Measuring Temperature

Temperature is a critical physiological parameter that reflects the body’s heat balance and can indicate underlying health conditions. In home care settings, accurate temperature measurement is essential for monitoring clients’ health and detecting signs of illness or infection. Let’s explore the various methods of temperature measurement and the use of digital thermometers in detail:

Temperature Measurement Methods:
Axillary (Armpit): This method involves placing the thermometer under the client’s armpit and holding it in place until the temperature is recorded. Axillary temperatures are considered the least accurate due to external factors that can influence readings, such as clothing and ambient temperature.

Rectal (Rectum): Rectal temperature measurement is the most accurate method, as it reflects core body temperature. It involves gently inserting the thermometer probe into the client’s rectum and waiting for the temperature reading to stabilize.

Oral (Mouth): Oral temperature measurement is commonly used and involves placing the thermometer under the client’s tongue and closing their mouth until the reading is complete. This method is suitable for both children and adults but may be less accurate if the client has recently eaten or drank hot or cold substances.

Tympanic (Ear): Tympanic temperature measurement utilizes a thermometer probe inserted into the client’s ear canal to measure temperature. This method is quick and convenient but may be less accurate if the probe is not properly positioned or if the client has excessive earwax.

Temporal (Forehead): Temporal temperature measurement involves placing the thermometer probe against the client’s forehead and scanning across the temporal artery to obtain a reading. This method is non-invasive and suitable for clients of all ages but may be influenced by external factors such as perspiration or hair.

Normal Ranges: Each temperature measurement method has its own normal range, which may vary slightly. Generally, normal temperature ranges are as follows:
Axillary: 96.6°F – 98.6°F
Rectal: 98.6°F – 100.6°F
Oral: 97.6°F – 99.6°F
Tympanic: 96.6°F – 99.6°F
Temporal: 97.0°F – 99.0°F

Fever Definition for Adults: A fever in adults is typically defined as a temperature of 100.6°F or higher. Fever indicates that the body is responding to an illness or infection and triggers the body’s immune response.

Digital Thermometers: Digital thermometers are widely used in home care settings due to their ease of use, accuracy, and versatility.

Key features of digital thermometers include:
Quick and convenient temperature measurement, typically ranging from 2 to 60 seconds.
Digital display of temperature readings for easy interpretation.
Audible alerts, such as a flash or beep, upon completion of temperature measurement.
Battery operation with periodic battery replacement required.
Disposable plastic probe covers for infection control purposes.

Accurate temperature measurement is essential for monitoring clients’ health and detecting signs of illness or infection in home care settings. By understanding the various temperature measurement methods and utilizing digital thermometers effectively, caregivers can provide timely and appropriate interventions to ensure the well-being of their clients.

Guide to Using a Digital Thermometer for Oral Temperature Measurement
Taking an oral temperature using a digital thermometer is a common method for assessing body temperature in both adults and children aged 5 and older. It’s essential to follow proper procedures to ensure accurate results and maintain hygiene standards. Below is a step-by-step guide on how to use a digital thermometer for oral temperature measurement:

Preparation:
Wash Your Hands: Before handling the thermometer or assisting the client, wash your hands thoroughly with soap and warm water to prevent the spread of germs.

Prepare the Thermometer: Ensure that the digital thermometer is clean and has a fresh probe cover on the tip. This helps maintain hygiene and prevents cross-contamination.

Taking the Temperature:
Positioning the Thermometer: Instruct the client to sit comfortably with their mouth closed.
Placement: Place the thermometer tip under the client’s tongue, ensuring it’s positioned towards one side of the mouth. The client should close their lips gently around the thermometer, but they should avoid talking or biting down.

Hold the Thermometer: Ask the client to hold the thermometer in place under their tongue. If the client requires assistance, hold the thermometer securely in the same spot for the duration of the measurement.

Wait for the Reading: Allow the thermometer to remain in place for about 40 seconds while it takes the temperature reading. During this time, the temperature readings will gradually increase, and the “F” symbol may flash on the thermometer’s display.

Final Reading: Once the temperature reading stabilizes, usually after 30-40 seconds, the thermometer may emit a beeping noise indicating that the final reading is reached.

