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Thermoregulation: intervention for febrile shivering
Published on January 30, 2020 22 min
Other Talks in the Series: Nursing
The role of the nurse in supporting health and well-being for people with learning (intellectual) disabilities
- Prof. Ruth Northway
- University of South Wales, UK
Hello everyone, and welcome to this presentation on thermoregulatory responses. My focus today is on how thermoregulatory feedback systems became a guide to intervention research in the nursing management of fever symptoms. I'm Barbara Holtzclaw, and I'm at the University of Oklahoma Health Sciences Center in Oklahoma City, USA. This is where my program of research took a shift from a direction I was in, studying responses of people losing heat to those with rising temperatures.
I'd first like to acknowledge the contributions to my work from the Robert Wood Johnson Clinical Nurse Scholars Program who funded my postdoctoral work. I also would like to thank the faculty and the clinical mentors who have informed me all these years and encouraging me throughout my career, specifically my mentor, Dr. June Abbey, who inspired me to answer clinical questions with research. Finally, I'd like to acknowledge that meaningful clinical research is seldom done in isolation. I had nurse clinicians that often identified the symptoms most in need of management, and I had research collaborators who helped me lead the work. It's also important that I share that, finding solutions to this problem didn't happen in the solitude of a library or even in an ivory tower. It took a virtual village of curiosity and concern and knowledge from interdisciplinary collaborators on three university campuses.
My objectives for this presentation are to share with you how my interests in thermoregulation actually motivated me to take a deep dive into the mechanisms that surround specific symptoms. By doing that, I was able to more appropriately develop interventions aimed directly at the underlying cause to either prevent or treat the symptom. My hope is that this talk will help you understand that the thermoregulatory mechanisms that cause shivering when you are cold are the same as those responsible for the shivering seen in fever. Understanding that muscle activity in shivering produces heat during fever helps to explain why we should avoid either cooling or stimulating that response. We should consider fever as a whole array of responses, with the two that are most prevalent being the acute phase response, and this is what causes the aches and malaise during fever, and the thermal consequences which cause chills and elevated body temperature. Many people and some nurses are not aware that the ache and ill-feeling that accompanies fever is related to the biochemical actions of the acute phase response and not to the rising temperature.