HYPERTHERMIA

(HIPERTERMIA)
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

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 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.

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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 Rationales

Determination and management of the

Identify the triggering factors.
underlying cause are necessary to recovery.

HR and BP increase as hyperthermia

Monitor the patients HR, BP, and especially progresses. Tympanic or rectal temperature
the tympanic or rectal temperature. gives a more accurate indication of core
temperature.

Extremes of age or weight increase the risk for

Determine the patients age and weight.
the inability to control body temperature.

Fluid resuscitation may be required to

Monitor fluid intake and urine output. If the
correct dehydration. The patient who is
patient is unconscious, central venous
significantly dehydrated is no longer able to
pressure or pulmonary artery pressure should
sweat, which is necessary for evaporative
be measured to monitor fluid status.
cooling.

Review serum electrolytes, especially Sodium losses occur with profuse sweating and
serum sodium. accidental hyperthermia.

Nursing Interventions

The following are the therapeutic nursing interventions for Hyperthermia:

Interventions Rationales

Adjust and monitor environmental factors like

Room temperature may be accustomed to
room temperature and bed linens as indicated.
near normal body temperature and blankets

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 and linens may be adjusted as indicated to
regulate temperature of the patient.

Exposing skin to room air decreases warmth

Eliminate excess clothing and covers.
and increases evaporative cooling.

Antipyretic medications lower body

Give antipyretic medications as prescribed. temperature by blocking the synthesis of
prostaglandins that act in the hypothalamus.

Hyperthermia increases the metabolic

Ready oxygen therapy for extreme cases.
demand for oxygen.

Provide chlorpromazine (Thorazine)

Shivering increases the metabolic rate and
and diazepam (Valium) when excessive
body temperature.
shivering occurs.

If the patient is dehydrated or diaphoretic,

Encourage ample fluid intake by mouth.
fluid loss contributes to fever.

Provide additional cooling mechanisms commensurate with the significance of temperature

elevation and related manifestations:

Noninvasive: cooling mattress, cold

These measures help promote cooling and
packs applied to major blood vessels lower core temperature.

Evaporative cooling: cool with a

Alcohol cools the skin too rapidly, causing
tepid bath; do not use alcohol shivering.

Invasive: gastric lavage, peritoneal

These invasive procedures are used to quickly
lavage, cardiopulmonary bypass in lower core temperature. These patients
an emergency require cardiopulmonary monitoring.

Cooling too quickly may cause shivering,

Modify cooling measures based on the patients
which increases the use of energy calories and
physical response.
increases the metabolic rate to produce heat.
This is to ensure patients safety even without
Raise the side rails at all times.
the presence of seizure activity.

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 Intravenous normal saline solution
Start intravenous normal saline solutions or as
replenishes fluid losses during shivering
indicated.
chills.
Provide high caloric diet or as indicated by the Appropriate diet is necessary to meet the
physician. metabolic demand of the patient.
Educate patient and family members about the
Providing health teachings to the patient and
signs and symptoms of hyperthermia and help
family aids in coping with disease condition
in identifying factors related to occurrence of
and could help prevent further complications
fever; discuss importance of increased fluid
of hyperthermia.
intake to avoid dehydration.
This organization provides information and
Refer at-risk individuals to the Malignant
additional resources for patients who have a
Hyperthermia Association of the United States.
history of malignant hyperthermia.
Discuss the significance of informing future
health care providers of the malignant Alternative anesthetic drugs or methods can
hyperthermia risk; recommend a medical alert be used for these patients.
bracelet or similar identification.