Record the Temperature: After obtaining the temperature reading, record it along with the time of measurement. This documentation is essential for tracking changes in the client’s temperature over time.

Post-Measurement:
Clean the Thermometer: After use, clean the thermometer following agency protocols to maintain hygiene standards. Dispose of the used probe cover appropriately.
Store the Thermometer: Store the thermometer in a clean and dry place according to agency guidelines to prevent damage and contamination.

Important Considerations:
Avoid taking oral temperatures immediately after the client has consumed hot or cold beverages or engaged in activities like eating, drinking, smoking, or chewing gum.

Do not attempt to take oral temperatures in certain situations, such as when the client is younger than 5 years old, using oxygen, experiencing difficulty breathing, coughing, unconscious, confused, or unable to breathe through the nose.

Always follow agency protocols and guidelines for temperature measurement and hygiene practices to ensure the safety and well-being of the client.

Utilizing a Digital Rectal Thermometer for Temperature Measurement
Taking a rectal temperature involves inserting a thermometer into the rectum, making it a method primarily used for babies and occasionally for children up to 3 years old. While rectal temperatures can provide the most accurate readings, they are typically not used with adults unless specifically ordered by a physician. It’s crucial to follow proper procedures to ensure safety, accuracy, and client comfort.
Here’s a step-by-step guide on how to use a digital rectal thermometer for an adult:

Preparation:
Ensure Cleanliness: Verify that the rectal thermometer is clean and free from any residue or contamination.
Wear Gloves: Before starting the procedure, wear disposable gloves to maintain hygiene and prevent the spread of germs.
Apply Lubricant: Apply a small amount of lubricant, such as petroleum jelly, to the sensor (tip) of the thermometer to facilitate insertion and minimize discomfort for the client.

Taking the Temperature:
Positioning the Client: Prioritize the client’s safety and comfort by asking them to turn onto their left side. Offer assistance if needed to help them assume the correct position.

Prepare the Area: Partially remove the top bed linens to expose the anal area while ensuring the client’s modesty and privacy are maintained.

Locate the Anus: With one hand, gently lift the upper buttock to locate the anus, ensuring a clear path for thermometer insertion.

Insert the Thermometer: Carefully insert the rectal thermometer into the client’s rectum, guiding it no more than one inch (about 2.5 centimeters) inward to obtain an accurate reading.

Hold in Place: Hold the thermometer securely in place for approximately 30 seconds to allow it to register the temperature. Never leave the client unattended with a rectal thermometer inserted.

Remove the Thermometer: After the designated time has elapsed, gently remove the thermometer from the rectum, taking care not to cause discomfort or injury to the client.

Cleanse the Area: Use a clean, damp cloth to wipe the client’s anal area, removing any residual lubricating jelly or fecal matter. Then, readjust the top bed linens to cover the client appropriately.

Record the Reading: Record the rectal temperature reading according to your home care policies, ensuring to prefix the temperature with an “R” to denote “Rectal” and note the time of measurement.

Post-Measurement:
Clean the Thermometer: Thoroughly clean the rectal thermometer following your agency’s protocols and guidelines to maintain hygiene standards and prevent cross-contamination.

Dispose of Gloves: Safely dispose of the used gloves and wash your hands thoroughly with soap and water to minimize the risk of infection.

Using a Digital Rectal Thermometer for Temperature Measurement in Children
When measuring a child’s temperature rectally, it’s essential to follow proper procedures to ensure accuracy, safety, and the child’s comfort.

Preparation:
Ensure Cleanliness: Verify that the rectal thermometer is clean and free from any residue or contamination before use.

Wear Gloves: Before beginning the procedure, wear disposable gloves to maintain hygiene and minimize the risk of infection.

Apply Lubricant: Apply a small amount of lubricant, such as petroleum jelly, to the sensor (tip) of the thermometer to facilitate insertion and prevent discomfort for the child.

Taking the Temperature:
Positioning the Child: Position the child belly down on your lap or on the bed, ensuring they are comfortable and secure. Alternatively, you can position the child face-up with their legs bent toward their chest, supported by one hand.

