Thermometer:
A thermometer is
device used check the body temperature.
There are
four types of thermometers:
1.
Mercury in
glass-clinical thermometer .
2.
Electronic
thermometer.
3.
Disposable
thermometer .
4.
Tympanic
membrane thermometer .
1. Clinical
Thermometer
A clinical thermometer is a special instrument
designed to measure the temperature of the body.
It is available in both Fahrenheit and Celsius
(centigrade ) scales.
The thermometer has two part , a bulb and steam
Bulb : A bulb containing mercury.
·
The bulbs are of different size and shapes.
·
Greater the
surface of the glass, surrounding the mercury , more rapidly the mercury is
heated up, thus more rapidly the
thermometer register.
·
The oral
thermometers are with long and slender bulbs and they register more rapidly
·
The rectal The thermometer often have colored bulbs.
Stem : In which the mercury
can rise.
·
On the stem is a graduated scale
representing the degree of temperature the lowest registered being 35™ C or 95™ the highest being 43.3™ or 11™ F, because the body temperature above or below
these point are rare .
·
The stem usually
has a curved surface that magnifies the lines and figures on the scale and a
flattened back with a sharp ridge that makes it easier to read the scale and prevent the rolling thereby
lessening the danger of breaking .
·
The clinical thermometers are different from the
lotion thermometers .
·
Therefore the
mercury fall down on cooling . the grading of the lotion thermometer are from
the freezing point to the boiling point of the water.
Care
of Thermometer:
·
The thermometer
has to shake down, grasp the thermometer securely by the upper end of the stem
and never hold it by the bulb.
·
While shaking
the thermometer the nurse should be careful to prevent from striking it with
anything such as a table, desk wall etc.
·
The nurse should
always wash under cold running water, as washing in hot water brakes the
thermometer due to expansion of mercury level beyond its capacity.
·
Always rinse
them in clean water dry them and store them in dry cotton surfaced container
·
The nurse
should never put the thermometer in the mouth of a person who cannot
understand the instruction or who is not able to hold thermometer or small
children.
·
The thermometer
should be washed in 1:40 strength Dettol
solution for 5 minutes or 1:20 strength
savlon solution.
·
A good blood
supply under the tongue and the fact
that the thermometer can be held in place by the tongue while the mouth is close make the
mouth a convenient place for taking the temperature.
·
Also contain a
plentiful blood supply in the rectum, which is not influenced by external air
temperature.
·
Rectal
temperature is nearest the temperature if the inside of the body then is mouth
temperature.
·
The axilla
usually is moist from perspiration, and even if it is dried, enough moisture
and air may be present to prevent an accurate body temperature reading.
Advantages:
1. Low price .
2. Wide availability .
3. Reliable accuracy.
Dis-Advantages:
1.
Delayed time for recording.
2.
Easily
breakable.
2. Electronic
Thermometer:
It consist of a battery powered display unit, a thin
wire cord and a temperature sensitive
probe , covered by a disposable plastic sheath to prevent transmission of
infection . separate probes are
available for oral and rectal insertion, temperature reading appears, both in
Fahrenheit and centigrade. It is easy to read
.duration of patients discomfort is small ,only a few seconds.
3. Disposable
Thermometer
It is a single use thermometer,
made of thin plastic strips chemically impregnated paper. They are used for
children to take oral and axillary temperatures. Only 45 second are needed to
record temperature. It is less accurate.
4. Tympanic
Membrane Thermometer:
These a small
hand –held devices similar to otoscope with disposable speculum , infrared
–sensing electronics and liquid crystal displays. Most are battery
operated and rechargeable. Result are
displayed 1 to 2 second after placing their speculum in the outer third of the
ear canal . it is accurate.
The
common site for checking /taking Body temperature are:
1.Mouth.
2.Axilla.
3.Groin.
4.Vagina.
5.Rectum.
Some
time the nurse has to convert the
temperature reading from one scale to anther i.e Fahrenheit to Celsius.
The
equation to convert Fahrenheit scale to Celsius is C=(F-32)O 5/9
Example
to convert 102° Celsius.
C =
(102-32)O5/9
C= 70O 5/9 38.8°C.
