Measurement of body temperature
In a healthy person in , the body temperature of is constant, with slight fluctuations in the morning and evening hours and does not exceed 37 ° C.Such a constant temperature depends on the processes of heat production and heat transfer in the body. The equilibrium between heat generation and heat transfer is established and maintained as a result of heat regulation - a process in which the formation and release of heat of organisms is regulated. Heat generation is basically a chemical process, the source of which is oxidation, that is,combustion of carbohydrates, fats and some proteins in all cells and tissues of the body, primarily in skeletal muscle and liver. Heat output is basically a physical process, about 80% of the heat formed in the body radiates from the surface of the body, about 20% in the evaporation of water during respiration and perspiration, and about 1.5% in urine and feces.
Normally, the temperature in children is slightly higher than in adults, as the children have more intensive oxidative processes necessary for growth.
In women, the voltage of oxidative processes can change within a month due to the cyclicity of the sexual function. This entails sometimes a temperature increase in the menstrual period by a few tenths of a degree. Daily fluctuations in temperature are directly dependent on fluctuations in oxidative processes associated with work or food intake. In healthy people, the temperature in the morning is a few tenths of a degree lower than in the evening. Temperature indicators depend on the place where it is measured. Thus, the temperature of the mucous membrane of the oral cavity, vagina, rectum is 0.2-0.4 ° C higher than the temperature of the adult skin, measured in the axillary region and inguinal folds. The average adult body temperature, measured in the axillary region, is assumed to be 36.5-37.5 ° C, in children it is 0.5-1 ° C higher( 37-37.5 ° C), and in the elderly it is lower( 35.5-36.5 ° C).Thus, physiological fluctuations in temperature do not exceed 1 ° C.
Measuring and monitoring body temperature is a daily and important responsibility for the nurse of separation of any profile.
Body temperature is measured by a medical thermometer.
The first medical thermometer was proposed by Fahrenheit in 1723. In our country a Celsius thermometer is used, which consists of a glass tube with a capillary, at the end of which there is a reservoir filled with mercury. This tube is attached to a scale on which fissions are deposited - from 34 to 42 ° C.The existing scale scale, expressed in degrees, allows us to call the thermometer a thermometer. The volume of mercury filling the reservoir and a small part of the thermometer's capillary tube increases with heating. The level of the mercury column in the capillary rises. It is not possible to descend independently after stopping heating. You can return mercury to the tank only by shaking it several times. Do this carefully, so as not to drop the thermometer or hit it against nearby objects. To store thermometers, a glass is usually used, at the bottom of which a layer of cotton wool is placed. At 1/3 or 1/2 of the volume, the beaker is filled with 70% alcohol, any disinfectant solution( for example, 0.5% chloramine solution) can be used, strictly keeping the exposure time in accordance with Order No. 408 and OST 42-21-2-15.In order to shake the thermometer out of the hand when shaking, a rubber cap is put on the top of the thermometer.
Before measuring the temperature, the thermometer must be thoroughly wiped and, shaking off the mercury to below 35 ° C, give the patient or place the thermometer himself.
The axillary basin should first be wiped with a dry towel, since moisture cools the mercury, and the thermometer will show a lower temperature. Between the thermometer and the body should not get underwear, and next to be a warmer or bubble with ice. In places used to measure body temperature, there should be no inflammatory process( redness of the skin, swelling), as there may be a local increase in temperature. Weak patient sick sister holds his hand. The duration of the measurement is at least 10 minutes.
In very exhausted and severe patients, body temperature can be measured in the rectum. Contraindications to the measurement of temperature in this way are stool retention, diarrhea, rectum disease. Before entering the rectum, the thermometer should be lubricated with petroleum jelly or any fat, and then inserted half the length into the patient's position on the side. Buttocks should fit snugly against each other.
After each measurement of the temperature in the rectum, the thermometer should be thoroughly washed with warm water and disinfected in alcohol or in one of the available disinfectants.
To children, the temperature is measured in the inguinal fold. To do this, the child's leg is bent somewhat in the hip joint so that the thermometer is in the formed fold of the skin.
Usually body temperature is measured 2 times a day, in the morning and in the evening - at 7-8 hours and 16-17 hours. The thermometer readings are entered in the temperature sheet, where the points denote the morning and evening temperatures. On the markings within a few days, a temperature curve is formed which, in many diseases, has a characteristic appearance. If necessary, an hourly temperature measurement is made and a graph of daily temperature variations is drawn on the points.
The normal temperature for measurement in the armpit is 36.4-36.8 ° C.During the day, body temperature can vary: it is the lowest of all between 17 and 21 pm. The difference between morning and evening temperatures in healthy people does not exceed 0.6 ° C.After eating, heavy physical activity and in a hot room, the body temperature increases slightly.