Understanding Body Themperature

Common terminology

ü  Apyrexia                                     A normal body temperature

ü  Body temperature                         Represents the balance between the heat produced by the body and the

heat lost

ü  Circadian rhythm             Sleep cycle (body temperature is lower at different times of the sleep

cycle)

ü  Conduction                      The transmission of heat from one object to another

ü  Convection                      The transmission of heat by movement of the heat through a liquid or gas

ü  Core temperature                         The temperature of the deep tissues and organs within the cranial,

thoracic and abdominal cavities

ü  Evaporation                     To lose heat through moisture, i.e. sweating

ü  Frenulum                        The thin membrane anchoring the tongue to the soft palate

ü  Heat stroke                     A potentially serious condition produced by    prolonged exposure to 

excessive temperatures, which can lead to coma and death

ü  Homeostasis                    Maintenance of a constant but dynamic internal environment

ü  Hyperpyrexia                   A very high body temperature

ü  Hypothermia                    A very low body temperature

ü  Metabolic rate                 The speed at which the body’s internal mechanisms     are functioning

ü  Pyrexia                           A high body temperature

ü  Surface temperature         Temperature of the skin surface (rises and falls in

response to the environment)

Normal body temperature

The following levels may vary slightly in different textbooks, but the following is intended to offer a simple, useful guide.

Ø Normal range              = 36–37^oC

Ø Pyrexia                      = 38–40^oC

Ø Hyperpyrexia             = 40.1^oC and above

Ø Heat stroke                = Usually occurs around 41–42^oC

Ø Death                        = 43^oC and above

Ø Hypothermia               = 35^oC and below

Ø Death                        = 20^oC

The sites that can be used to monitor temperature are:

Ø the axilla (axillary)

Ø  the mouth (orally)

Ø  the tympanic membrane (inner ear, aural)

Ø  the rectum (rectally)

Ø  the skin

Monitoring temperature

Monitoring a client’s body temperature is essential to establish current health status, identify actual or potential problems, facilitate medical and nursing intervention, and monitor client progress.

Equipment

Ø  Appropriate thermometer (digital, tympanic, rectal, or mercury) paying due

Ø  regard to the age of the client, their level of ability to co-operate, local

Ø  clinical guidelines and contemporary evidence

Ø  Designated chart for recording

Ø  Protective covers/probe covers

Ø  Equipment for disposal, cleansing and disinfection

Axillary measurement

Procedure	Rational
Wash hands using effective techniques	To prevent cross-infection
Collect appropriate equipment	Remember that only electronic or mercury thermometers are suitable for axillary measurement
Hold mercury thermometer at eye level, rotating slightly to ensure mercury line is visible. Check mercury is low enough to record the temperature. If not, shake it down in a downward direction, taking care not to hit any nearby objects	For accuracy of measurement To prevent breakage
Explain procedure and ensure client has understood	Promotes client co-operation and informed consent
Screen the bed or close door. Assist client to comfortable position and move clothing away from shoulder	Promotes comfort, maintains client’s privacy, prevents embarrassment, exposes axillary area
Place the thermometer in the centre of the client’s axilla	To ensure good contact with the skin when the arm is lowered
Rest the client’s arm across the chest, advising them to remain as still as possible	To avoid thermometer moving out of position
Leave in position until electronic thermometer signals, or 7–8 minutes for mercury thermometers	To ensure accuracy of measurement
Remove thermometer, read and record result, noting any significant changes	To ensure continuity of care and meet legislative requirements
Remove disposable cover and clean thermometer, adhering to local policy	To prevent cross-infection
Report any abnormal findings	To ensure client receives appropriate care

Oral measurement

Procedure	Rational
Assist client into a comfortable position, explain procedure, and gain consent	For information-giving and client comfort
Hold mercury thermometer at eye level, rotating slightly to ensure mercury line is visible. Check mercury is low enough to record the temperature. If not, shake it down in a downward direction, taking care not to hit any nearby objects	For accuracy of measurement. To prevent breakage
Cover thermomenter with a disposable cover	To reduce infection risk
Place thermometer under the client’s tongue beside the frenulum	To ensure correct reading
Advise client not to talk, to keep lips closed to form a seal and, if fully co-operative, ask them to hold the thermometer in situ.	To keep thermomdter in place. If the client is unable to hold the thermometer in situ consider using another route.
Leave in place for a minimum of seven minutes	To allow adequate time for the thermometer to register
Remove thermometer, remove cover, read at eye level, record results and report any significant change	To ensure continuity of care and prompt attention if necessary
Clean thermometer according to local policy	To minimize cross-infection

Refferences

Mills, Elizabeth Jacqueline. 2004. Nursing Procedures, 4^th Edition. USA : Lippincott

Penelope Ann Hilton.2004.Fundmental OF Nursing Skill. London : Whurr Publishers

Temple, Jean Smith and Johnson, Joyce Young. 2006. Nurse’s Guide To Clinical  Procedure, 5^th Ed.

            USA : Lippincott