Programs

Tympanic Membrane 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: tympanic thermometer, disposable probe cover, and gloves

  1. Perform hand hygiene and put on gloves.
  2. Get the tympanic thermometer from its base unit and apply a disposable probe cover to the earpiece. Be sure the probe cover is secure and locked into place.
  3. Explain the procedure to the patient and ask for his or her assistance in following directions.
  4. Assist the patient in tilting his or her head away from you, so that the ear is directly facing you. Gently pull up and back on the pinna (outside edge of ear) to straighten the ear canal.
  5. Inspect the ear canal for obvious abnormalities before proceeding. If a physical abnormality is present, stop and report it to the medical professional. You may attempt the procedure in the opposite ear, or choose a different method to obtain the patient’s temperature. Do not attempt to remove earwax from the ear canal.
  6. Place the covered probe into the straightened ear canal.
  7. Press the button on the thermometer to begin measuring the patient’s temperature. Hold the thermometer in place until the device indicates measuring is complete (depending on the device model, it may beep or flash).
  8. Gently remove the thermometer and check the temperature reading.
  9. Eject the disposable probe cover into the waste receptacle and return the thermometer to its base unit.
  10. Remove gloves and perform hand hygiene.
  11. Record temperature, method used (tympanic), date, and time in the patient’s chart.
  12. Alert the medical professional of any changes in the patient’s condition.

Important Information

A tympanic membrane thermometer uses an infrared sensor to measure the temperature of the tympanic membrane (ear drum). This type of thermometer is considered an accurate and reliable predictor of a patient’s core temperature because the tympanic membrane’s blood supply is sourced from the carotid artery, which is the same artery that carries blood to the hypothalamus in the brain [1]. However, there are a few situations that can affect the accuracy of a tympanic membrane temperature reading. It is not recommended to use this method if there is a physical deformity of the ear canal, the patient reports ear pain, or excessive earwax, drainage, or sores are present. Tympanic membrane thermometers can be used only to measure tympanic membrane temperatures and should not be used to measure temperatures via the mouth, armpit, or rectum.

References

1. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3658932/

More Resources

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.

Dressing and Undressing a Patient

Patients who have suffered a stroke or have weakness or injury to one side of their body may struggle with dressing and undressing. In order to help these patients regain their strength and independence, it is important that the nurse’s aide only assist them as needed. The nurse’s aide may need to teach patients how to dress and undress safely with their limitations.

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.

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.

Measuring the Radial Pulse

The radial artery, located in the wrist, is easy to feel and an efficient location to measure heart rate. Changes to the rhythm or strength of the radial pulse can indicate heart disease, damage to the arm, or body fluid status. It is important to remember to check the radial pulse on both sides as differences between left and right can indicate injury or disease processes.

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.

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