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Nursing Interventions To Control Pyrexia In a Neurosurgica L Intensive Care Unit
Gülay Altun Uğraş1,Serpil Yüksel2,Seher Gürdil Yılmaz3,Keziban Şirin4,Yüksel Turan5,Selin Eroğlu6
1Mersin Üniversitesi, Hemşirelik, Mersin, Türkiye
2Necmettin Erbakan Üniversitesi Sağlık Bilimleri Fakültesi, Hemşirelik Bölümü Cerrahi Hastalıkları Hemşireliği Anabilim Dalı, Hemşirelik, Konya, Türkiye
3Mersin Üniversitesi İçel Sağlık Yüksekokulu Hemşirelik Bölümü Cerrahi Hastalıkları Hemşireliği Anabilim Dalı, Hemşirelik, Mersin, Türkiye
4İstanbul Üniversitesi Cerrahpaşa Tıp Fakültesi, Nöroşirurji Anabilim Dalı Nöroşirurji Servisi, Hemşirelik, İstanbul, Türkiye
5İstanbul Üniversitesi Cerrahpaşa Tıp Fakültesi, Nöroşirurji Anabilim Dalı Yoğunbakım Ünitesi, Hemşirelik, İstanbul, Türkiye
6İstanbul Üniversitesi Cerrahpaşa Tıp Fakültesi, Nöroşirurji Anabilim Dalı Yoğunbakım Ünitesi, Hemşirelik, İstanbul, Türkiye
Introduction: Whilst pyrexia is one of the key defence mechanisms of the body, it also causes raised intracranial pressure (ICP) by accelerating metabolic activity in neurosurgical patients and adversely affects the healing process. In the literature, pyrexia control in neurosurgical patients is reported to be effective in preventing adverse consequences arising from uncontrolled pyrexia.

Material and Methods: This study employs a retrospective descriptive methodology. It was undertaken by examining a sample of medical records for 72 patients. All were over 18 years of age, had remained in the Neurosurgical Intensive Care Unit of a University Hospital for at least one week and had a recorded axillary temperature exceeding 38°C. Written permission from the Ethics Committee of the relevant institution was obtained to allow the research to proceed. Data were gathered between September 2013 and February 2014 using a data collection form developed by the researchers. Descriptive statistical methods (frequency, average, standard deviation) were used for the data analysis.

Results: 72 out of 180 (40%) patients admitted to NICU between 2010 and 2014 developed a pyrexia. The principal interventions by nurses to maintain pyrexia control were identified as: giving an antipyretic agent by doctor"s order (98.6%), using a cooling electrical fan (88.9%), giving a tepid bed bath (75%) and adjusting the room temperature or removing blankets (72.2%). The most frequently used antipyretic agents were identified as dipyrone (27.8%), a combination of dipyrone and paracetamol (26.4%) or paracetamol alone (16.7%).

Conclusion: From the study data, it was determined that the most frequent method used to provide pyrexia control in NICU patients was pharmacological, and that the most frequently used nursing interventions were attempts at physical cooling. Keywords : Pyrexia, neurosurgical intensive care unit, nursing interventions, physical cooling methods