Proc5 measure vs_temp taking
- 1. Page 1 of 2 Republic of the Philippines NUEVA ECIJA UNIVERSITY OF SCIENCE AND TECHNOLOGY General Tinio, Cabanatuan City, Nueva Ecija ClinicalLearningSkillsLaboratory HEALTH ASSESSMENT (NCM 101) CHECKLIST: vital signs: temperature Name: ______________________________________________________________ Score: Block: ________________________ Date:____________________________ PROCEDURE Assessing Body Temperature Performed Comments YES NO ASSESSMENT 1. Assess: Clinical signs of fever Clinical signs of hypothermia Site most appropriate for measurements Factors that may alter core body temperature 2. Determine: The policies and procedures for the facility The client’s record for medications that may increase or decrease the present temperature PLANNING 1. Assembleequipmentandsupplies: Thermometer Thermometer sheath or cover Water-soluble lubricant for a rectaltemperature Disposable gloves (if necessary) Towel for axillary temperature Tissue/wipes IMPLEMENTATION 1. Priorto performingtheprocedure,introduceselfand verifythe client’sidentityusingagencyprotocol. Explain to the client what youare going to do, why it is necessary, and how he or she can participate. 2. Wash handsand observeotherappropriateinfection control procedures. 3. Provideforclientprivacy. 4. Place the client in the appropriate position. 5. Clean the thermometer Place the thermometer to appropriate route/site Wait the appropriate amount of time.
- 2. Page 2 of 2 Remarks: _________________________________________________________________________________________________________________________ _________________________________________________________________________________________________________________________ RatingScale: Excellent : 96 – 100% Very Satisfactory : 90 – 95% Very Good : 85 – 89% Good : 80 – 84% Fair : 75 – 79% Poor : 74 and below _______________________________________________ Student’sPrintedName and Signature _______________________________________ SkillsLaboratoryInstructor Electronic and tympanic thermometer will indicate that the reading is complete through a light or tone. 6. Remove the thermometer and discard the cover or wipe with a tissue ifnecessary. 7. Read the temperature. If the temperature is obviously too high, too low or consistent with the client’s condition, recheck it with a thermometer known to be functioning properly. EVALUATION AND DOCUMENTATION 8. Document the temperature in the vital signs record sheet. 9. Report abnormal results to the primary care provider. 10. Document the procedure in the client’s record TOTAL: