Temperatures

Vital Signs

Various determinations that provide information about the basic body conditions of the patient.

Four main vital signs: temperature, pulse, respiration, and blood pressure.

Other important vital signs…

That provide information about the patient’s condition include the color of the skin, the size of the pupils in the eyes and their reaction to light, the level of consciousness, and the patient's response to stimuli.

Health assistants may have responsibility of measuring and recording vital signs.Not in realm of duties to

reveal this information to the patient

Physician will decide if this information should be told to patient.

Accuracy Is Essential

Abnormal vital signs are often the first indication of a disease or abnormality.

Accuracy Is Essential

Never guess or report an inaccurate reading.

If you note any abnormality or change in a vital sign, report it immediately to your supervisor.

If you have difficulty obtaining a correct reading for any vital sign, ask another individual to check the reading.

Temperature

Measurement of the balance between heat lost and heat produced in the body

Heat is lost through perspiration, respiration and excretion (urine and feces).

Heat is produced by metabolism of food and muscle and gland activity.

Homeostasis

Constant state of fluid balance.

Ideal health state in the human body.

Homeostasis

Rate of chemical reactions in body is regulated by the temperature.

If temperature is too high or too low, body’s fluid balance is also affected.

Variations in Body Temperature

Normal range for body temperature is 97 degrees F to 100 degrees F.

Variations caused by individual differences, time of day, part of body and other factors.

Time of Day Affects Body Temperature

Usually lower in morning after body has rested.

Higher in evening after muscular activity and food intake with metabolism.

Parts of Body Where Temperature Is Measured

Leads to Variations. Oral temperature: measured in

mouth Clinical thermometer left in place 3- 5

minutes Normal oral temperature in 98.6

degrees F Range 97.6-99.6 Most common, convenient and

comfortable method

Rectal Temperature

Measured in rectum Clinical thermometer held in

place 3-5 minutes Normal rectal temperature is 99.6

to 100.6 f Most accurate because it is an

internal measurement

Axillary or groin temperature

Axillary is taken in armpit while upper arm is held close to body and thermometer is inserted between two folds of skin

Groin is taken between two folds of skin formed by the inner part of the thigh and lower abdomen

Axillary or Groin Temperature

Clinical thermometer is held in place 10 minutes.

Normal is 97.6*F. Range: 96.6-98.6*F. Both types are less accurate

because they are external temperatures.

Aural Temperature

Taken with special thermometer that is placed in the ear or auditory canal

Thermometer detects and measures the thermal, infrared energy radiating from blood vessels in the tympanic membrane or eardrum.

Aural Temperature

Since this provides a measurement of body core temperature, there is no normal range for aural

Most tympanic thermometers will record the temperature in less than 2 seconds.

Factors Causing an Increase in Body

TemperatureIllness and infectionExerciseHigh temperatures in the environment

Factors Causing a Decrease in Body

TemperatureStarvation or fastingSleepDecrease muscle activityMouth breathingCold temperatures in the

environment

Abnormal Conditions

HypothermiaFeverHyperthermia

Hypothermia

Low body temperature below 95*F (35*C) rectally

Can be caused by prolonged exposure to the cold

Death usually occurs if temperature drops below 93*F (33.9*C) for a period of time

Fever

Elevated body temperature

Usually above 101*F (38.3*) rectally

Usually caused by infection or injury

Hyperthermia Body temperature exceeds 104* F

(40*C) rectally Can be caused by prolonged exposure

to hot temperatures, brain damage, or serious infection

Immediate actions must be taken to lower temperature

Temperatures above 106*F (41.1*C) can quickly lead to convulsions and death

Clinical thermometers

Glass thermometers used to record temperature

Consists of a slender glass tube containing mercury, which expands when exposed to heat

Oral thermometer

Has a long, SLENDER BULB AND/OR BLUE TIP

Security oral thermometer has a shorter, rounder bulb and may be marked with a blue tip

Rectal thermometer

Has a short, stubby, rounded bulb, and may be marked with a red tip

Some have word oral or rectal written on the stem

If clinical thermometer breaks,

the mercury can evaporate and create a toxic vapor that can harm both humans and the environment

Electronic thermometers

Used in many facilities Register the temperature on a

viewer in a few seconds Used to take oral, rectal, axillary,

and/or groin temperatures Blue probes for oral use Red probes for axillary or rectal use

Prevent cross contamination from patient to patient

Disposable cover is placed over thermometer probe before temperature is taken

Change disposable covers after each use

Electronic digital thermometers are

excellent for home use Eliminates the hazard of a mercury

spill Small battery operated unit usually

will register the temperature in about 60 seconds on a digital display screen

Disposable probe covers prevent contamination of the probe

Tympanic Thermometers

Specialized electronic thermometers

Records aural temp in the ear Disposable cover is placed on the

ear probe Probe is inserted into the auditory

canal, and a scan button is pushed

Plastic or paper thermometers

Used in some facilitiesContain special chemical

dots or stripsChange color when exposed

to specific temperaturesUsed once and discarded

Reading a glass clinical thermometer

Hold it at eye level and find the solid column of mercury

Read at the point where the mercury line ends

Each long line represents 1 degree Exception at times is long line for

98.6*F

Reading a glass clinical thermometer

98.6*F represents normal oral body temperature

Each short line represents 0.2 degrees (two-tenths)

Temperature recorded to nearest tow-tenths of a degree

Recording temperature

If temperature is taken orally, not necessary to indicate an oral reading

For rectal temperature, Place a (R) by the reading

For axillary temperature, place an (Ax) by the reading

Recording temperature

For groin temperature, place a (Gr) by the reading

For aural temperature, place a (T) for tympanic by the reading

Avoid factors that could alter or change

temperature Eating,

drinking hot or cold liquids and/or smoking can alter the temperature in the mouth

Ask before checking the patient’s temp, if the patient has done any of these things , wait 15 minutes before checking temperature

Cleaning thermometers Glass clinical thermometers Must be cleaned thoroughly after use Follow agency procedure Wipe with soapy cotton ball or gauze

pad after use Rinse in cool water to prevent

breakage and to avoid destroying column of mercury

Shake the thermometer down to 96*F

Hold securely between thumb and index finger

Use a snapping motion of the wrist Avoid countertops, tables, and so

forth Soak in a disinfectant (frequently

70 % alcohol) for a minimum of 30 minutes

Paper/plastic sheath on glass thermometer

Used to cover thermometer while temperature is taken

Discarded after use Thermometer remains clean

because there is no contact with patient

Many agencies still soak in disinfectants between use.

Electronic and tympanic thermometers

Probe covered with plastic sheath Plastic sheath discarded after

each use No contamination of probe Follow agency policy for cleaning

and care of thermometers