Fundamentals of Nursing Q 459
An infected patient has chills and begins shivering. The best nursing intervention is to:
A. Apply iced alcohol sponges
B. Provide increased cool liquids
C. Provide additional bedclothes
D. Provide increased ventilation
Correct Answer: C. Provide additional bedclothes
In an infected patient, shivering results from the body’s attempt to increase heat production and the production of neutrophils and phagocytic action through increased skeletal muscle tension and contractions. Initial vasoconstriction may cause skin to feel cold to the touch. Applying additional bed clothes helps to equalize the body temperature and stop the chills. Attempts to cool the body result in further shivering, increased metabolism, and thus increased heat production.
Option A: This intervention would further increase shivering. Therapeutic temperature modulation, which incorporates mild hypothermia and maintenance of normothermia, is being used to manage patients resuscitated after cardiac arrest. During this therapy, the shiver response is activated as a defense mechanism in response to an altered set-point temperature and causes metabolic and hemodynamic stress for patients.
Option B: Cool liquids may increase the shivering. Recognition of shivering according to objective and subjective assessments is vital for early detection of the condition. Once shivering is detected, treatment is imperative to avoid deleterious effects. The Bedside Shivering Assessment Scale can be used to determine the efficacy of interventions intended to blunt thermoregulatory defenses and can provide continual evaluation of patients’ responses to the interventions.
Option D: Increased ventilation may be done, but it could still increase shivering. Nurses’ knowledge and understanding of the harmful effects of shivering are important to affect care and prevent injury associated with uncontrolled shivering. Chills may also be a symptom of a serious or life-threatening condition that should be immediately evaluated in an emergency setting, such as hypothermia, which is an abnormally low body temperature.