Ramu has a fever. His temperature starts at 100°F, rises to around 103°F, and then falls back to 100°F. This cycle repeats several times within a single day, forming a typical pattern. What kind of fever is Ramu having?

1. A

   Constant

2. B

   Intermittent

3. C

   Remittent

4. D

   Relapsing

Appeared in: DSSSB - 28 August 2019 (Shift-1)

Explanation

• The defining characteristic of the fever described is that the temperature fluctuates but never returns to the normal baseline.
• In a remittent fever, the temperature varies throughout the day but always remains elevated above normal (98.6°F or 37°C).
• The patient's temperature range of 100°F to 103°F fits this pattern perfectly, as the lowest point is still a fever.
• This pattern is commonly seen in conditions like infective endocarditis, brucellosis, and typhoid fever.

Why Other Options Were Wrong

• Option A: A constant (or sustained) fever shows very little fluctuation, typically less than 1°C (1.8°F) in 24 hours. The patient's temperature varied by 3°F, which is a significant fluctuation.
• Option B: An intermittent fever is characterized by temperature spikes that return to a normal level (around 98.6°F) at least once within 24 hours. The patient's temperature only fell to 100°F, which is still a fever.
• Option D: A relapsing fever involves febrile periods lasting for days, separated by intervals of one or more days of normal temperature. The patient's fever cycle repeats several times within a single day.

Related Visual

Clinical Relevance

• Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Classification of Fever Patterns as background academic context rather than a clinical decision trigger.
• Identifying the specific fever pattern is a crucial diagnostic skill for nurses, as it can provide important clues to the underlying cause of the illness.
• For example, remittent fevers are often associated with infectious diseases like typhoid fever or infective endocarditis, while intermittent fevers are classic for malaria or sepsis.
• Accurate documentation of temperature fluctuations on a fever chart is essential for the healthcare team to recognize these patterns.

How to Approach the Question

• First, identify the key details in the question: the temperature range (100°F to 103°F) and the time cycle (repeats within a day).
• Note the lowest temperature in the cycle, which is 100°F.
• Compare this lowest temperature to the normal body temperature (approx. 98.6°F). Recognize that 100°F is still a fever.
• The crucial insight is that the temperature fluctuates but never returns to normal.
• Review the definitions of the four fever types provided in the options.
• Match the observed pattern (fluctuates, but stays high) with the correct definition, which is 'Remittent fever'.

Concept Tested & Keywords

• Concept Tested: Classification of Fever Patterns
• Stem keywords: fever, temperature, rises, falls, cycle, pattern
• Lead-in keywords: What kind of fever
• Clinical cues: Temperature fluctuates between 100°F and 103°F, indicating a variation of 3°F.
• Clinical cues: The lowest temperature reached is 100°F, which is still above the normal body temperature.

Question ID

QkvMUqa8_4em_YmR7RP64V

Copy ID

Reference Book

E6 Nursing Fundamentals Taylor p. 118-120

E6 Nelson Textbook of Pediatrics(2024) — Volume 1 p. 1642-1644