What is the first thing that the nurse should do to ensure an accurate temperature reading?

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See the fever guide on the last page of this Helping Hand to know what is recommended for your child.

Nội dung chính

    Kinds of ThermometersWays to Take a TemperatureHow to Take a TemperatureRectal TemperatureOral TemperatureTympanic TemperatureAxillary TemperatureKinds of Glass Thermometers (Not Recommended)How to Read a Glass ThermometerCare of the ThermometerWhen to Call the DoctorWhat is the first thing that the nurse should do to ensure an accurate temperature reading?What instructions does the nurse give the patient to obtain the most accurate tympanic temperature reading?Which action would the nurse perform if on entering the room to measure temperature a patient is drinking coffee?

Kinds of Thermometers

    Digital thermometers (best to use)Glass (not recommended)Fever strips (not recommended)

Each thermometer looks different. Know which kind you are using.

Ways to Take a Temperature

    Rectal. The thermometer is placed in the child’s bottom. It is thought to be the most accurate temperature.Oral. The thermometer is placed in the mouth under the tongue. Note: Pacifier digital thermometers are not recommended. They can be inaccurate.
    Axillary. The thermometer is placed in the armpit.Tympanic. The thermometer is placed in the ear.Temporal artery. The thermometer scans the surface of the forehead. These are sometimes used to screen for fever. If the temperature is higher than normal (greater than 101° F), it needs to be taken with a more accurate kind of thermometer. Temporal artery thermometers should not be used on infants.

How to Take a Temperature

Children move around. You may need
to hold the thermometer and hold your child the same time to get a correct temperature. For safety, never leave a child alone while you are using a thermometer.

If using a glass thermometer (not recommended), it may take a little longer to get a correct temperature. Remember: You are placing a piece of glass in your child’s body toàn thân. Never leave your child alone while taking his temperature.

Rectal Temperature

    Use a thermometer with a
    stubby tip. This type of thermometer is less likely to tear the skin (tissue) inside the rectum (Picture 1).Put a diaper or other cloth across your lap. Place your child over the padding on his or her stomach or back. Taking a rectal temperature can cause the child to have a bowel
    movement.Put a small amount of petroleum jelly, such as Vaseline®, on the tip of the thermometer.Slide the tip gently into the rectum (Picture 2). Never try to force the thermometer.
      If your child is less than 3 months old, put it in the rectum only ½ inch. The silver tip on the end of the thermometer is about ½ inch.If your child is more than 3 months old, put the thermometer about 1 inch into the rectum.

    Hold the thermometer
    in place. You will hear a beep in about 30 seconds. For glass thermometers, hold in place for 3 minutes. Take the thermometer out and read the temperature.

Oral Temperature

    Use a thermometer with a long, thin tip (Picture 1).Be sure your child has not had anything
    hot or cold to eat or drink for 20 minutes before you take his temperature.If your child is so ill that he cannot control shivering, do not take an oral temperature. Take the temperature a different way.Place the tip of the thermometer in your child’s mouth, under the tongue and close to the middle (Picture 3). Tell your child to keep the lips firmly closed.If your child cannot hold the thermometer in place with his tongue and fingers without biting
    it, hold it in place for him. You will hear a beep in about 30 seconds. For glass thermometers, hold in place for 3 minutes. Take the thermometer out and read the temperature.

Tympanic Temperature

    If your child has been outdoors on a cold day or is overheated from play, he needs to be inside for 15 minutes before taking the temperature this
    way.Earwax, ear infections and ear tubes do not keep you from getting correct readings.Slowly pull your child’s ear backwards to straighten the ear canal (back and up if over 1 year old) (Picture 4).Gently put the tip of the thermometer in the ear until it stops. The tip
    should point to the space between the eye and the ear on the other side of the head.When you hear a beep in about 2 seconds, remove the thermometer and read the temperature.

