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 Temperature Illness and infection Exercise High temperatures in the environment

Factors Causing a Decrease in Body Temperature Starvation or fasting Sleep Decrease muscle activity Mouth breathing Cold temperatures in the environment

Abnormal Conditions Hypothermia Fever Hyperthermia

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 facilities Contain special chemical dots or strips Change color when exposed to specific temperatures Used 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