To
convert Celsius scale to Fahrenheit is F=CO9/5+32.
Example
to convert 37°C to Fahrenheit
F= (37O9/5)+32
F=66.6+32=98.6°F.
Contraindication For
Taking Temperature by mouth /Oral
:
1.
Patient who
is extremely nervous delirious , unconscious, hysterical or mentally confused.
Or the patient one who cannot follow the instruction.
2.
Patient who
is a mouth breather.
3.
Patient
with convulsions
4.
Patient
with mouth injuries
5.
Patient
with upper respiratory tract infection /problems.
6.
Children
below six
7.
Mentally
retarded
8.
Immediately
after consuming hot or cold beverages.
Requisites
for Taking Temperature :
A
tray containing.
·
Clean
thermometers in one container (Jar or glass or bottle).
·
Three more
container with 1:40 strength Dettol solution.
·
A container with
soapy swabs.
·
A container with
wet cotton swabs.
·
A kidney tray
with paper bag for soiled swabs.
·
Seconds watch .
·
Blue ball pen.
Guidelines for
Checking Temperature:
1.
The most appropriate site for measuring temperature is
assessed according to each patient.
2.
All
necessary equipment is assembled to ensure an uninterrupted procedure.
3.
Wash hands
to prevent spread of infection.
4.
Maintain
privacy
5.
Explain the
purpose and procedure to the patient before checking to gain the confidence.
Procedure for checking oral/ mouth Temperature
|
Sl No |
Steps of Procedure |
Rationale |
|
1 |
Place patient
in a comfortable position |
To ensure
comfort, and accuracy of temperature reading. |
|
2 |
Assemble all the required equipment |
To save time and energy. |
|
3 |
Explain purpose and procedure. |
To gain cooperation and confidence. |
|
4 |
Wash hands before
and after procedure. |
To reduce transmission of micro organisms. |
|
5 |
Check whether the patient had any hot or cold drinks
or chewed betel leaves. |
If the patient gives anything wait for 15minutes as
it gives false readings. |
|
6 |
Hold the thermometer with the finger tips. At the
end of stem of the thermometer |
To reduce the contamination of the bulb |
|
7 |
Read the mercury level while holding it at the eye
level. |
To have accurate reading (mercury level to be below
the normal level). |
|
8 |
Before placing the thermometer in the mouth of the
patient rinse with cold water.(Use of hot water breaks the thermometer). |
To remove solution irritating to oral mucosa |
|
9 |
Ask the patient to open the mouth, and gently place
the thermometer under tongue in posterior or sublingual pocket ,later to the
center of the lower jaw |
Heat from blood vessels in sublingual pocket
produces temperature reading . |
|
10 |
Ask the patient to hold thermometer under tongue
with lips closed. Cation to be against biting it |
To ensure safety. Breaking of thermometer causes
mercury poisoning. |
|
11 |
Leave the thermometer inside for 2-3 min. |
To allow time for expansion mercury. |
|
12 |
Never leave the patient alone with the thermometer
in the mouth. |
The patient may break and cause mercurial poisoning. |
|
13 |
Carefully remove the thermometer and read at eye
level. |
To ensure accuracy . |
|
14 |
Wipe the thermometer with wet cotton swab. Wipe in
rotating fashion from fingers ,towards bulb. |
From the least area of contamination to the most
contaminated area . |
|
15 |
Never hold the thermometer by touching the bulb. |
The heat from the nurses hand cause expansion of the
mercury level. |
|
16 |
Wash the thermometer in cold water ,dry and put it
,after disinfection ,in storage container |
To prevent infection. |
|
17 |
Use separate thermometers to patients suffering with
infectious diseases. |
To prevent from spread of infectious diseases |
|
18 |
Replace the articles after cleaning . |
For easy availability of next use. |
|
19 |
Record the temperature in the TPR chart. |
To detect increase of temperature if any . |
|
20 |
Report any unusual variation to the physician. |
To take necessary action. |
2.Checking
Temperature by Rectal Method :
Purpose :
1. To determine body temperature for infants, young
children , adult unconscious patient
&postoperative patient.
