Axillary Temperature with Electronic Thermometer

Written by Hollie Finders, RN
Hollie Finders is a registered nurse with years of experience working in the health care field. She has degrees in both biochemistry and nursing. After working with patients of all ages, Hollie now specializes in pediatric intensive care nursing. Hollie’s LinkedIn

Procedure

Equipment needed: axillary thermometer, disposable probe cover, and gloves

Perform hand hygiene and put on gloves.
Explain the procedure to the patient and ask for his or her assistance in following directions.
Get the thermometer from its base unit and apply a disposable cover to the probe. Be sure the probe cover is secure and locked into place. If the thermometer has multiple modes, be sure to use axillary mode.
Expose the axilla (armpit) by moving the patient’s arm away from the torso.
Inspect the axilla for rashes and/or open sores. If present, stop and attempt to use the opposite axilla or choose another method for obtaining the patient’s temperature. Be sure to report the found skin issues to the nurse.
If needed, dry the axilla by wiping the area with a tissue.
Place the tip of the covered probe into the center of the axilla and return the arm to the patient’s side. Create a tight seal around the probe by folding the patient’s arm onto his or her chest.
Hold the probe in place until the thermometer signals completion (depending on the device, it may flash or beep). Read the temperature on the electronic display screen.
Gently lift the arm away from the body and remove the probe.
Eject the disposable probe cover into the waste bin and return the thermometer to its base unit.
Remove gloves and perform hand hygiene.
Record temperature, method used (axillary), date, and time in the patient’s chart.
Alert the medical professional of any changes in the patient’s condition.

Important Information

Compared to other temperature measurement methods, the axillary measurement is considered the least reliable. An axillary temperature measurement typically reads 0.5 to 1 degree Fahrenheit lower than an oral temperature reading [1]. For this reason, it is recommended to use this method only when other methods are contraindicated or when taking an axillary temperature is the safest method for the patient (e.g. unconscious, confused, uncooperative, and/or disoriented patients). If a patient has an injury to the arm or shoulder, has recently had chest or breast surgery, or has a rash or an open sore in the axilla, the unaffected side should be used to perform the temperature measurement.

References

1. https://www.ncbi.nlm.nih.gov/pubmed/11198790

More Resources

Passive Range of Motion Exercises

Range of motion exercises are used to help prevent or decrease contractures, improve flexibility of joints, and improve strength [1]. Bedridden patients as well as those with reduced mobility may greatly benefit from passive range of motion exercises. However, do not perform these exercises without an order to do so, as it may be contraindicated in certain situations.

Prone Position

Prone position is not used as commonly as other patient positions. This position allows for full extension of the hips and the knees and gives many bony prominences a break from continuous pressure. However, placing patients in prone position does not come without the risks of pressure ulcers.

Sim’s Position

The position a patient is placed in is often ordered by the physician, or recommended by a speech, occupational, or physical therapist. The position dictates whether a patient is sitting, lying, standing; or if they are on their side, back, or prone (face-down). Positioning is also determined by the patient’s current needs, such as: Are they eating? Sleeping? Having surgery on their back? Are they receiving nutrition through a nasogastric tube?

Supine Position

Supine position is a natural and comfortable position for most people. For this reason, it is a highly utilized position for nursing procedures. Unfortunately, this position puts pressure on many bony prominences that can lead to discomfort and/or pressure ulcers if the pressure is not relieved every so often (typically every two hours or less).

Transferring the Resident from a Bed with a Mechanical Lift

A mechanical lift is used to transfer residents who cannot support their own weight. When used properly, mechanical lifts prevent injuries for both residents and health care workers. It is important that a nurse’s assistant be trained to use the mechanical lift before attempting to operate it. Most facilities require at least two health care workers to assist when using a mechanical lift.

Offering the Bedpan

When a resident is bed-bound, they must use a bedpan to urinate and defecate. This can be embarrassing for the resident, so it should be done with sensitivity to the resident’s privacy and dignity. There are two types of bedpans. A regular bedpan is the deeper and more rounded of the two. A fracture pan has a relatively flat upper end with a trough at the lower end. Fracture pans are used for residents who have difficulty, or restrictions against, moving their hips and/or backs.