7:13 AM
maestr0
Core temperature is controlled by the hypothalamus. Normally, the body temperature remains relatively constant, fluctuating only 0.6 ° C in body temperature averaging 36 ° C to 38 ° C (Perry and Potter, 1998). The temperature is affected by:
• Infection
• Exposure to prolonged heat or cold
° burns
• Changing white blood cells
• Some drugs
• Comments on blood products
° exercise
• Changes hormonal
° Damage to the upper hypothalamus / brain.
Body temperature can be measured at different sites. Intensive Care, body temperature is controlled via the pulmonary artery, esophagus and bladder. It is further common for axillary, oral, , tympanic or rectal are used to inexact the base body. There are disadvantages and advantages for every of these places, but an accurate measurement of body temperature is essential that the road is used correctly gain.
TERMINOLOGY
Fever, hyperpyrexia stemperature above the normal value for high temperatures above 40 ° C.Hypothermic temperatures below 34.4 ° C fever free without fever
The normal average temperature varies with the measurement site.
The average cost for adults are:
Oral temperature: 37 ° C
• Site rectal: 37.5 ° C
• Site axillary: 36.5 ° C
Road ° the eardrum: from 36.8 to 37.9 ° C (Braun et al,1998;Perry and Potter1998).
In the United Kingdom, the mainstream of trusts eliminate mercury thermometers and replace it w/ electronic devices. This reflects concerns about potential releases of mercury, reducing cross-infection from the use of disposable probe covers, and measurements of electronic devices faster than mercury thermometers.
ElectronicThermometers
The recording position of the temperature of a patient with an electronic thermometer is the same as a mercury thermometer for each site. However, the manufacturer must always be followed with respect to the amount of time the probe is still in place and to prepare, enable and cleaning of the unit.
Intervention: taking and recording body temperature
Mr. Ellis record the temperature every few minutes.
Measurement of oral temperature
the site would not be appropriate for Mr. Ellis because of the level of oral hisNote consciousness.altered
BENEFITS oral
• Easy to reach.
° The introduction of the thermometer just above the sublingual artery, which is close to the external carotid artery, changes in the kernel to appear immediately (Watson 1998).
DISADVANTAGES
Readability can be affected by the ingestion of food or liquids, smoking, mouth breathing and oxygen delivery (Braun et al. 1998).
This site is not appropriate if the patient is incapable of the thermometer in the position or when the thermometer may cause injury to keep - for example in the case of oral pain or trauma, confused or unconscious patients, those with history of seizures, and patients with chills. It is also against-indicated for people who need to breathe through the mouth because the air flow, the accuracy of the result (Braun et al. 1998) influence.
Risk of exposure to body fluids.
EQUIPMENT
Mercury thermometer ° / electronic thermometer.
• Coverage disposable (according to hospital policy leading).
° Pen and documentation sheets.
Disinfectants ° to clean the thermometer according to local policy.
PROCEDURE
• Examine and safe use of the site by mouth.
• Make sure that the patient is not hot or cold liquids or foods eaten or smoked in the previous 20 minutes, as this influences the accuracy of measurement (Braun et al. 1998).
• Prepare the equipment.
• Place the procedure to the patient the importance of maintaining the correct position of the thermometer understand.
• Wash your hands.
Glass thermometer:
• Keep the end of the glass thermometer in your fingertips, comprehend the mercury point.
° If the mercury is higher than 35.5 ° C, stirring the mercury touching the wrist down until it is below 35 ° C.
• Provide disposable cover.
• Ask the patient to open his mouth, and place the bulb of the thermometer of money in the pocket sublingual on both sides of the brake under the tongue.
• Ask the patient to the thermometer with mouth closed, which will ensure that the thermometer is in place.
• Leave the thermometer in place for at least 2 minutes (Torrance and Semple, 1998).
• Remove the thermometer, remove the cover and read at eye level.
More Infor patient reading and measuring of the document.
• Report changes to several older colleagues.
• Own thermometer in accordance with local policy.
TIP!
Each patient must be assigned its own glass thermometer or probe cover to avoid cross-contamination. If mercury thermometers are used in your clinical area make sure to distinguish how to clear a spill of mercury, a mercury thermometer at the break.
Measurement of rectal temperature
Reward
° It will be used as the main advantage of this site is that it is safe for use in the insensitive and the patient was moderately accurate. Although rectal body temperature reflects more accurately the axillary site is rarely used, because the measure of the eardrum was found to be cheaper (Stavem et al. 2000) and just as accurate (Cronin and Wallis 2000).
Disadvantages
• Potential painful and uncomfortable for patients.
° Not suitable for patients who underwent rectal surgery or rectal disorder.
Comments
• Risk of exposure to body fluids.
° C. below the site by the oral and tympanic due to changes in core temperature, because it is a cavity and are therefore more heat than other sites (Severine and McKenzie, 1997).
