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Axillary Temperature with Electronic Thermometer

Written by Hollie Finders, RN
Hollie Finders is a registered nurse with years of experience working in the health care field. She has degrees in both biochemistry and nursing. After working with patients of all ages, Hollie now specializes in pediatric intensive care nursing. Hollie’s LinkedIn

Procedure

Equipment needed: axillary thermometer, disposable probe cover, and gloves

  1. Perform hand hygiene and put on gloves.
  2. Explain the procedure to the patient and ask for his or her assistance in following directions.
  3. Get the thermometer from its base unit and apply a disposable cover to the probe. Be sure the probe cover is secure and locked into place. If the thermometer has multiple modes, be sure to use axillary mode.
  4. Expose the axilla (armpit) by moving the patient’s arm away from the torso.
  5. Inspect the axilla for rashes and/or open sores. If present, stop and attempt to use the opposite axilla or choose another method for obtaining the patient’s temperature. Be sure to report the found skin issues to the nurse.
  6. If needed, dry the axilla by wiping the area with a tissue.
  7. Place the tip of the covered probe into the center of the axilla and return the arm to the patient’s side. Create a tight seal around the probe by folding the patient’s arm onto his or her chest.
  8. Hold the probe in place until the thermometer signals completion (depending on the device, it may flash or beep). Read the temperature on the electronic display screen.
  9. Gently lift the arm away from the body and remove the probe.
  10. Eject the disposable probe cover into the waste bin and return the thermometer to its base unit.
  11. Remove gloves and perform hand hygiene.
  12. Record temperature, method used (axillary), date, and time in the patient’s chart.
  13. Alert the medical professional of any changes in the patient’s condition.

Important Information

Compared to other temperature measurement methods, the axillary measurement is considered the least reliable. An axillary temperature measurement typically reads 0.5 to 1 degree Fahrenheit lower than an oral temperature reading [1]. For this reason, it is recommended to use this method only when other methods are contraindicated or when taking an axillary temperature is the safest method for the patient (e.g. unconscious, confused, uncooperative, and/or disoriented patients). If a patient has an injury to the arm or shoulder, has recently had chest or breast surgery, or has a rash or an open sore in the axilla, the unaffected side should be used to perform the temperature measurement.

References

1. https://www.ncbi.nlm.nih.gov/pubmed/11198790

More Resources

Sim’s Position

The position a patient is placed in is often ordered by the physician, or recommended by a speech, occupational, or physical therapist. The position dictates whether a patient is sitting, lying, standing; or if they are on their side, back, or prone (face-down). Positioning is also determined by the patient’s current needs, such as: Are they eating? Sleeping? Having surgery on their back? Are they receiving nutrition through a nasogastric tube?

Prone Position

Prone position is not used as commonly as other patient positions. This position allows for full extension of the hips and the knees and gives many bony prominences a break from continuous pressure. However, placing patients in prone position does not come without the risks of pressure ulcers.

Assisting the Resident to Sit on the Side of the Bed

Having the resident sit on the side of the bed is otherwise referred to as dangling. When a resident quickly changes position, especially from lying to sitting or standing, there can be a rapid drop in the resident’s blood pressure. This drop in blood pressure may cause dizziness or lightheadedness.

Applying a Condom Catheter

Condom catheters are used for men who are incontinent. These catheters are external and are meant to be used short-term and changed daily.

Feeding the Patient

Not all patients will need help feeding themselves. Some patients will only need assistance opening cartons or cutting their food. To promote independence, always let the patient do as much as he or she can before assisting. It is vitally important that the nurse’s aide verifies that the patient receives the correct meal tray. Patients may have special diets that play a critical role in their health (i.e., pureed diet, gluten-free diet, food allergies, etc.). Feeding the wrong food to the wrong patient could result in serious complications.

Assisting the Resident to Transfer from the Bed to a Chair or Wheelchair

It is important to remember on which side to place the chair when assisting a patient in transferring. Putting the chair on the resident’s unaffected side allows the resident to lead with his or her strong extremity. This eases the procedure for the resident and reduces the risk of falling.

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