Axillary Temperature

    Use an oral thermometer with a long, thin tip (Picture 1).Make
    sure the child’s underarm is dry.Place the tip of the thermometer under your child’s arm so it only touches skin. It should not touch clothing (Picture 5).Press the child’s upper arm against his chest to keep the arm still and the thermometer in place.Digital thermometers may take longer than 30 seconds before beeping when using this method. Glass thermometers need to be held in place for 7 to 10 minutes. Remove the thermometer and read the
    temperature.Since axillary temperatures take a little longer, reading a book or watching television might help to keep the child still.

Glass mercury thermometers are no longer recommended and can be dangerous. There are serious health risks if a glass mercury thermometer breaks. Mercury is toxic if inhaled or if the liquid touches the skin.

There are two kinds of glass thermometers, one with mercury and
one without mercury.

    Mercury-không lấy phí glass thermometer. If you choose to use a glass thermometer, pick one that is mercury-không lấy phí such as a Geratherm®. Mercury-không lấy phí glass thermometers have a silver tip. A silver line runs along the numbers to show the temperature. You may see a blue line filling the extra space that is not taken by the silver line. The opposite end is color-coded. Green is for oral or axillary and red for rectal (Picture 6). To be sure, check the
    package to know which thermometer you have.

    Mercury glass thermometer. Glass mercury thermometers also have a silver tip. A dark line runs along the numbers to show the temperature. The tip of an oral or axillary glass mercury thermometer is long and narrow. The tip of a rectal glass mercury
    thermometer is short and round. The space that is not taken by the dark mercury line is usually clear.

How to Read a Glass Thermometer

Check to see what type of thermometer you have.Check the tip of a glass thermometer to make sure it is not broken or cracked. Do not use
a broken or cracked thermometer.Hold the thermometer eye level with the numbers facing you.Look for the numbers and measuring scale of black lines (Picture 8). These vertical (up and down) lines stand for degrees of temperature. Most thermometers have two scales for temperature, Fahrenheit and Celsius. Read the numbers for °F (degrees of Fahrenheit).

    Each long line is for 1°F temperature.The four shorter lines between each long line are for
    0.2°F (two tenths) of a degree of temperature.

Look for the line of fluid running along between the numbers and the vertical black lines.

Read the number that is closest to where the column of fluid ends. For example:

The thermometer’s temperature should always
start below the first number on the line. If needed, shake the glass thermometer down. Grasp it firmly the end opposite the tip and flick your wrist sharply. Take care to be away from people and objects before shaking (Picture 9)

Care of the Thermometer

    Clean a
    thermometer before and after use with cool soapy water. Or, it can be disinfected with an alcohol swab or cotton ball dipped in alcohol. Never use hot water, bleach or household cleaners on your thermometer. Do not put it in the dishwasher.Do not put it away without washing it first. A dirty thermometer might infect your child again.Keep it in a safe, cool place and out of reach of children. Glass thermometers should be stored in their plastic container.If a mercury
    thermometer breaks, call the Central Ohio Poison Center 1-800-222-1222. They will tell you how to get rid of the mercury.If a mercury-không lấy phí thermometer breaks, it can be cleaned up with paper towels and soap. The liquid is not toxic.

When to Call the Doctor

Most doctors agree that a temperature over 101°F is a fever. However, you may not need to call a doctor
every time your child has a fever. Typically, temperatures lower than 101°F do not need to be treated unless your child is uncomfortable.

For information on fever and treatment, including medicines, see Helping Hand HH-I-105, Fever.

Call your child’s doctor right away if your child has a fever AND:

    Is younger than 3 months of age and has a rectal temperature higher than 100.4°F or less than 96.5°FLooks very ill, is very fussy or is hard to wake
    upHas a stiff neck, severe headache, severe sore throat or severe stomachacheHas repeated vomiting and diarrheaShows signs of dehydration like dry or sticky mouth, sunken eyes or not urinatingHas a new skin rashHas had a seizure. See Helping Hand HH-I-195, Fever and Seizures (Febrile Seizures)Has a chronic condition or one that
    lowers immunity, such as sickle cell disease, cancer or frequent oral steroid useHas been in an extremely hot place, such as an overheated carFever is above 104 °F over and over, and shows no other signs (for all children)Fever keeps coming back after seven days (for all children)You do not know if your child needs treatment

The chart on the next page will help guide you to know when to call your child’s health provider. If you call, be sure to
state which method you used to take the temperature.

