (102°F).
Evaluate each option based on standard pediatric nursing principles for fever management.
Option A (IV fluid): Consider the physiology of fever. It increases metabolic rate and fluid loss. Is hydration important? Yes. So, this is likely appropriate.
Option B (Light blanket): Think about comfort and thermoregulation. Will a light blanket prevent shivering without overheating? Yes. This seems appropriate.
Option C (Temp check): Consider monitoring. Is it important to track the fever? Yes. This is a standard nursing action.

Concept Tested & Keywords

Concept Tested: Management of pediatric fever and contraindicated nursing actions.
Stem keywords: Child, fever, 102°F, contraindicated
Lead-in keywords: which action is
Clinical cues: Fever of 102°F indicates a moderate fever in a child, requiring appropriate management to ensure comfort and prevent complications.
Negative lead-in flag: contraindicated

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E6 Nelson Textbook of Pediatrics(2024) — Volume 1 p. 1644-1646

E6 Ghai Essential Pediatrics(pp 26-904 of 913) p. 221-223