2. To aid in making diagnosis.
Requisites :
1.
Rectal
clinical Thermometer .
2.
Swab in a
container.
3.
Tissue
paper.
4.
Lubricant
or jelly.
5.
Disposable
gloves.
6. Kidney tray with paper bag.
7. A blue pen.
8. Seconds watch.
9. TPR Graph chart.
Guidelines for checking rectal Temperature :
1.
Thermometer
must be disinfected in a proper disinfectant to prevent transmission of micro
–organisms .
2.
Before checking the temperature wipe the thermometer
from bulb to stem, to keep the bulb clean
3.
After
taking temperature ,wipe the thermometer from the tem to the bulb ,to avoid
contamination ,to fingers of the nurse, with faeces
4.
Use
separate thermometer for patients suffering from infectious diseases .
5.
Lubricate
the bulb of the rectal thermometer before placing the thermometer in the
rectum.
Procedure:
|
Sl no |
Steps of procedure |
Rationale |
|
1 |
Place the patient in side lying position screen the
patient |
To maintain privacy and proper exposure. To insert
the thermometer . |
|
2 |
Explain the procedure to the attainders. |
To prevent from fear. |
|
3 |
Wash Hands . |
To prevent from spread of micro –organisms |
|
4 |
Wear gloves & clean the buttocks. |
To prevent from infection . |
|
5 |
Lubricate the bulb of the thermos meter with
Vaseline. Separate buttocks and insert the thermometer about 1 ½ inches 3.5 cm into the rectum. Keep it in
position for 5 minutes. |
To insert the
thermometer with ease. |
|
6 |
Remove the thermometer from the rectum wipe it clean
cotton swabs. |
To remove the faecal
matter and clean the Vaseline. |
|
7 |
Read the level of mercury at the eye level. |
To record the temperature accurately. |
|
8 |
Place the patient in a comfortable position. |
To ensure
safety .
|
|
9 |
Wash hands |
To prevent from infection. |
|
10 |
Record in the TPR chart. |
To avoid chance of forgetting the exact reding |
|
11 |
Replace the articles after use. |
For easy next use. |
3. Checking
Temperature by Axillary method :
Purpose :
1. To determine the body temperature of the patient when
oral and rectal methods are contraindicated.
2. To aid in
making diagnosis.
Requisites:
1. Oral clinical
Thermometer.
2. Swab in a container.
3. Kidney tray with paper bag.
4. Watch the seconds .
5. T P R Graph chart.
6. Blue ball pen.
|
Sl no |
Steps of procedure |
Rationale |
|
1 |
Bring all the requisites at the bedside |
For easy availability |
|
2 |
Screen bed |
To maintain privacy. |
|
3 |
Make the patient lie in supine position or in
sitting position. |
To provide easy access to axilla. |
|
4 |
Move the clothing’s away from the axilla. |
For easy exposure of axilla |
|
5 |
Wash hands. |
To reduce transmission of micro –organism. |
|
6 |
Hold the stem of the glass thermometer with finger tips . |
To reduce contamination of bulb end. |
|
7 |
Rinse the thermometer in cold water if it is in a
disinfectant solution . |
To remove |
|
8 |
Read the mercury level while holding thermometer at
eye level and gently rotating it. |
Thermometer reading must be below normal body
temperature. |
|
9 |
Dry the axilla. |
To prevent moisture altering the skin temperature. |
|
10 |
Insert thermometer into the center of axilla, lower
arm over thermometer and place it across patients chest. |
Maintains proper position. |
|
11 |
Hold the thermometer for 5 minutes in the axilla. |
To ensure accuracy of reading . |
|
12 |
Remove the thermometer &clean it with et swab
from finger towards bulb .dispose the swab in paper bag. |
To avoid contact with micro –Organisms. |
|
13 |
Read thermometer at eye level. |
To ensure accuracy of reading. |
|
14 |
Record the riding in the TPR graph chart. |
To prevent from forgetting and false riding. |
|
15 |
Assist patient in putting on clothes. |
To ensure comfort. |
|
16 |
Wash hands, clean article and replace. |
To prevent from transmission of information and easy
accessible when next used. |
0 Comments