Fever Guide °F (degrees in fahrenheit)

Child’s Age

Normal

Call the Doctor

Call 911 or go to Emergency Department (ED)

Birth to 3 months (Only choose rectal)

Rectal (in baby’s bottom)

96.5-100.4°F

more than 100.4°F or less than 96.5°F

more than 100.4°F or less than 96.5°F and child looks sick

Oral (under the tongue)

NOT RECOMMENDED

Ear (tympanic)

Axillary (armpit)

4 to 24 months (1st choice- rectal, 2nd choice- ear, 3rd choice- axillary)

Rectal (in baby’s bottom)

Up to 100.4°F

more than 100.4°F for 3 days or more than 102°F and child looks sick

105°F and child does not respond to fever medicine

Oral (under the tongue)

NOT RECOMMENDED

Ear (tympanic)

Up to 99°F

104°F Take rectal temperature

Axillary (armpit)

Up to 99°F

103°F Take rectal temperature

2 to 4 years(1st choice- rectal, 2nd choice- ear, 3rd choice- axillary)

Rectal (in baby’s bottom)

Up to 100.4°F

more than 102°F

105°F and child does not respond to fever medicine

.

Oral (under the tongue)

NOT RECOMMENDED

Ear (tympanic)

Up to 99°F

104°F Take rectal temperature

Axillary (armpit)

Up to 99°F

103°F Take rectal temperature

4 years old and older(1st choice- oral, 2nd choice- ear, 3rd choice- axillary)

Rectal (in baby’s bottom)

Up to 100.4°F

more than 102°F and lasts more than 3 days or 104°F

105°and child does not respond to fever medicine

Oral (under the tongue)

Up to 99.4°F

more than 102°F and lasts more than 3 days or 104°F

Ear (tympanic))

Up to 99°F

104°F Take oral or rectal temperature

Axillary (armpit)

Up to 99°F

103°F Take oral or rectal temperature

Temperature- Digital and Glass Thermometers (PDF)

HH-II-189 4/11 Revised 2/17 Copyright 1975 Nationwide Children’s Hospital

What is the first thing that the nurse should do to ensure an accurate temperature reading?

What is the first thing that the nurse should do to ensure an accurate temperature reading? 1. Assess that the equipment used is working properly.

What instructions does the nurse give the patient to obtain the most accurate tympanic temperature reading?

What instruction should the nurse give the patient to obtain the most accurate oral temperature reading? “Keep the thermometer securely under your tongue until the reading is complete.”

Which action would the nurse perform if on entering the room to measure temperature a patient is drinking coffee?

The nurse enters the room and observes the client drinking a cup of coffee. Which action would be most appropriate? Assess the client’s temperature about 30 minutes after the client has finished drinking the coffee.
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How do I make sure my temperature reading is accurate?

Place the thermometer tip under the tongue. Hold the thermometer in the same spot for about 40 seconds. Readings will continue to increase and the F (or C) symbol will flash during measurement. Usually, the thermometer will make a beeping noise when the final reading is done (usually about 30 seconds).

What is the most accurate way to collect a patient's temperature?

A rectal temperature is generally considered to be the most accurate, and the standard for monitoring the core body temperature, but it is generally not recommended for use in patients, due to the risk of rectal perforation and tears with this method. Have a separate thermometer to use for oral than for rectal.

What steps will you follow when taking the body temperature of a person?

There are 4 ways to take (measure) a temperature:.
Under the armpit (axillary method).
In the mouth (oral method).
In the ear (tympanic method).
In the rectum/bum (rectal method).

What are the 3 most accurate methods of obtaining temp?

rectal (in the bottom) — most accurate method for children under 3 years old. oral (in the mouth) — best for kids 4–5 years or older who can cooperate. axillary (under the arm) — the least accurate digital thermometer, but good for a first check.