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Thermoregulation
hypo/hyperthermia/ heat stroke
| Question | Answer |
|---|---|
| What is the normal human body temperature and which part of the brain controls it? | Normal body temperature is 98.6 F (37C). It is controlled by the hypothalamus, the body's thermostat |
| Which specific parts of the hypothalamus are responsible for cooling and heating? | The anterior hypothalamus is the cooling center, and the posterior hypothalamus is the heating center. |
| How does the body respond to cold temperatures | When cold, the body responds with vasoconstriction, shivering, and an increased Basal Metabolic Rate (BMR) to generate heat |
| How does the body respond to hot temperatures? | When hot, the body responds with vasodilation and sweating to release heat |
| List three ways heat is lost from the body. | Heat is lost by convection (air or water movement), conduction (touching cold surfaces), and evaporation (sweating) |
| What is a potential downside of sweating for thermoregulation? | Sweating helps cool the body but can cause fluid & electrolyte loss (Na, K, water). |
| Define hypothermia. | Hypothermia is defined as a core body temperature <95F 35C |
| Name three risk groups for hypothermia. | Risk groups include older adults, children/infants, and psychologically/mentally impaired individuals. (Other answers: substance users, those with certain medical conditions or on specific medications). |
| What are the key signs of mild hypothermia (89.6-95F / 32-35C)? | The body tries to compensate, leading to shivering, increased HR, BP, RR, and potentially respiratory alkalosis. Hyperglycemia and cold diuresis (increased urine output) can also occur. |
| What are the key signs of moderate hypothermia (82.4−89.6 ∘F/28−32 C)? | Shivering worsens then stops, mental status changes (hallucinations, agitation), blood shunts to organs (cool skin). Afib/ Vfib, bradycardi, low K, Resp & BMR slow, leading to respiratory acidosis, hypoventilation, and hypoxemia |
| What are the key signs of severe hypothermia (<82.4 F/28 ∘ C) | Body systems begin shutting down, with massive vasodilation (vasoconstriction fails). Pupils become fixed and dilated, PE may occur, the pt is unresponsive/coma-like. VtachVfib leading to low CO, BP, and brain perfusion, coma, and death if untreated |
| What are the four stages of frostbite? | 1: Frostnip (superficial, numbness, pallor) 2: Clear blisters, hardened skin, black/dry later 3: Tissues under skin freeze, blood blisters, blue-gray skin, pain 4: Damage down to muscle & bone, necrosis, may need amputation |
| What is the primary rewarming method for frostbite and what should you AVOID? | Rewarm in warm water (not too hot). DO NOT rewarm if risk of re-freezing exists as it worsens tissue injury. Also, do not rub or massage the affected area |
| What are the initial priorities for treating hypothermia? | focus on ABCs (airway, breathing, circulation), remove wet clothes, warm patient gradually, and start IV fluids. |
| Give an example of a passive external, active external, and active internal rewarming technique for hypothermia | Passive External: Warm blankets. Active External: Warming blankets, warm air. Active Internal: Warm IV fluids, warm oxygen, lavage, ECMO |
| What is "afterdrop" and how can it be prevented during rewarming | Afterdrop occurs when cold blood from extremities returns to the core too fast, causing cold blood to return to the core and dropping the core temp further. It can lead to hi-K, arrhythmias, and hypotension. To prevent it, rewarm the trunk first. |
| How long should you check for a pulse in a hypothermic patient before starting CPR? | Check pulse for 60 seconds |
| When are defibrillation and medications effective for a hypothermic patient in cardiac arrest? | Defibrillation & meds don't work until core temp is >86 ∘F (30 C) |
| What is Targeted Temperature Management (TTM) and why is it used? | TTM is therapeutic hypothermia used to protect the brain after cardiac arrest. Temp is intentionally lowered to 32−36 ∘C (89.6−96.8 ∘F) for 24 hours to slow metabolism and reduce oxygen needed by the brain, thus reducing brain injury |
| List two key labs/diagnostics used for hypothermia assessment | ABG, Electrolytes, Glucose, CBC/H&H, Coagulation (PT/aPTT), ECG, Chest X-ray, Head CT, Toxicology, Pregnancy test. (Any two are acceptable) |
| How does the body normally cool itself, and why is high humidity a problem for cooling? | hypothalamus keeps temperature balanced, and the body sweats, with sweat evaporating to cool the body down. In humid weather, sweat doesn't evaporate well, increasing the risk for overheating. |
| What are the symptoms of Heat Cramps? | Muscle cramps (arms, legs, abs), hard/tender muscles, twitching. Skin is moist and cool. VS normal or slightly elevated temp |
| What is the main difference in mental status between Heat Exhaustion and Heat Stroke? | Heat Exhaustion has no severe CNS changes (mild confusion at most). Heat Stroke has severe CNS symptoms like confusion, irrational behavior, seizures, and coma. |
| What is the core temperature for Heat Stroke? | Core Temperature: >104 ∘F (40 ∘ C). |
| What is the priority treatment for Heat Stroke? | Cool the body to ~102.2 ∘F (39 ∘ C), and manage airway, breathing, circulation. |
| Why should antipyretics be avoided in heat stroke? | Antipyretics are not effective for non-fever hyperthermia. |
| What is rhabdomyolysis and what is its main risk in heat stroke? | Rhabdomyolysis is the breakdown of muscle that releases myoglobin, which can lead to acute kidney injury (AKI). |
| What is a key nursing intervention to prevent shivering during cooling for heat stroke? | Treat shivering with benzodiazepines. |
| Name two populations at high risk for thermoregulation disturbances. | Infants and older adults. (Other answers: people with cardiovascular disease, diabetes, hypothyroidism; homeless; outdoor workers/athletes; individuals on certain medications ). |
| How does alcohol affect thermoregulation in a cold environment? | Alcohol causes vasodilation, leading to faster heat loss. |
| How does hypothermia protect the body in certain situations? | Hypothermia slows metabolism and oxygen consumption, protecting the brain and heart (e.g., in cardiac arrest or during TTM). |
| What is the main difference between fever (from infection) and environmental hyperthermia regarding the hypothalamus? | In fever, the hypothalamic set point is increased. In environmental hyperthermia, the set point is unchanged. |
| Do patients with environmental heat stroke typically sweat? | No, sweating is typically absent in heat stroke patients due to thermoregulatory system failure and dehydration. |
Created by:
Naturallyirb
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