Comprehensive,Nursing Care Plan for Fever
This guide presents 12 evidence-based nursing diagnoses related to fever, with concise care plans for clinical reference or study. Each card includes assessment, diagnosis, goal, planning, interventions, and evaluation.
1. Hyperthermia
Elevated body temperature above normal due to failed thermoregulation.
Assessment
- Temperature > 38°C (100.4°F)
- Flushed, warm skin
- Tachycardia, tachypnea
- Lethargy, malaise, chills
Diagnosis
Hyperthermia related to infectious process as evidenced by elevated core temperature and flushed skin.
Goal
- Patient’s temperature will decrease to normal range within 24 hours.
- Absence of complications such as dehydration or seizures.
Planning
- Monitor temperature every 2–4 hours.
- Identify and address underlying cause.
Interventions
- Administer antipyretic medications as ordered.
- Encourage oral fluid intake (unless contraindicated).
- Adjust room temperature, provide tepid sponging as needed.
- Monitor vital signs closely and report significant changes.
Evaluation
- Temperature returns to baseline within target time frame.
- No evidence of new or worsening symptoms.
2. Risk for Deficient Fluid Volume
Fever increases insensible fluid loss through perspiration and respiration.
Assessment
- History of fever
- Dry mucous membranes, reduced skin turgor
- Decreased urine output, concentrated urine
- Thirst, hypotension, dizziness
Diagnosis
Risk for deficient fluid volume related to excessive fluid loss secondary to elevated body temperature.
Goal
- Patient maintains adequate hydration: moist mucous membranes, stable VS, normal urine output.
Planning
- Monitor intake and output (I&O).
- Assess labs: hematocrit, BUN, electrolytes.
Interventions
- Encourage oral fluids, offer preferred fluids regularly.
- Administer IV fluids if ordered.
- Monitor for signs & symptoms of dehydration.
Evaluation
- Urine output ≥ 0.5 mL/kg/hr, skin & mucosa remain moist, labs stay within normal limits.
3. Acute Pain
Fever often causes headache, muscle aches, and generalized discomfort.
Assessment
- Self-reported pain: location, intensity (e.g., numeric scale)
- Restlessness, facial grimacing
Diagnosis
Acute pain related to infectious process and fever as evidenced by patient report of pain/discomfort.
Goal
- Pain score < 3/10 within 4 hours of intervention.
Planning
- Assess pain regularly and after interventions.
Interventions
- Administer antipyretics and analgesics as prescribed.
- Encourage relaxation and comfort measures (quiet, dim environment).
- Educate about pain relief options.
Evaluation
- Pain is minimized and patient appears comfortable.
4. Risk for Imbalanced Nutrition: Less Than Body Requirements
Fever can decrease appetite and impair intake.
Assessment
- Dietary recall, current intake
- Weight trends, BMI
- Nausea or vomiting
Diagnosis
Risk for imbalanced nutrition: less than body requirements related to increased metabolic needs and decreased appetite due to fever.
Goal
- Patient maintains or gains appropriate weight; energy levels adequate.
Planning
- Monitor daily weight, calorie intake.
Interventions
- Offer small, nutrient-dense, easy-to-digest meals/snacks.
- Avoid forcing food; respect preferences.
- Consult dietitian as needed.
Evaluation
- Maintains weight; reports adequate energy; intake meets needs.
5. Impaired Comfort
Fever causes chills, sweating, malaise, and may disrupt comfort.
Assessment
- Reports of subjective discomfort
- Shivering, restlessness, irritability
Diagnosis
Impaired comfort related to fever and associated symptoms.
Goal
- Patient verbalizes comfort improvement within shift.
Planning
- Assess comfort regularly; individualize measures.
Interventions
- Adjust clothing/bedding for temperature comfort.
- Provide distraction or relaxation (reading, music).
- Apply cool compress if needed.
Evaluation
- Patient expresses improved comfort; restful demeanor.
6. Fatigue
Persistent tiredness due to infection, fever, metabolic demand.
Assessment
- Patient reports feeling tired/weak
- Reduces activity/mobility
Diagnosis
Fatigue related to increased metabolic demands of fever.
