How does fever affect metabolism and what nursing considerations follow?

• A. Increases metabolic rate and fluid loss; monitor hydration, adjust fluid intake, and monitor electrolytes.
• B. Decreases metabolic rate and reduces fluid needs.
• C. Has no impact on hydration; ignore fluids.
• D. Only impacts skin temperature; no need to adjust fluids.

Answer: (A)

Fever raises metabolic rate, meaning the body's energy demands climb. That higher metabolism drives greater caloric needs and increases fluid loss through sweating and faster breathing. Because of this, patients with fever are at risk for dehydration and electrolyte imbalances.

Nursing actions focus on maintaining fluid and electrolyte balance. Assess and document intake and output, monitor body weight, look for signs of dehydration (dry mucous membranes, skin turgor changes, decreased urine output), and adjust fluids accordingly—whether oral fluids or IV support. Keep an eye on electrolytes and correct any imbalances as prescribed, since shifts in sodium, potassium, and other electrolytes can accompany fever. Address the fever itself with appropriate antipyretics and comfort measures to help reduce metabolic demand and improve comfort, while ensuring adequate nutrition to meet increased needs.