Cardiovascular: Body temperature (for nursing assistant training)
Now, as a nursing assistant, you will need to measure your client’s temperature. There are several areas of the body where you can do that, including the oral cavity; the rectum; the axilla, or armpit; the tympanic membrane, or eardrum; and the temporal artery on the forehead.
we need to cover some definitions. Our body is always generating heat through metabolism, and a part of the brain, called the hypothalamus, tries to keep the core body temperature constant like a thermostat.
When we are febrile, meaning we've got a fever, the thermostat is raised higher, and this can be due to an infection, inflammation, or cancer.
However, body temperature could also be high in hyperthermia, where the thermostat is set at the right temperature, but the body simply can’t get rid of the heat.
This can be due to an extremely hot environment, excessive exercise, and reduced sweat production. In contrast, hypothermia is when body temperature gets too low, and it might be due to exposure to cold for a prolonged period of time, either accidentally or in preparation for a medical procedure.
an easy and relatively comfortable method. A normal oral temperature is between 97.6 to 99.6 degrees Fahrenheit, or 36.5 to 37.5 degrees Celsius, for adults, and 97 to 99 degrees Fahrenheit, or 36 to 37 degrees Celsius, for children.
But because the mouth is a large space open to the outside environment, this is not a very accurate way to obtain a temperature because the temperature can change significantly.
So, don’t take an oral temperature if the client has been coughing, sneezing, eating, drinking, smoking, or chewing gum in the past 15 minutes.
Oxygen therapy with a face mask can also interfere with the results. In addition, it's important to hold the thermometer tightly in their mouth, so you should avoid this method for clients who are unable to do this, like those who are unconscious, have undergone a jaw or mouth injury or surgery, or have trouble breathing through their nose.
including an electronic thermometer, a blue oral probe, and a probe sheath. So, first, ask the client if they have coughed, sneezed, eaten, drank, smoked, or chewed gum in the past 15 minutes.
If they have, wait 15 to 30 minutes before proceeding. Then, remember to practice hand hygiene and slide a probe sheath over the temperature probe.
Then, switch it on and wait until you see a ready sign on the screen. the next step is to ask the client to open their mouth before inserting the thermometer into one of their posterior sublingual pockets at the base of the tongue, not in front of it.
Most electronic thermometers also chime when they're done. Next, ask the client to open their mouth and take the thermometer away.
The temperature will be visible on the screen. You can then push the button on the probe to detach the probe sheath and discard it in the appropriate manner.
Finally, practice hand hygiene and make sure the thermometer is ready to be used again by putting away the probe, switching the thermometer off, and connecting it back with its charger.
if the client is comatose, confused, critically ill, in a shock, or unable to close their mouth, obtaining a rectal temperature would give the most accurate measurement.
The rectal temperature is normally 0.7° to 1° F, or 0.4° to 0.5° C, higher than the oral temperature. This means it should be between 98.6 to 100.6 degrees Fahrenheit, or 37 to 38.1 degrees Celsius, for adults, and 98 to 100 degrees Fahrenheit, or 37 to 38 degrees Celsius, for children.
However, this method is often uncomfortable, both physically and emotionally, and it’s also riskier than the other methods.
It should be avoided in clients with hemorrhoids, diarrhea, lesions around the anus, or those who have recently had surgery involving this region.
Furthermore, the thermometer can stimulate the vagus nerve found inside the rectum, which could trigger a reflex that slows down the heart rate and lowers blood pressure, so patients clients with heart conditions should also avoid this procedure.
start by gathering the supplies you’ll need, including gloves, paper towels, tissues, a lubricant jelly, an electronic thermometer, a red rectal probe, and a probe sheath.
Alternatively, you can also use a chemical dot thermometer along with a thermometer sheath. This type of thermometer has chemical dots that can change color depending on the temperature.
It is often preferred for screening temperature in newborns as well as during surgical or other invasive procedures. It’s also preferred for those in reverse isolation or oral intubation.
However, it is not used for acutely ill clients or for keeping track of temperature in clients undergoing treatments. start by practicing hand hygiene, help the client roll over into Sims' position with the upper leg bent, and adjust the linens and the clothing to expose the area of the buttocks.
Through all this, make sure to respect the client’s privacy. Then, check that the wheels on the bed are locked.
Raise the bed to a comfortable working height. Then, for the electronic thermometer, attach the red rectal probe stem to the thermometer, slide the sheath over the probe, switch it on, and check for a ready sign on the screen.
If it’s a chemical dot thermometer, simply slide the cover sheath. Next, leave the thermometer on a clean paper towel on the over-bed table.
Place some of the lubricant on the paper towel and then apply plenty of it on the tip of the thermometer to help it get inserted more smoothly.
Lower the side railings on the side you’re working on. Wear gloves and, with one hand, separate their buttocks.
Make sure to stop and don’t force if you feel resistance. Hold the electronic thermometer for 20-30 seconds or until it chimes; the chemical dot thermometer should be held there for three minutes.
