Measuring and Recording Temperature
Measurement of balance between heat lost
and produced by the body.
Homeostasis = balance
If the body temperature is too high or too low, homeostasis is affected.
F = Fahrenheit
C = Celsius or Centigrade
Temperature is usually higher in the evening.
Parts of the Body Where
Temperature Can Be Taken
In the mouth
Glass or electronic - Most common
Normal 98.6º F (97.6 – 99.6º F or 37º C)
Normal 99.6º F
Armpit or groin
Normal 97.6º F
In the ear or external auditor canal
Uses different modes
Usually in less than 2 seconds
Normal 98.6º F
Factors that body temperature
High temperatures in the environment
Factors that body temperature
Starvation or fasting
Decreased muscle activity
Exposure to cold in the environment
Hypothermia Below 95º F
Caused by prolonged exposure to cold
Death when temp below 93º F
Fever Elevated temperature, above 101º F
Hyperthermia Elevated temperature, above 104º F
Caused by prolonged exposure to
hot temperatures, brain damage, or serious infection
Temperatures above 106º F can
lead to convulsions and death
Measuring and Recording Temperatures
Clinical (glass) thermometer contains mercury
Comes in oral, security, and rectal
Electronic can be used for oral, rectal, axillary or groin
Most have disposable probe cover
Tympanic placed in auditory canal
Taker pushes the scan button
Paper or plastic are used in some hospitals
Contain special chemicals or dots that change colors
To record temperature:
986 is an oral reading
996 (R) is a rectal reading
976 (Ax) is an axillary reading
986 (T) is an aural reading
Eating, drinking hot or cold liquids, or smoking can alter oral temperature. Be sure it has been 15 minutes since the patient did any of those things before taking the temperature.
Measuring and Recording Pulse
The pressure of blood pushing against the wall of an artery as the heart beats and rests.
Dorsalis Pedis Artery
Taken with a stethoscope at the apex of the heart
Actual heartbeat heard and counted
Tips of earpieces and diaphragm of stethoscope should be cleaned with alcohol before use
Heart sounds heard resemble “lubb-dupp”
Bradycardia – Under 60 beats per minute
Tachycardia – Over 100 beats per minute
Rhythm – Regularity of the pulse (regular or irregular)
Volume – Strength or intensity (strong, weak, thready, or
Pulse can be increased by:
Pulse can be decreased by:
Measuring and Recording Respiration
Process of taking in Oxygen (O2) and expelling Carbon Dioxide (CO2)
1 inspiration + 1 expiration = 1 respiration
Normal rate = 14 – 18 per minute
Character – depth and quality of respirations
Dyspnea – difficult or labored breathing
Apnea – absence of respirations
Cheyne-Stokes – periods of dyspnea followed by periods
of apnea; noted in the dying patient
Rales – bubbling or noisy sounds caused by fluids or
mucus in the air passages
Leave your hand on the pulse while counting respirations and be sure the patient doesn’t know you are counting the respirations.
Measuring and Recording Blood Pressure
Measure of the pressure blood exerts on the walls of arteries
Blood pressure read in millimeters (mm) of mercury (Hg) on an instrument known as a sphygmomanometer
Systolic: Pressure on the walls of arteries when the heart is contracting.
Normal range – 100 to 140 mm Hg
Diastolic: Constant pressure when heart is at rest
Normal range – 60 to 90 mm Hg
Factors that blood pressure
Excitement, anxiety, nervous tension
Exercise and eating
Factors that body temperature
Rest or sleep
Excessive loss of blood
Blood pressure is recorded as a fraction.
Sphygmomanometers: Usually aneroid or mercury, although many hospitals are using electronic.
Measuring/Recording Height and Weight
Used to determine if a patient is underweight or overweight
Height/weight chart used as averages
+ or - 20% considered normal
When are height-weight measurements routinely done in a health care setting?
Usually ordered for patients with edema due to heart, kidney, or other diseases.
