Methods of Temperature Measurement: Rectal and Axillary (Nursing)

00:00 Let's take a look of how we take a rectal temperature. Just know this route is not a common route of how we obtain a temperature but it is appropriate in certain patient situations.

00:16 So let's start by performing our hand hygiene and putting on our gloves. We're going to place a probe cover on the thermometer and lubricate the tip. Then we're going to turn on the thermometer by following the manufacturer's directions and then positioning is important for your client. So you can position the client on their back with their knees bent up, and then separate the buttocks to expose the anus. Or, if your patient can tolerate it, you can also place your patient in a prone position as well. So just assess your patient and see what's appropriate here. Then, we're going to gently insert the thermometer into the rectum about an inch. It's important that we're careful on insertion here and we're not going too far, so about an inch is appropriate. Then we're going to facilitate keeping the thermometer in place per the manufacturer's recommended time while allowing for client comfort, so you can be discussing with your client here and making sure they're not having any pain or discomfort. Note the temperature reading, then we can remove the thermometer when the device beeps and if the indicated appropriate time has been met, we'll dispose of the probe and then be sure to clean the thermometer per the facility protocol. Now if we need to, we want to make sure we provide cleaning or peri-care to the client, remove our gloves, perform our hand hygiene, and then document the results of the temperature and of course the route taken in the electronic health record. So let's take a look of how we take a rectal temperature. So before we get started, just note that this route is more invasive than other routes that we can use to obtain a temperature. So again, this is very rarely used but it could be special conditions in which it's warranted for your patient. So before we get started, of course perform hand hygiene and put on your gloves. Okay, as we put on our gloves, just know make sure you get familiar with your equipment. Now, when we're obtaining a rectal temperature there's different equipment that may be special that we use for this type of route. And each equipment is going to vary from facility to facility so make sure you get familiar with yours. So now, go ahead and get started, we're going to go ahead and place a probe cover on our thermometer. Now, the great thing about this type of equipment I'm using when I take out the probe, it automatically turns on for me. So I'm going to go ahead and our probe cover set on the back of our equipment which makes it very convenient. I'm going to put my probe down into my probe cover that's disposable.

03:07 This is a one-time use. Now, once I've done this, it's very important to make sure you lubricate the tip of the thermometer. So I'm going to do this now and I'm using a water soluble jelly. This is really important because many times when we're doing this route, we can cause damage to the delicate tissue so we want to make sure we lubricate here.

03:40 So once we're ready to do this, we can go ahead and position our client. Now, we can position our client on their back with their knees bent up, so you want to keep this in mind whatever's going to be the most comfortable. However, right now, I've got my patient in the prone position because that was what's the most comfortable for my client. So once we've done this, we can separate the buttocks to expose the anus. Now, it's really important when I insert the thermometer into the rectum I only go about an inch. So once I have inserted, I want to facilitate keeping the thermometer in place per the manufacturer's recommended time. So we'll just check on our client and make sure they're comfortable.

04:23 Now, we can go ahead and note the temperature reading. Now, once we have done this, we can remove the thermometer once we have obtained our temperature. Now, we want to make sure we dispose of the probe cover appropriately and make sure that we follow our agency's protocol to clean the thermometer. Now at this point, we may need to clean the client and help clean them up then we're going to remove our gloves, perform our hand hygiene, and of course document the results in the electronic health record. And make sure that you include the route taken. Let's talk about how we take an axilla temperature. We're going to perform hand hygiene and place a probe cover on the thermometer. Now, turn on the device according to the manufacturer's directions and then we're going to place the thermometer directly on the skin, not on the clothing, of the armpit. Have the patient close the armpit by making sure the client's arm is touching their chest wall comfortably. Now, facilitate keeping the thermometer in place per the manufacturer's recommended time while allowing for patient comfort. Now, we can note the temperature reading. Then we're going to remove the thermometer when the device beeps indicating the appropriate time has been met then we can dispose of the temperature probe. Be sure here to clean the thermometer per the facility protocol. Now, we can remove our gloves, perform our hand hygiene, and of course document the results of the temperature including the route taken in the electronic health record. Now let's take a look of how we take an axilla temperature. So just know we rarely use this route because it's really not the most accurate. Now, we may use this in pediatric clients especially but just know we have different routes that are more accurate. But let's explore how we use this.

06:24 First, we're going to perform our hand hygiene and put on our gloves. Okay, so with our equipment here, we have our very nice disposable covers then I'm going to slide the temperature probe in and make sure it clicks down. Now, once I do this my device goes ahead and turns on and make sure you follow your manufacturer's directions. Now, here is the important part when we're taking this route. I want to make sure I place the thermometer directly on the skin, not on the clothing. If we did this on the clothing around the armpit, we're not going to get a very accurate reading. So, once we have done this, I'm going to make sure the client closes their arm and puts their arm towards their chest wall to obtain the reading. So I'm going to have Brandon slightly lift his arm and I'm going to put the temperature probe underneath his gown to maintain privacy "And Brandon if you'll go ahead and close your arm to your chest wall" and make sure we keep the client comfortable here. So we're going to facilitate at keeping the thermometer in place for the recommended time to obtain our reading, and again making sure we ensure comfort for our client. Now, once we have done this, we can go ahead and note our temperature reading. Then I can remove the device and then with our disposable temperature probe, we can get rid of this at this time. And of course, make sure you clean the thermometer per your facility protocol. Now, we can remove our gloves, perform our hand hygiene, and of course document the results in the electronic health record and make sure you include the route.