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Updated: Aug 7, 2026
19:15
Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
Published on: August 25, 2014
Insights
Fever in infants under 24 months requires careful evaluation for serious bacterial infections. This clinical approach helps avoid misdiagnosis and unnecessary testing in young children.
Area of Science:
- Pediatrics
- Infectious Diseases
- Clinical Medicine
Background:
- Fever in infants under 24 months is a common clinical challenge.
- The presence of fever raises concern for serious bacterial infections (SBIs).
- Accurate diagnosis is crucial to prevent under- or overtreatment.
Purpose of the Study:
- To provide a structured clinical approach for evaluating fever in infants.
- To guide practitioners in identifying infants with SBIs.
- To minimize excessive diagnostic work-ups while ensuring timely detection of serious infections.
Main Methods:
- The study outlines a clinical decision-making process for febrile infants.
- It emphasizes key historical and physical examination findings.
- It suggests criteria for further investigations and management.
Main Results:
- A systematic approach can differentiate benign febrile illnesses from SBIs.
- Early identification of high-risk infants is facilitated.
- Unnecessary laboratory tests and hospitalizations can be reduced.
Conclusions:
- A well-defined clinical strategy is essential for managing fever in infants.
- This approach balances the need for prompt diagnosis of SBIs with the avoidance of overtreatment.
- Effective management reduces healthcare costs and improves patient outcomes.
Abstract:
Fever in infants (age less than 24 months) is a medical urgency because of the possibility that a severe bacterial infection may be present. A clinical approach to this recurring dilemma is provided to help the practitioner avoid the twin dangers of either missing a serious infection or embarking on an over-exuberant diagnostic work-up.
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01:25Increased Body Temperature
A body temperature above 38°C (100.4 °F) is known as fever or pyrexia, and a person with fever is termed 'febrile.' Typically, the hypothalamus, a part of the brain that acts as the body's thermostat, regulates body temperature through a thermoregulatory setpoint. It receives signals from cold and warm thermal receptors throughout the body and adjusts the body's temperature accordingly. Fever occurs when this hypothalamic setpoint is altered, usually in response to an infection or illness.
01:22Methods of reducing fever
The signs and symptoms of fever include hot and dry skin, flushed face, thirst, muscle aches, anorexia, headache, tachycardia, tachypnea, and fatigue. Elevated body temperature is reduced using two methods: pharmacological and nonpharmacological. Proper identification and treatment of the root cause of a fever is of utmost importance.
Pharmacological Methods of Reducing Fever:
Pharmacological Methods of Reducing Fever:
01:14Assessing Body Temperature - Oral
Here are the steps to accurately measure oral temperature using an electronic thermometer:
Step 1:
Start by practicing proper hand hygiene to prevent the spread of microorganisms.
Step 2:
Take the thermometer out of the charging unit, switch it on, and wait for the ready sign.
Step 3:
Gently slide the probe cover until a click is heard. This simple action prevents cross-contamination and ensures the correct placement of the probe cover.
Step 4:
Instruct the patient to open their mouth and place...
Step 1:
Start by practicing proper hand hygiene to prevent the spread of microorganisms.
Step 2:
Take the thermometer out of the charging unit, switch it on, and wait for the ready sign.
Step 3:
Gently slide the probe cover until a click is heard. This simple action prevents cross-contamination and ensures the correct placement of the probe cover.
Step 4:
Instruct the patient to open their mouth and place...
01:27Assessing Body Temperature - Rectal
Rectal temperature measurement is considered the most precise method for assessing core body temperature and typically registers higher than oral temperature. For adults, the rectal thermometer should be inserted 1 to 1.5 inches into the rectum to obtain the most accurate reading.
Follow these steps for rectal temperature assessment:
Step 1: Perform hand hygiene and don clean gloves to prevent cross-infection.
Step 2: Position the patient in a side-lying position to better visualize the rectal...
Follow these steps for rectal temperature assessment:
Step 1: Perform hand hygiene and don clean gloves to prevent cross-infection.
Step 2: Position the patient in a side-lying position to better visualize the rectal...
01:15Nursing Evaluation
The evaluation stage signals the end of the nursing process. The nurse gathers evaluative data to assess whether or not the patient has attained the expected results. Whereas the nurse collects data in the nursing assessment to identify the patient's health concerns, the evaluation stage data determines if the indicated health issues are resolved. Evaluative data collection includes two sections: the data acquired to evaluate patient outcomes and the time criteria for data collection.
Section...
Section...
01:26Patterns of Fever
Before understanding the types and patterns of fever, it is essential to know its phases.