Reasons NOT to give APAP for fever?

I've heard of the pre blood culture holding of the apap.. but are there other instances when you would not give tylenol?

Would you only give tylenol for a low grade fever IF the patient felt the fever uncomfortable?

Thanks all.. = )
Error.. not low grade.. but actual fever, over 100.4 F

apap=tylenol? I haven't heard it called that, or I've forgotten, or I'm confused...I don't know the reason for withholding it before blood cultures and would like to know!

We don't give it in our BMT patients unless they're a child or the temp is very high. Letting them have a fever is one of the only defenses their body has naturally against bacteremia. The bacteria don't tolerate the higher body temp as well and die more easily. Also, we don't want to mask the fever. Left untreated, the fever can be a good indicator of if the antibiotics are working, especially in someone who otherwise feels decently and isn't obviously septic.

ok...that's the reason for withholding it with a fever, but why withhold for blood cultures?

Quote from Whisperaok...that's the reason for withholding it with a fever, but why withhold for blood cultures?

Back in the day, I was always told to draw the BC and then give the tylenol. They said that the bacteria were more active and you had a better chance of "capturing" the organism. I'm not sure if this holds true for most fevers today, excepting those diseases with typical fever patterns, like Malaria,or drug fevers. (of course for both Malaria and Drug fevers, the BC may well be negative, as Malaria is found on a smear, and the drug fever will stop only when we stop the offending drug.In cases that do have a recurring fever pattern, you can time Blood Cultures as the bacteriologic burden is highest in the blood stream about 1 hour prior to fever spiking. But for the most part for a typical say, ICU pt in the US, you won't know exactly when he is going to develop a fever. And the majority of them do not develop fever patterns that are useful or diagnostic. Did that help or further muddy the water?

http://allnurses.com/general-nursing...266-page4.htmlany old thread here.....

ah hah! thank y'all...

I wouldn't give APAP (I use that term in my notes, BTW) if the patient has a hepatitis or other liver dysfunction/failure. At least it wouldn't be my first choice.

Quote from Whisperaapap=tylenol? I haven't heard it called that, or I've forgotten, or I'm confused...

no, tylenol has no effect of the actual bacteria that may or may not exist in the blood stream when collecting cultures.Tylenol is an antipyretic and combats the effect of the bacteria and the bodies response to the insult to it. Tylenol does not kill, diminish of affect the actual bacteria in any way in the blood stream and does NOT, NOT affect blood cultures. Giving Tylenol and lowering the bodies temperature and ability to fight infection does affect the over all outcomes though and is not given by my hospital until a temp hits 103. Allow the body to fight....

I have had doctors tell us to not give tylenol unless the temp is 103. But unfortunately, most patients want it if a temp is 99! Many patients just don't understand that an elevated temp is not necessarily a bad thing, and a lot of family members will freak out over a temp. I was told the same thing about the bacteria "being more active and will grow out better" if the cultures are drawn while the temp is up, but on the other hand, I have had lab techs tell me this is not true. That didn't help a bit, did it?