00:00
So, in our vital signs series, let's talk about how we collect our patient's temperature.
00:09
So first, it's important to know your normal vital sign range. Our temperature range is
going to be anywhere from about 36-38 degrees Celsius to 97.8 to about 99.1 degrees
Fahrenheit. Just know, this is going to vary a little bit depending on what site you take this
temperature at. We'll talk about this a little bit later in the presentation. So why in the
first place is it even important to collect temperature on our patient? Well, this is going to
help monitor our patient's condition especially if maybe they have an infection that could be
occurring in the body. And again, just as we just talked about, identifying a potential
problem and then evaluating that response to a nursing intervention. So let's take a look at
different ways to determine body temperature. So if you take a look at the body image on
the screen, all these potential sites can be used for taking a temperature on the patient.
01:06
So if you take a look at the top here that's in portal is very common and we're going to use
that in our acute care facilities. Also, oral temperature is really common especially for home
use. But you've got to remember when we're talking about oral temperature, things can
affect that. Right? If we ate or drink something right before we took that temperature.
01:26
Tympanic is talking about ear. And axillary is something we don't really use this very often.
01:32
It's also slightly lower than oral. So again, depending where you take these temperature
sites at, your temperature reading can be just varied a little bit. Also you see here bladder
which is our core temperature which is really uncommon that we're going to take a body
temperature here as well as rectal. So sometimes we may use this in the pediatric client,
but again it's not often used and it's slightly higher than our oral temperature. So why is
our normal body temperature important? Well, normal body temperature is what our body
needs for important enzymes in our body to function. So if we have extreme high or
extreme low temperatures, this can cause complete imbalances and can even become a life
threatening emergency in our patient. Now, there are many factors that affect body
temperature so let's talk about those. One of those being age and of course exercise can
raise our body temperature. Now, hormonal levels can affect that as well as our Circadian
rhythm with that sleep-wake cycle. Also, the environment that we're in will definitely affect
our body temperature. Summer, winter for example, extreme heat, extreme cold, and of
course illness or infection. So let's look at those individual factors that affect body
temperature, age being that first one that we discussed. Newborns can actually loose up
the 30% of heat through their heads. So let's look at the other end of the spectrum when
we're talking about age. It's not unusual for an older adult to reach temperatures know
higher than about 36 degrees Celsius or about 96.8 degrees Fahrenheit. Now again, there
are some variations for these. And of course, don't forget about exercise. The more that we
increase our metabolic demand, the higher our heat production will be and our body
temperature will increase. Now, hormone levels can also affect our body temperatures.
03:30
Women usually experience greater fluctuations because there are hormonal variations that
can occur during the menstrual cycle. Also, women may experience hot flashes caused by
hormonal changes in a menopause period. Now, let's talk about our Circadian rhythm.
03:48
So, as a person looking at our body temperature over 24-hour period, if you took our
temperature at about 01:00 in the morning to 0400 hours all early early in the morning, our
lowest body temperature is about this time. Now our body temperature reaches maximum
temperature at about 1800 hours or 6 pm in the evening. So as you can see throughout
your day, your body temperature varies a little bit depending on your Circadian rhythm.
04:19
Now, let's talk about environment. Of course, this is going to affect our temperature and
sometimes pretty easily. So if we just enter a warm room for example, our body heat can
rise. Now for outside without any warm clothing on at all, our person's body temperature
maybe low owing to that radiant and conductive heat loss. And I don't know about you but
of course if you think about in the summer or because of outside temperatures, our body
temperature rises, we may sweat, same thing if we're in extreme cold. We could have a
really low body temperature that can lead to hypothermia or dangerous events. Now,
infection illness is something that we commonly will see in the patient's hospital and taking
care of our patients. So if we see the presence of a fever, it's usually related to that
stimulation of the body's immune system. That's because if we see a fever in our patient,
that body is trying to kill a virus or a bacteria that's causing illness on our patient. So that's
why checking body temperature with our patients are so very important when they're in the
hospital. It's also harder for bacteria and viruses to survive at higher temperatures. So as a
nurse, let's ask ourselves. When is a fever a serious sign? When we're talking about our
adult population, a fever may be uncomfortable, it's usually not a cause for concern though
unless it reaches about 39.4 degrees Celsius or about 103 degrees Fahrenheit or even
higher. Now, let's look at the younger population. So for infants and toddlers though,
a slightly elevated temperature may even indicate a serious infection. So let's look at some
causes of abnormal body temperatures and classifications. So the first one we have here is
pyrexia otherwise known as fever. Now if you remember, this is actually an important
defense mechanism. Sometimes the higher the body heat, this can help kill viruses or
bacteria for example. Now we'll call this febrile. You may hear this often. Now, however if a
patient is febrile, this can turn into hypothermia and even malignant hyperthermia which
can be dangerous for our nervous system and our body's functions. Now, hypothermia,
when we're talking about malignant hypothermia, this can result from a body's inability to
promote heat loss or reduce heat production. So that temperature just keeps going up and
up and up. Also a heat stroke means we're having prolonged exposure to the sun or high
environmental temperatures. This can also be dangerous for us as well. This can also,
another form of this is heat exhaustion where you have profuse diaphoresis otherwise
known as profuse sweating that results in a lot of water and electrolyte loss. And if you
lose a lot of water or electrolyte from your body, this can also be become dangerous for
your patient. Now on the flipside of this, we have hypothermia or frostbite. This is exposure
to extreme cold and that body is unable to compensate. Now when we're talking about
extreme hypothermia or frostbite, this can affect our body's tissues, for example. Now let's
take a look at some different thermometers on how we collect that temperature. One of
those is an electronic ear thermometer. This is really great when you're talking about the
pediatric patient, for example, very non-invasive and this goes in our patient's ear
otherwise known as a tympanic temperature. Or you may be able to use a digital oral
thermometer. This many times the probe will go underneath the patient's tongue and again
we've got to screen our patient to see that they just have something really cold to drink
like ice water or really hot to drink like a cup of coffee, this is going to affect our patient's
oral temperature. And a very favorite of many of the acute care places is a forehead
thermometer. So we use this called a temporal thermometer because this is non-invasive
for our patients as well and accurate. So, just know when you're talking about
thermometers there are different devices that your facility may use and also for home use.