Assessing and Measuring Body Temperature

Fevers often follow specific clinical patterns:

• Intermittent fever: The temperature alternates between a fever and a return to normal or subnormal levels each day.
• Remittent fever: The temperature rises above normal but does not return to the baseline.
• Crisis: A sudden, rapid drop from a fever to a normal temperature, often following medical treatment.
• Lysis: A gradual, steady return to a normal temperature.

Hyperthermia and Hypothermia

Extreme deviations from the norm are medical emergencies. Hyperthermia refers to an extremely high temperature that can be fatal. Conversely, hypothermia is a temperature significantly below normal. While a slightly lowered temperature is sometimes clinically induced for specific surgeries to decrease oxygen demand, accidental hypothermia is life-threatening.

Nursing Alert: Survival is rare if the core temperature rises above $108\text{ °F}$ ($42.2\text{ °C}$) or drops below $93.2\text{ °F}$ ($34\text{ °C}$).

Measurement Methods and Equipment

Healthcare providers use various types of equipment to measure temperature. Most modern facilities utilize electronic thermometers, which are fast, accurate, and safe. For clients in isolation or those deemed infectious, disposable single-use thermometers are often used to prevent cross-contamination. While glass thermometers (often alcohol-filled) are still found in some home settings, mercury-filled glass thermometers are illegal in the United States due to safety concerns.

Common Measurement Routes

The accuracy and appropriateness of a temperature reading depend heavily on the route used:

Clinical Documentation

Accurate and prompt documentation is vital for patient safety. Vital signs should be recorded in a graphic record (often electronic), which allows healthcare providers to visualize trends over time.

When documenting, clinicians should not merely look at absolute values but should focus on significant deviations from the client's established baseline. For example, a temperature that is slightly below the "average" but consistent with a specific client's history may be less concerning than a sudden spike in a client who is normally afebrile.

NCLEX Alert: Documentation must be timely, accurate, and appropriate. Always follow your specific facility's format for recording vital signs to ensure seamless communication within the healthcare team.