Vital Signs, Height, and Weight 349 • Rectal temperature: taken by inserting a lubricated thermometer one inch or less into the anus for three to five minutes. Rectal temperatures should not be taken if a resident has diarrhea, hemorrhoids, rectal bleeding, or rectal surgery. Rectal temperatures are also not advised for residents with certain heart conditions, as taking a rectal temperature can stimulate the vagus nerve and cause a temporary decrease in heart rate and blood pressure. • Axillary temperature: taken by placing a thermometer into the axilla. Wait 15 minutes after the resident has washed or applied deodorant to the underarm to take an axillary temperature. Do not use this location if the resident has had breast or chest surgery. • Tympanic temperature: taken in the ear, the thermometer must be placed properly in the ear for an accurate reading. If the resident has been sleeping or resting on one ear, use the opposite ear to get an accurate reading. Do not use a tympanic thermometer if there is drainage from the ear. • Temporal temperature: taken on the forehead, where the temperature of the temporal arteries on each side of the head can be measured. Only use the area of the forehead that is bare—if a hat, wig, or bandage covers the forehead, it can affect the temperature. Rectal and temporal artery temperatures provide more accurate measurements than temperatures at other sites. A resident’s body temperature can change slightly (by 1°F ) during a day due to the dilation (expansion) of blood vessels. How much a resident eats or drinks, the external temperature, and age can also affect temperature. An older person may not adjust as quickly to changes in temperature and may often express feelings of being cold. Pyrexia (fever) is caused by the body heating up to protect itself. Pyrexia can be the sign of an infection, some other disease process, an injury, or a possible reaction to a medication. Hypothermia, although uncommon, is a body temperature below 95°F (35°C). Average temperature ranges also vary based on the type of thermometer used (Figure 16.2). Nondigital Thermometers Nondigital thermometers can be used to take oral, rectal, or axillary temperatures. Figure 16.1 earlier in this section shows a nondigital thermometer. These thermometers are tubes filled with a liquid (colored alcohol) that expands and moves up or down in response to heat. The bulb at the end of the thermometer is inserted into the body. The bulb of a rectal thermometer is thicker and wider than the bulb of an oral thermometer. Some thermometers are marked with a colored dot—blue for oral or axillary, and red for rectal. CULTURE CUES Anxiety About Vital Signs Taking vital signs may be a new or upsetting activity for some residents. Residents from different cultures or generations may feel frightened and wonder what is happening. They may also be worried about the outcome of the vital sign. When taking vital signs, be sure to move slowly and patiently. Provide thorough and accurate explanations about what you are doing. If the resident does not speak your language, ask someone to interpret, if possible. Apply It 1. When taking vital signs, what actions can you take that show you are moving slowly and patiently? 2. What communication skills can you use to provide thorough and accurate explanations for concerned or confused residents? Average Ranges of Body Temperature Thermometer Twelve Years and Older Oral 97.6°F–99.6°F (36.4°C–37.5°C) Rectal 98.6°F–100.6°F (37.0°C–38.1°C) Tympanic 98.6°F–100.4°F (37.0°C–38.0°C) Axillary 96.6°F–98.6°F (35.9°C–37.0°C) Temporal Artery 97.2°F–100.1°F (36.2°C–37.8°C) Goodheart-Willcox Publisher Figure 16.2 Average temperatures for people twelve years and older vary based on the type of thermometer used. Copyright Goodheart-Willcox Co., Inc.