IMPORTANT FEVER
- Introduce yourself - Temperature > 38C measured rectally
- Speak in Tagalog o Fever of unknown origin: lasting greater than
- If FEMALE, ensure OB history is taken two weeks without cause determined through
history, physical exam and diagnosis
TAKING THE HISTORY o Heat stroke/hyperthermia: greater than 42C
- Must obtain General Data - Pathophysiology
- Chief Complaint o Raised hypothalamic set point
- HPI Infection
- Characterize symptoms Vascular disease
o Onset Malignancy
o Location o Excess heat production
o Duration Salicylate overdose
o Character Hyperthyroid
o Aggravating/Associated Factors Environmental heat
o Relieving Factors Malignant hyperthermia
o Temporal Factors o Defective heat loss
o Severity of Symptoms Ectodermal dysplasia
- Associated active medical, surgical, psychiatric Heatstroke
problems that influence chief complaint Anticholinergic overdose
- Past experience with symptoms - Differential diagnoses
o Prior treatment o Infection
o Medications given Viral
Dose Bacterial
Frequency o Inflammatory
Route Kawasaki
Duration IBD
Compliance Juvenile rheumatoid arthritis
Response o Drug use or toxins
o Data from past charts o Neoplasm
o What patient has done about the symptoms ALL
- Significant positives and negatives Lymphoma
- Common cases assigned - History of Present Illness
o Fever o Onset
o Abdominal Pain When did the fever begin?
o Diarrhea o Duration
o Headache How long has the fever lasted?
o Chest Pain o Characteristics
- Review of Systems Pattern of fever
o Must choose at least three to five systems for Temperature, was it measured and if
ROS that are related or that can be related to it was, what method was used?
the chief complaint o Associated/Aggravating symptoms
o One of these symptoms will always be the Is there associated cough, abdominal
general survey pain, chest pain?
Weight change Think about possible system
Fever involvement here
Chills o Relieving factors
Malaise Was anything done for the fever?
Change in appetite Medications taken
Change in sleep pattern Did the medication work?
o The other two to four symptoms will depend o Temporal
on the chief complaint Ask about travel time
- Remember Note the season of the year
o Past medical history Influenza
o Current health status Dengue
o Risk factors Respiratory infection
o Family history o Severity of symptoms
o Personal and social history How much is the patient
- At the end of the interview inconvenienced by the fever?
o SUMMARIZE YOUR FINDINGS Are they still able to go about their
Make sure you ask your patient if daily activities?
what you are saying is correct - Review of systems
o Ask if the patient has anything to add to your o General status
summary Malaise
o Ask the patient if there is any other complaint Lethargy
at the time Chills
o THANK THE PATIENT FOR THEIR TIME Change in appetite
Change in sleep pattern
Weight change