Clinical triggers for detection of fever and dehydration. Implications for long-term care nursing.

1. Fever is a common problem among long-term care residents, and the clinical manifestations of fever and infections may be vague or nonspecific. 2. The majority of fevers in this study were staff-detected versus resident-initiated; this implies that staff vigilance is important in the detection of fever. 3. Staff documentation of impaired oral intake during febrile episodes was associated highly with either elevated serum sodium or blood urea nitrogen/creatinine ratios. Therefore, nursing assessment and interventions to hydrate residents at the first indication of impaired oral intake may prevent dehydration. 4. Routine mandated vital signs were found to be of little or no value in detecting fevers.