352 Chapter 16 Procedure Using a Rectal Thermometer— Digital Rationale Body temperature that is outside the normal range can be a sign of a disease or condition or the result of an injury. The decision to use a rectal thermometer is based on the need for accuracy and the age and condition of the resident. Always follow the thermometer manufacturer’s instructions and facility policy. Preparation 1. Ask the licensed nursing staff how this procedure fits into the plan of care, if there are doctor’s orders for the procedure, if there are any special instructions or precautions, and if the resident can be moved into the positions required for this procedure. 2. Wash your hands or use hand sanitizer before entering the room. 3. Knock before entering the room. 4. Introduce yourself using your full name and title. Explain that you work with the licensed nursing staff and will be providing care. 5. Greet the resident and ask the resident to state her full name, if able. Then check the resident’s identification bracelet. 6. Use Mr., Mrs., or Ms. and the last name when conversing. 7. Explain the procedure in simple terms, even if the resident is not able to communicate or is disoriented. Ask permission to perform the procedure. 8. Bring the necessary equipment into the room. Place the following items in an easy-to-reach place: • a digital thermometer • the appropriate probe attachment (the red probe for a rectal temperature) • disposable probe covers • disposable gloves • water-soluble (dissolves in water) lubricating gel • tissues or toilet paper • pen and pad, form, or digital device for documenting temperature • sheet or drape The Procedure 9. Provide privacy by closing the curtains, using a screen, or closing the door to the room. 10. If the resident is in bed, lock the bed wheels and then raise the bed to hip level. 11. Maintain safety during the procedure. If the resident is in a bed with side rails, raise and lock the rails on the opposite side of the bed from where you will be working. Lower the rail on the side you are working. 12. Wash your hands or use hand sanitizer to ensure infection control. 13. Put on disposable gloves. 14. Place a disposable probe cover over the red probe. Start the thermometer and wait until it shows it is ready. 15. Assist the resident into a side-lying or lateral position. Have the resident bend her upper leg up to her stomach as far as possible. Help, if needed. 16. If the resident is covered by a drape or top sheet, fold it back to expose the buttocks. Expose only the area necessary for the procedure. Keep the rest of the resident covered to protect her privacy. 17. Apply enough water-soluble lubricating gel (about the size of a quarter) for comfortable entry. Best Practice: To lubricate the end of the covered probe, you may put the gel directly on the probe or you may use tissue or toilet paper to apply the lubricant. 18. With one hand, gently raise the upper buttock to expose the anal area. 19. With the other hand, gently insert the rectal probe one inch or less into the anus. 20. Hold the probe in place until you hear or see the signal that the reading is complete. 21. Remove the thermometer and read the temperature on the display screen. 22. Dispose of the probe cover safely in a waste container or per facility policy. 23. Wipe the lubricant off the resident and discard the tissue or toilet paper. 24. Clean the probe with alcohol according to facility policy. Return the probe to its storage compartment on the thermometer. 25. Remove and discard your gloves and wash your hands or use hand sanitizer to ensure infection control. 26. Document the temperature on a pad, on a form, or in the electronic record. 27. If the resident is in bed, check to be sure the bed wheels are locked. Then reposition the resident and lower the bed. 28. Follow the plan of care to determine if the side rails should be raised or lowered. Copyright Goodheart-Willcox Co., Inc.