Chapter 2: Temperature
Methods of measuring a client’s body temperature vary based on developmental age, cognitive functioning, level of consciousness, state of health, safety, and agency/unit policy. The healthcare provider chooses the best method after considering client safety, accuracy, and least invasiveness, all contingent on the client’s health and illness state. The most accurate way to measure core body temperature is an invasive method through a pulmonary artery catheter. This is only performed in a critical care area when constant measurements are required along with other life-saving interventions.
Methods of measurement include oral, axillary, tympanic, rectal, temporal artery and dermal routes.
Oral temperature can be taken with clients who can follow instructions, so this kind of measurement is common for clients over the age of four, or even younger children if they are cooperative. Another route other than oral (e.g., tympanic or axillary) is preferable when a client is on oxygen delivered via a face mask because this can alter the temperature.
For children younger than four, axillary temperature is commonly measured unless a more accurate reading is required.
Rectal temperature is an accurate way to measure body temperature (Mazerolle, Ganio, Casa, Vingren, & Klau, 2011). The rectal route is recommended by the Canadian Pediatric Society for children under two years of age (Leduc & Woods, 2017). However, this method is not used on infants younger than thirty days or premature infants because of the risk of rectal tearing. If the rectal method is required, the procedure is generally only used by nurses and physicians.
Temporal artery temperature is not a common method of measurement, but may be used in some agencies; this process involves holding the device and sliding it over the skin of the forehead and then, down over the temporal artery in one motion. Dermal strips can be placed on the forehead to measure skin temperature, but are not yet widely used, and the accuracy of this method has not yet been verified.
Points to Consider
The accuracy of measurements is most often influenced by the healthcare provider’s adherence to the correct technique.
The following pages detail the normal temperature ranges and techniques associated with each of the temperature methods.