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Vital Signs: How to Take a Temperature

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Temperature - What's Normal?
Body temperature for an adult is said to be normal at 98.6 degrees F (37 degrees C). However, it is quite normal for body temperature to vary by one or two degrees (97.5 to 99.5 degrees F or 36-38 degrees C). Some people run sub normal and some run a degree higher. Body temperature will also vary with the time of day. It can be lower in the morning and slightly higher in the late afternoon or evening.

Influencing Factors
Temperature can be influenced by other factors such as exercise or a lot of activity prior to checking the temperature. Drinking cold or hot liquids can also affect an oral temperature. Of course the accuracy of the thermometer can also affect the results.

Types of Thermometers
There are several types of thermometers. These include glass or multiple examples of digital thermometers. These can give readings in Centigrade or Fahrenheit. An oral thermometer is used by placing it under the tongue for an oral temperature; or into the armpit for an axillary temperature. A rectal thermometer is primarily used for infants and small children. The tip of the rectal thermometer is placed (carefully) into the rectum. An ear thermometer takes a tympanic temperature. And there are several digital thermometers that can read a temperature just by placing the designated area on the forehead, or some that now just need to be held near the body and don't require contact.

How Long Does It Take?
The glass thermometer is said to still be the most accurate thermometer, but it poses sanitary issues and needs a probe cover as well as safety precautions.
When taking an oral, axillary or rectal temperature with a glass thermometer use caution so as not to break it. It should be held in place at the tip for three minutes.
Digital thermometers record much faster and need to be help in place only until they beep or for a designated period of time, usually seconds. The tympanic thermometers usually take only seconds to record and can be safely used on infants and small children as well as adults.

How Will the Site Affect the Temperature?
An axillary temperature will typically read one-half to one degree lower than an oral temperature and a rectal temperature will typically read a degree higher than an oral temperature. The tympanic temperature is usually the same as an oral temperature, and considered to be more accurate as there are fewer influencing factors.

Fever VS Hypothermia
An elevated temperature is known as a fever or hyperthermia and a low body temperature is referred to as hypothermia. Unless otherwise directed by the physician or your facility, temperatures greater than 101 degrees F or lower than 96 degrees F (greater than 38 degrees C and lower than 36 degrees C)need immediate intervention; call the physician to report. Children can tolerate higher temperatures than adults, but check with the pediatrician for parameters to report.

What Can it Mean?
An elevated temperature can be due to such factors as infection, hyperglycemia (high blood sugar) or DKA (diabetic ketoacidosis). Hypothermia can result from such factors as hypoglycemia (low blood sugar), hypovolemia from blood loss, anemia, and narcotic use. Report abnormalities to the physician. Document specific circumstances in the patient's chart.
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