Equipment
° Glass thin rectal mercury thermometer (rectal thermometers are marked with a hint of blue) or electronic thermometer with rectal probe.
• Cover not reusable.
° Water .. soluble lubricant.
° tissues.
° Pen and documentation sheets.
Disinfectants ° to clean the thermometer according to local trust policy.
Procedure
• Examine the relevance of the rectal site (see the pros and cons above).
• Prepare the equipment.
• Place the procedure for the patient.
Characters • curtains around the bed.
• Position the patient on the side, left lateral position, if possible, with knees bent. Keep the body completely covered, ensuring that the anal area can easily be exposed.
• Wash your hands and pertain disposable gloves.
GlassThermometer:
• Keep the end of the glass thermometer in your fingertips, read the mercury level.
° If the mercury is higher than 35.5 ° C, stirring the mercury touching the wrist down until it is below 35 ° C.
• Provide disposable cover.
• Apply the lubricant on a cloth. Dip the tapered ending of the thermometer in the lubricant, up to 5 cm, which reduces the trauma to the rectal mucosa.
° Rendering rectal area. With the non-dominant hand for the customer than the buttocks stabbed to expose the anus.
More Infor patient to take a deep breath, slow down the anal sphincter. When the patient exhales, gently put the thermometer into the rectum two inches towards the navel (Severine & McKenzie year1997). If a conflict, remove the thermometer.
• Keep the thermometer in place for a minimum of 3 minutes (Torrance and Semple, 1998).
• Remove the thermometer, remove the cover and read at eye level.
• Clean the client area of anal lube and / or remove excrement.
• Remove gloves and wash hands.
• Help the patient to replace clothing and a more comfortable position to resume.
Infor read more patient and able to document clearly indicates that the site is used rectally.
• Report changes to several older colleagues.
• Own thermometer in accordance with local policy.
TIP!
Place the thermometer Hold the thermometer to break. - Sudden movement can cause hypothermia is suspected as a low reading thermometer used.
Measurement of axillary temperature
Benefits
• Non-invasive.
Disadvantages
° takes longer to achieve an accurate reading.
• Less accurate than other sites, because: the armpit is not close to several large vessels, skin temperature varies with changes in the environment, and readings will be affected by peripheral vasoconstriction.
Equipment
• Thermometer / glass mercury thermometer.
° Pen and documentation sheets.
Disinfectants ° to clean the thermometer according to local trust policy.
Procedure
• Review or other location can be used (see the pros and cons above).
• Prepare the equipment.
• Place the procedure for the patient.
Characters • curtains around the bed.
Position the patient • in a sitting or lying position. Keep the body completely covered, so axillary area easily accessible.
• Make sure armpit is dry.
• Wash your hands.
Glass thermometer:
• Carry on the end of the glass thermometer in your finger tips, read the mercury level.
° If the mercury is higher than 35.5 ° C, shaking the mercury down by flicking the wrist downward until it is below 35 ° C.
• Insert a thermometer into the center of the armpit patient, patient to put his arm below the thermometer and place the forearms on his chest to keep the thermometer in place.
• Keep the thermometer in place for at least 5 minutes (Torrance and Semple, 1998).
• Remove the thermometer and read at eye level.
• Help the patient to replace clothing and a more comfortable position to resume.
• Wash your hands.
Infor read more patient and able to document clearly indicates that the site is used axillary.
• Report changes in senior colleague.
• Own thermometer in accordance with local policy.
TEMPERATURE MEASUREMENT eardrum
Benefits
• Easy access.
• Provides accurate heart reading because of its proximity to the eardrum to the hypothalamus and the blood supply shared with the hypothalamus by the internal carotid arteries (Severine and McKenzie, 1997).
• Measure fast.
• Exposure limited to bodily fluids.
Disadvantages
• Requires removal of hearing aids.
° Not suitable for patients who have undergone ear surgery, or blood or fluid is present in the ear canal.
Measures ° can be distorted if the earwax (cerumen) or otitis media is present.
Equipment
° tympanic ear thermometer with disposable cover.
° Pen and documentation sheets.
Procedure
• Review of this site are appropriate.
• Prepare the equipment.
• Place the procedure for the patient.
• Place disposable cover on the thermometer.
• Presentation patient external ear canal, and insert the probe by pulling the auricle up and back, that rectifying the external auditory canal, exposing the eardrum. Probe fit perfectly into the gap, so it is closed. This will eliminate the effect
flow in the channel can have a significant impact on the accuracy of reading (Braun et al. 1998).
• Keep the thermometer in place until a reading is displayed on the digital camera.
• Perform cover the probe.
• Wash your hands.
More Infor reading of the patient, and able to document clearly showing that the site is used eardrum.
• Report made several changes to a colleague of superior quality.