Insert the Thermometer: With one hand, gently insert the rectal thermometer into the child’s anus until the tip is fully inside the rectum. Take care not to force it if you encounter resistance.

Hold Steady: Maintain the thermometer steady with your hand until you hear the beep, indicating that the temperature measurement is complete. This typically takes approximately 30 seconds.

Remove the Thermometer: Carefully remove the thermometer from the child’s rectum, ensuring gentle and steady movement to prevent discomfort.

Cleanse the Area: Use a clean, damp cloth to cleanse the child’s anal area, removing any residual lubricating jelly or fecal matter. If necessary, replace the underpad or diaper used to protect the bedding.

Document the Reading: Record the rectal temperature reading along with the time of measurement, ensuring accurate documentation for reference and monitoring purposes.

Post-Measurement:
Sanitize the Thermometer: Thoroughly sanitize the rectal thermometer according to your agency’s procedures to maintain hygiene standards and prevent cross-contamination between uses.
Dispose of Gloves: Safely dispose of the used gloves and wash your hands thoroughly with soap and water to minimize the risk of infection transmission.

Axillary Temperature Measurement:
The axillary route involves placing the thermometer in the armpit area to measure temperature, commonly used for babies, young children, or individuals for whom other methods are not feasible. Here’s a detailed guide on how to measure temperature using the axillary route:

Preparation:
Ensure Accessibility: Loosen any clothing that may obstruct access to the armpit area, ensuring it’s dry and free from moisture.

Position the Thermometer: Place the thermometer under the client’s armpit, ensuring it is in direct contact with the skin.

Wait for Readiness: Await the digital thermometer to signal readiness, indicating that the temperature measurement is complete.

Note: While the axillary method is quick and convenient, it is considered the least accurate compared to other methods such as oral, rectal, or tympanic readings. It can serve as an initial check before considering more accurate temperature measurement methods.

Electronic Thermometers: Electronic thermometers are widely used in healthcare facilities for measuring temperatures through various routes, including oral, rectal, or axillary. Here’s an overview of electronic thermometers and their usage:
Digital Results: Electronic thermometers provide digital results within a short span of time, typically ranging from 2 to 60 seconds.
Battery-Operated: These thermometers are battery-operated and can be stored in wall units for recharging when not in use.
Probe Cover: A disposable plastic sheath is used to cover the probe of the thermometer for infection control purposes.
Usage Procedure: Follow the same procedures outlined for digital thermometers, ensuring proper hygiene and adherence to safety protocols.
Tympanic (Ear) Thermometers: Tympanic thermometers measure the ear’s internal temperature by detecting infrared heat within the ear canal. Here’s how to use a tympanic thermometer effectively:
Prepare: Wash hands thoroughly before proceeding with temperature measurement.
Cover the Earpiece: Place a disposable sheath over the earpiece of the thermometer to maintain hygiene.
Positioning:
For Adults: Gently pull back on the top and outside edge of the ear to straighten the auditory canal.
For Infants/Children: Pull the ear directly back to straighten the auditory canal.
Insert the Probe: Carefully insert the covered probe tip into the ear canal, ensuring a fully sealed ear canal while holding the ear in position.
Measurement: Press and hold the button for the specified duration until a beep is heard, indicating the completion of temperature measurement.
Record: Remove the thermometer, discard the cover, and record the temperature along with the time for reference.

Recording and Storage:
Record: Record the temperature accurately in the client’s chart or care plan.
Cleaning: Clean the thermometer following your employer’s protocols to ensure proper maintenance and hygiene.

Discouraged Thermometers for Home Care Settings: Certain thermometers are discouraged for use in home care settings due to their lack of accuracy and reliability. These include:

Plastic Strip Thermometers: These thermometers solely measure skin temperature and are less reliable for core body temperature measurement.

Pacifier Thermometers: Pacifier thermometers are imprecise and challenging to use accurately, as they require the child to keep the pacifier in their mouth for an extended period.

Smartphone App Thermometers: Smartphone app thermometers are not recommended due to concerns about their reliability and accuracy, making them unsuitable for accurate temperature monitoring in home care settings.