Nursing & Healthcare Programs

Rectal 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: rectal thermometer, disposable probe cover, lubricant, tissue, and gloves

  1. Perform hand hygiene and put on gloves.
  2. Explain the procedure to the patient and ask for their assistance in following directions.
  3. Raise the side rail on the patient’s left side for safety. If the bed can be raised, adjust it to a comfortable working height.
  4. Assist the patient into Sims’ position (left side lying).
  5. Adjust the linens to expose only the buttocks.
  6. Apply a disposable cover to the temperature probe. Be sure the probe cover is secure and locked into place.
  7. Apply an adequate amount of lubricant to the probe cover. Ensure the tip and 1-2 inches of the probe is lubricated.
  8. Using one hand, separate the buttocks to expose the anus.
  9. With the other hand, insert the lubricated probe 1-1.5 inches into the rectum in the direction of the umbilicus. If there is any resistance, stop the procedure immediately, withdraw the probe carefully, and notify the medical professional. Do not force the probe into the rectum.
  10. 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.
  11. Gently remove the probe and eject the disposable probe cover into the waste bin.
  12. Use a tissue to wipe away any excess lubricant or feces found around the patient’s anus. Dispose of the tissue in the proper waste receptacle.
  13. Assist the patient back into a comfortable position and, if raised, return the bed to the lowest setting.
  14. Return the thermometer to its base unit.
  15. Remove gloves and perform hand hygiene.
  16. Record temperature, method used (rectal), date, and time in the patient’s chart.
  17. Alert the medical professional of any changes in the patient’s condition.

Important Information

A rectal temperature provides the most accurate core body temperature reading compared to other non-invasive methods [1]. This makes a rectal temperature desirable; however, this procedure comes with more patient discomfort and more safety risks (bowel perforation, mucosal damage, and/or vagus nerve stimulation) than the other temperature measurement methods [2]. In order to avoid these risks, the nurse’s assistant must communicate with the patient throughout the procedure, encouraging him or her to relax, take deep breaths, and remain still.

Prior to performing a rectal temperature, the nurse’s assistant should verify with the nurse that the patient does not have any of the following contraindications: diarrhea, hemorrhoids, rectal bleeding, rectal disease, recent rectal surgery, bleeding tendencies, neutropenia, or certain heart conditions [3].

References

1. https://www.ncbi.nlm.nih.gov/pubmed/7663592

2. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3440892

3. https://www.guideline.gov/summaries/summary/36842L

More Resources

Supine Position

Supine position is a natural and comfortable position for most people. For this reason, it is a highly utilized position for nursing procedures. Unfortunately, this position puts pressure on many bony prominences that can lead to discomfort and/or pressure ulcers if the pressure is not relieved every so often (typically every two hours or less).

Measuring Blood Pressure

Many factors can interfere with obtaining an accurate blood pressure. The most common mistakes that lead to inaccurate blood pressures are a result of improper technique, including: not supporting the patient’s arm, using the wrong sized cuff, positioning the cuff too low on the patient’s arm, improper positioning of the cuff’s artery marker, and attempting to measure blood pressure through clothing.

Orthopneic Position

Patients with respiratory illnesses such as chronic obstructive pulmonary disease (COPD) find ways to help themselves breathe more easily. This can include sleeping with extra pillows to keep them propped up or leaning forward to ease the work of breathing. The orthopneic position is one forward-leaning position used to help patients breathe comfortably when they are having difficulty.

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.

Oral Temperature Measurement with an Electronic Monitor

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.

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.