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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

Fowler’s Position

Fowler’s position is used when a patient is eating, is having difficulty breathing, or is ordered by a doctor. This position is easily recognized because the patient will be sitting “straight up.” Semi-Fowler’s is sitting “half-way up,” and is used when patients cannot be laid flat, but wish to be in a more relaxed position than Fowler’s.

Moving the Resident to the Side of the Bed

Residents are usually kept in the center of the bed for safety reasons. However, moving a resident to the side of the bed is an important step to take before turning a resident onto his or her side. Performing this action allows the resident to end up side lying in the center of the bed and not smashed up against the side rail.

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.

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.

Nail Care (Fingers and Toes) for CNAs

Nail care of both the feet and the hands should be performed as part of the patient’s daily hygiene routine. The status of the patient’s nails can reflect their overall health. Nail issues can also lead to infection that can spread systemically (ex, ingrown nails or fungus). You should never clip a patient’s nails with nail clippers, and always review your institution’s policy about what nail care is allowed.

Handwashing for CNAs

Handwashing is considered the single most important practice to prevent the spread of infection. Even when hands look clean, they could potentially be crawling with dangerous microorganisms and pathogens. Using soap and friction during handwashing helps loosen the oils on the skin, allowing dirt and pathogens to be rinsed away.

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