Then, remove the thermometer, use a tissue to clean the area of the buttocks, and readjust the linens as well as the client’s clothing.
After removing the sheath with a tissue and discarding both the tissue and the sheath, note the temperature on the screen of the electronic thermometer.
For the chemical dot thermometer, the last blue dot on the matrix is the client’s temperature. hygiene.
Return the side rails to the raised position, adjust the height and head of the bed, help the client move back into a comfortable position, and make sure that the wheels are locked.
Finally, the thermometer needs to get ready for its next use, so, for an electronic thermometer, switch it off, put away the probe, and put it on charge.
For the chemical dot thermometer, discard it if it’s single-use or put it back into its case if it’s reusable. let’s focus on the ears.
The tympanic membrane thermometer, or TMT, measures the temperature from a patient’s eardrum. It’s almost as accurate as rectal temperature if done properly, but accuracy might be affected by ear infections, like otitis media or a buildup of cerumen, or earwax.
need a tympanic thermometer and a tympanic probe sheath. using a hearing aid; if they do, slowly take it away and wait for a couple of minutes before proceeding.
If you’re left handed, use the right ear canal. Applying gentle pressure, aim the probe towards the client’s nose so that the beam gets to the tympanic membrane.
Make sure you’re not blocking the canal. Press the scan button and remove the thermometer when you hear the chime: usually after 1 second.
Then, take the thermometer away and read the temperature on the screen. You can then push the button on the side to detach the probe sheath and discard it in the appropriate manner.
Finally, practice hand hygiene and make sure the thermometer is ready to be used again by switching it off and connecting it back with its charger if needed This method is the safest but the least accurate.
You can use it on newborns or unconscious people if other methods cannot be obtained. A normal axillary temperature falls between 96.6 to 98.6 degrees Fahrenheit, or 36 to 37 degrees Celsius, for adults and 96 to 98 degrees Fahrenheit, or 35 to 36 degrees Celsius, for children.
including paper towels and tissues, an electronic thermometer, a blue oral probe, and a probe sheath. Here, you can also use a chemical dot thermometer along with a cover sheath.
if they have bathed or used an antiperspirant or deodorant in the past 15 minutes. If they have, wait 15 to 30 minutes before proceeding.
Then, make sure to practice hand hygiene and prepare the electronic thermometer by attaching it to the blue oral probe stem, sliding the sheath over the probe, switching it on, and checking for a ready sign on the screen.
For a chemical dot thermometer, simply slide the cover sheath. Then, help the client expose their arm from their clothing.
Use a paper towel to softly dry the axilla. You can now lift up their arm to reveal the axilla; center the probe in the axilla and fold the arm over and onto the client’s chest.
Ask the client to hold it in place until you hear the electronic thermometer chime, or for 3 minutes if it’s a chemical dot thermometer.
Then, assist them with lifting their arm up again, take the thermometer, and read the measurement. For an electronic thermometer, see the temperature on the screen and discard the probe sheath.
For a chemical dot thermometer, see the last blue dot on the matrix. position.
Finally, switch the electronic thermometer off, put away the probe, and put it on charge. If you’ve used a single-use chemical dot thermometer, discard it; otherwise, you can put a reusable one back into its case.
temperature, which is an artery located on the forehead. This method is easy, and it’s considered more accurate than oral and axillary.
However, the accuracy is affected by the patient's hair and sweat on the skin, and not every facility will have access to a temporal artery thermometer.
A normal temporal artery temperature is 98.6 degrees Fahrenheit, or 37 degrees Celsius, for adults and 98 to 100 degrees Fahrenheit, or 37 to 38 degrees Celsius, for children.
you’ll need a temporal artery thermometer, a towel, and alcohol wipes. Start by practicing hand hygiene, brushing any hair away, and using a towel to softly dry the forehead.
Then, place the sensor on the forehead, hold down the scan button, and slide it steadily across the forehead. You can then read the temperature on the screen.
is ready to be used again by switching it off, cleaning the sensor with alcohol wipes, and connecting it back with its charger.
when obtaining a client’s temperature, there are a few things you should report to the nurse right away, such as temperatures that are higher or lower than normal.
Also if you had problems reading the temperature or if you suspect the equipment might be faulty, report that, too. Document the date and time that you did the procedure, the temperature reading, and the method it was taken along with your observations.
For common abbreviations, “O” is for oral, “R” for rectal, “T” for tympanic, and “A” for axillary. Obtaining a client's temperature is important to detect abnormally high values, which could indicate fever or hyperthermia, or low values, which could indicate hypothermia.
You can take a client's oral or axillary body temperature using an electronic thermometer with the blue probe. Simply slide a disposable cover over and hold the thermometer in the sublingual pocket or axilla until it chimes.
Otherwise, you can take the client's body temperature at the rectum, tympanic membrane, or temporal artery. For axillary and rectal temperature measurements, a chemical dot single-use or reusable thermometer can also be used.
Remember to report any unusual signs or symptoms to the nurse and document the temperature reading, the method in which it was taken,
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