Hyperthermia: Body temperature elevated above normal range.

Hyperthermia is elevated body temperature due to a break in thermoregulation that arises when a body produces
or absorbs more heat than it dissipates. It is a sustained core temperature beyond the normal variance, usually
greater than 39 C (102.2 F). Such elevations range from mild to extreme; body temperatures above 40 C (104
F) can be life-threatening. Hyperthermia differs from fever in that it is characterized by an uncontrolled
increase in body temperature that exceeds the bodys ability to lose heat. The setting of the hypothalamic
thermoregulatory center is unchanged. In contrast to fever in infections, hyperthermia does not involve
pyrogenic molecules.

Common cases of hyperthermia result from the combined effects of activity and salt and water deprivation in a
hot environment, such as when athletes perform in extremely hot weather or when older adults avoid the use of
air conditioning because of expense. Hyperthermia may transpire more quickly in persons who have endocrine-
related problems; use alcohol; or take diuretics; anticholinergics; or phototoxic agents. Common forms of
accidental hyperthermia include heat stroke, heat exhaustion, and heat cramps. Malignant hyperthermia is a rare
reaction to common anesthetic agents such as halothane or the paralytic agent succinylcholine. Those who have
this reaction, which is potentially fatal, have a genetic predisposition.

Certain individuals, such as the elderly, infants and young children, the obese, outdoor workers, and those with
chronic medical conditions are at increased risk for developing a heat-related illness. A thorough assessment of
preoperative patients is necessary for prevention.

Related Factors

Here are some factors that may be related to Hyperthermia:

Anesthesia
Dehydration
Exposure to hot environment
Illness or trauma
Inability to perspire
Increased metabolic rate
Medications
Vigorous activity

Defining Characteristics

Hyperthermia is characterized by the following signs and symptoms:

Body temperature above the normal range

Hot, flushed skin
Increased heart rate
Increased respiratory rate
Loss of appetite
Malaise or weakness
Seizures

Goals and Outcomes

The following are the common goals and expected outcomes for Hyperthermia:

Patient maintains body temperature below 39 C (102.2 F).

Patient maintains BP and HR within normal limits.

Nursing Assessment
Assessment is necessary in order to identify potential problems that may have lead to Hyperthermia as well as
name any episode that may occur during nursing care.

Assessment
Identify the triggering factors.
Monitor the patients HR, BP, and especially the
tympanic or rectal temperature.
Determine the patients age and weight.
Monitor fluid intake and urine output. If the patient is
unconscious, central venous pressure or pulmonary
artery pressure should be measured to monitor fluid
status.
Review serum electrolytes, especially serum sodium.
Rationales
Determination and management of the underlying
cause are necessary to recovery.
HR and BP increase as hyperthermia progresses.
Tympanic or rectal temperature gives a more accurate
indication of core temperature.
Extremes of age or weight increase the risk for the
inability to control body temperature.
Fluid resuscitation may be required to correct
dehydration. The patient who is significantly
dehydrated is no longer able to sweat, which is
necessary for evaporative cooling.
Sodium losses occur with profuse sweating and
accidental hyperthermia.

Nursing Interventions

The following are the therapeutic nursing interventions for Hyperthermia:

Interventions Rationales
Room temperature may be accustomed to near normal
Adjust and monitor environmental factors like room body temperature and blankets and linens may be
temperature and bed linens as indicated. adjusted as indicated to regulate temperature of the
patient.
Exposing skin to room air decreases warmth and
Eliminate excess clothing and covers.
increases evaporative cooling.
Antipyretic medications lower body temperature by
Give antipyretic medications as prescribed. blocking the synthesis of prostaglandins that act in the
hypothalamus.
Hyperthermia increases the metabolic demand for
Ready oxygen therapy for extreme cases.
oxygen.
Provide chlorpromazine (Thorazine) and diazepam Shivering increases the metabolic rate and body
(Valium) when excessive shivering occurs. temperature.
If the patient is dehydrated or diaphoretic, fluid loss
Encourage ample fluid intake by mouth.
contributes to fever.
Provide additional cooling mechanisms commensurate with the significance of temperature elevation and
related manifestations:
Noninvasive: cooling mattress, cold packs
These measures help promote cooling and lower core
applied to major blood vessels
temperature.
Evaporative cooling: cool with a tepid bath; do
not use alcohol Alcohol cools the skin too rapidly, causing shivering.

Invasive: gastric lavage, peritoneal lavage,
cardiopulmonary bypass in an emergency
Modify cooling measures based on the patients
physical response.
Raise the side rails at all times.
These invasive procedures are used to quickly lower
core temperature. These patients require
cardiopulmonary monitoring.
Cooling too quickly may cause shivering, which
increases the use of energy calories and increases the
metabolic rate to produce heat.
This is to ensure patients safety even without the
presence of seizure activity.
Start intravenous normal saline solutions or as
indicated.
Provide high caloric diet or as indicated by the
physician.
Educate patient and family members about the signs
and symptoms of hyperthermia and help in identifying
factors related to occurrence of fever; discuss
importance of increased fluid intake to avoid
dehydration.
Refer at-risk individuals to the Malignant
Hyperthermia Association of the United States.
Discuss the significance of informing future health
care providers of the malignant hyperthermia risk;
recommend a medical alert bracelet or similar
identification.
Intravenous normal saline solution replenishes fluid
losses during shivering chills.
Appropriate diet is necessary to meet the metabolic
demand of the patient.
Providing health teachings to the patient and family
aids in coping with disease condition and could help
prevent further complications of hyperthermia.
This organization provides information and additional
resources for patients who have a history of malignant
hyperthermia.
Alternative anesthetic drugs or methods can be used
for these patients.