Goal
- Patient maintains adequate energy for ADLs (Activities of Daily Living).
Planning
- Monitor energy levels and ADL performance.
Interventions
- Cluster care to minimize exertion.
- Encourage frequent rest periods.
Evaluation
- Patient reports less fatigue, can perform self-care.
7. Risk for Seizures
Especially in children with high fever or pre-existing seizure disorder.
Assessment
- History of febrile/other seizures
- Current temperature trends
Diagnosis
Risk for seizures related to fever-triggered neuronal excitability (especially in peds).
Goal
- Patient remains seizure-free during febrile episode.
Planning
- Early identification and management of high temperature.
Interventions
- Maintain safe environment (padding, airway support readiness).
- Administer antipyretics as ordered without delay.
- Educate caregivers on seizure management/prevention.
Evaluation
- No seizure activity observed.
8. Disturbed Sleep Pattern
Fever, discomfort, and malaise may disrupt normal sleep.
Assessment
- Patient/caregiver report of poor sleep
- Frequent night waking, napping patterns
Diagnosis
Disturbed sleep pattern related to fever and associated discomfort.
Goal
- Patient reports improved sleep within 48 hours.
Planning
- Plan activities to avoid bedtime disruption.
Interventions
- Promote quiet, dark, comfortable environment at night.
- Administer antipyretics before sleep time.
- Limit fluid intake close to bedtime unless needed for hydration.
Evaluation
- Patient sleeps longer and reports improved rest.
9. Risk for Impaired Skin Integrity
Fever, diaphoresis, and immobility increase skin breakdown risk.
Assessment
- Examine skin for redness, moisture, early breakdown
- Observe mobility, periods of immobility
Diagnosis
Risk for impaired skin integrity related to excessive perspiration and bed rest during fever.
Goal
- Skin remains intact and without redness throughout fever episode.
Planning
- Regular skin assessment and hygiene maintenance.
Interventions
- Keep skin clean and dry; change linens/clothing promptly.
- Reposition patient a minimum of every 2 hours if immobile.
- Use moisture barriers/creams if needed.
Evaluation
- No breakdown, redness, or open areas observed.
10. Ineffective Thermoregulation
Body unable to maintain desired core temperature.
Assessment
- Temperature fluctuations (spikes, chills)
- Skin hot/cool to touch alternately
Diagnosis
Ineffective thermoregulation related to infectious process as evidenced by variable temperatures and chills.
Goal
- Temperature stabilized in normal range (< 38°C).
Planning
- Monitor temp. trends; identify patterns and triggers.
Interventions
- Adjust environmental controls (fan, blankets, aircon).
- Provide antipyretics as needed.
- Educate patient/family about fever management.
Evaluation
- Patient maintains stable, afebrile state.
11. Anxiety (related to fever)
Uncertainty related to cause/outcome of fever increases anxiety.
Assessment
- Verbalization of worry
- Restlessness, irritability
- Tachycardia, difficulty concentrating
Diagnosis
Anxiety related to unfamiliarity with fever and potential complications.
Goal
- Patient verbalizes reduced anxiety, demonstrates use of coping skills.
Planning
- Provide accurate education about fever, its management, and recovery.
Interventions
- Offer reassurance, frequent updates on condition/progress.
- Encourage questions and participation in care decisions.
- Refer to counseling as appropriate.
Evaluation
- Patient displays reduced worry, uses effective coping strategies.
12. Risk for Infection Transmission
Febrile illness may be contagious, risking spread to others.
Assessment
- Type of infection (bacterial/viral/other)
- Isolation precautions in place
Diagnosis
Risk for infection transmission related to contagious febrile illness.
Goal
- No transmission of infection to staff, family, or visitors.
Planning
- Reinforce standard & transmission-based precautions.
Interventions
- Enforce strict hand hygiene for all contacts.
- Educate patient/family about infection prevention (mask-wearing, cough etiquette).
- Use PPE and isolation as required.
Evaluation
- No secondary cases reported; infection control compliance observed.
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