Nursing & Healthcare Programs

Oral Temperature Measurement with an Electronic Monitor

Written by Amanda R. McDaniel, MS, BSN, RN
Amanda is a BSN/RN with a MS in Physiology and a BA in English. She worked as a medical writer in the pharmaceutical industry for 11 years before pursuing a career in nursing. She now works as a nurse on a NeuroTelemetry unit and continues to write and edit on a freelance basis. Amanda’s LinkedIn

Body temperature is one of the vital signs frequently measured in healthcare settings. Changes in a body temperature can indicate improvement or worsening of a patient’s condition, so accurate measurement is important. Oral (also known as sublingual) temperature measurement using an electronic monitor is a convenient and accurate method of assessment. It is quick, typically 20 to 30 seconds, and does not require the patient to change position. Oral temperatures are appropriate for most patients; however, patients who cannot breathe through their nose or cannot hold their mouth closed for the duration of the assessment for any reason should have their temperature taken via another route (axillary, tympanic, rectal, etc.).

Obtaining Oral Temperature with an Electronic Monitor

  1. Gather your supplies. These include:
    • Gloves
    • Thermometer
    • Thermometer probe covers
  2. Perform hand hygiene and don gloves (per institutional policy).
  3. Ask the patient if they have had anything to drink or eat in the past 15 minutes or whether they have smoked in the last 2 minutes (food, drink, and smoking can alter the temperature of the oral cavity).
  4. Turn the thermometer on and slide a disposable probe cover over the probe stem until the cover äóìclicksäó into place.
    • Check that you are using the correct probe. Typically, blue indicates that the probe is for oral and/or axillary temperatures while red indicates that the probe is used for rectal temperatures.
  5. Ask the patient to open his mouth and gently place the tip of the probe under the tongue in the posterior portion of the mouth. If needed, press the äóìStartäó button on the thermometer.
  6. Ask the patient to close his mouth around the probe and keep the tip of the probe under his tongue.
  7. The probe should stay in place until the monitor audibly signals (beeps) that the measurement has completed and the final measurement is shown on the display.
  8. Gently remove the probe from the patient’s mouth, then press the ejection button on the probe to remove the probe cover. Discard the probe cover and place probe back in storage position.
  9. Remove gloves and perform hand hygiene.
  10. Document the temperature in the patient’s record and inform the nurse of any significant change from previous temperature per institutional or unit protocol.
  11. Disinfect the thermometer and return it to the storage or charging location per institutional or unit protocol.

Amanda R. McDaniel, MS, BSN, RN

References

Fetzer, S. J. (2014). Vital signs and physical assessment. In A. G. Perry, P. A. Potter, and W. R. Ostendorf (Eds), Clinical nursing skills & techniques (8th ed., pp. 67-72). St. Louis, MO: Mosby Elsevier.

General Survey, measurement, vital signs. (2012). In C. Jarvis (Ed.), Physical examination & health assessment (6th ed., pp. 132-133). St. Louis, MO: Elsevier Saunders.

More Resources

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Perineal care should be performed during a bath, after using the bedpan, and/or after incontinence. Proper technique is important for maintaining hygiene, preventing infection, and avoiding skin breakdown. Because of the close proximity between a woman’s urethra, vagina, and anus, it is essential to only wipe in a front to back motion. Wiping in the opposite direction is associated with a greater risk for developing a urinary tract infection.

Perineal Care of the Male Resident

Perineal care should be performed during a bath, after using the bedpan, and/or after incontinence. Special care should be used when performing perineal care on an uncircumcised male. Failure to retract and wash the area under the foreskin can result in infection. Failure to return the foreskin to its normal position can result in paraphimosis.

Measuring the Respirations

Respiration is a vital sign that is measured frequently in the healthcare setting. Taking this measurement requires no equipment and relatively little time. However, it is a measurement that must be taken accurately, as a change in respiration may indicate the worsening of a patient’s condition.

Performing Ostomy Care

Residents who have had a portion of their intestines removed due to illness or trauma may have a temporary or permanent ostomy, which is an opening in the abdomen that is created for the elimination of urine or feces. The portion of the intestine that is connected to the abdominal wall and is visible is called the stoma. A pouch is placed over the stoma to collect feces.

Moving the Resident from a Bed to a Stretcher or Gurney

Moving a patient from a bed to a stretcher can pose huge safety risks to both the patient and to the health care workers completing the transfer. Always use the appropriate amount of people to complete a transfer, which may vary according to the patient’s weight and/or the facility’s policy. In some cases, a mechanical lift may be needed.

Removing Personal Protective Equipment

It is important to follow the correct procedure while removing personal protective equipment to avoid contaminating your skin or clothing. The most common source of contamination in this process stems from improper removal of gloves. Gloves are often the most soiled piece of equipment. To avoid contaminating your skin or the other equipment worn, gloves should always be removed first. Then remove the goggles, gown, and mask, in that order.