Be sure to:
Use the same scale every day
Make sure the scale is balanced before weighing the patient
Weigh the patient at the same time each day
Make sure the patient is wearing the same amount of clothing each day
OBSERVE SAFETY PRECAUTIONS! Prevent injury from falls and the protruding height lever.
Some people are weight conscious.
Make only positive comments
when weighing a patient.
Types of Scales
Clinical scales contain a balance beam and measuring rod.
Some institutions have bed scales or chair scales.
Infant scales come in balanced, aneroid, or digital.
When weighing an infant…keep one hand slightly over but not touching the infant
A tape measure is used to measure infant height. One way to accomplish this is to:
Make a mark on the exam table paper at the top of the head.
Stretch out the infant's leg and make a mark the paper at the heel.
Use a tape measure to measure from mark to mark.
Positioning a Patient
Medical exam table
Be sure you know how to operate the table!
Paper covers are usually used on exam tables
After use, tables are often cleaned with disinfectant
During any procedure, reassure the patient
Observe safety factors to prevent falls and injury
Use correct body mechanics
Observe the patient for signs of distress
Protect the patient's privacy
Learn the purpose and procedure for the
Horizontal recumbent (Supine)
Sims' (Left lateral)
Patient Assessment Techniques
Palpation Use of hands and fingers to feel various parts of the body – to determine whether a part of the body is enlarged, hard, out of place, or painful to the touch.
Percussion Physician taps and listens for sounds coming from various body organs. The sounds emitted allow a trained individual to determine the size, density, and position of underlying organs.
Auscultation Physician listens to sounds coming from within the body, usually with a stethoscope.
To convert degrees F to degrees C use the formula: (o F – 32) 5/9
To convert degree C to degrees F use the formula: (o C x 9/5) + 32
Convert the following Fahrenheit temperatures to Celsius temperatures and round off answers to the nearest tenth or one decimal point.
1. 140o F = 140-32=108 108 X 5/9 (or 0.5556) = 60 60o C
2. 88o F ________________________________ ______
3. 45o F ______________________________________
4. 98.2o F ________________________________________________
5. 64o F ______________________________________
6. 73.4o F _____________________________________ ___________
7. 212o F ________________________________________________
8. 116o F _________________________________________________
9. 97o F ______________________________________
10. 101o F _______________________________________________
11. 100o F _____________________________________ __________
12. 104.6o F ______________________________________________
Convert the following Celsius temperatures to Fahrenheit temperatures and round off answers to the nearest tenth or one decimal point.
13. 65. o C 65.6 x 9/5 (or 1.8) = 118.1 118.1 + 32 = 150.1 150.1o F
14. 42.8o C ____________________________________ __________
15. 54o C _____________________________________ __________
16. 8o C _____________________________________ __________
17. 91o C _____________________________________ __________
18. 0o C _____________________________________ __________
19. 72o C _____________________________________ __________
20. 99.8o C ____________________________________ __________
21. 59.2o C ____________________________________ __________
22. 63o C _____________________________________ __________
23. 85.8o C ____________________________________ __________
24. 103o C _____________________________________ __________
Recording and Reporting
Health care workers must listen carefully AND make observations.
They use their senses to:
See Color of skin, swelling or edema
Presence of rash or sore
Color of urine or stool
Amount of food eaten
Smell Body odor - Unusual odors of breath, wounds, urine or stool
Dryness or temperature of skin
Abnormal body sounds
Observations should be reported accurately – use facts and report what you saw, not the reasons.
NOT – “Mr. Cromwell is in pain.”
INSTEAD – “Mr. Cromwell is moaning and holding his side.”
Observations on a patient’s health record (chart) should be accurate, concise, and complete.
Objective observations – what was seen.
DO NOT record what you feel or think.
If a patient’s statement is recorded, use the patient’s words and use quotation marks.
Sign entries with name and title of the person recording the information.
Cross-out errors neatly with a straight line, write error, and initial error.
Read the following communication statements in Column II and select the appropriate observation in Column I by placing the letter beside the number.