Nursing & Healthcare Programs

Rectal 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: rectal thermometer, disposable probe cover, lubricant, tissue, and gloves

  1. Perform hand hygiene and put on gloves.
  2. Explain the procedure to the patient and ask for their assistance in following directions.
  3. Raise the side rail on the patient’s left side for safety. If the bed can be raised, adjust it to a comfortable working height.
  4. Assist the patient into Sims’ position (left side lying).
  5. Adjust the linens to expose only the buttocks.
  6. Apply a disposable cover to the temperature probe. Be sure the probe cover is secure and locked into place.
  7. Apply an adequate amount of lubricant to the probe cover. Ensure the tip and 1-2 inches of the probe is lubricated.
  8. Using one hand, separate the buttocks to expose the anus.
  9. With the other hand, insert the lubricated probe 1-1.5 inches into the rectum in the direction of the umbilicus. If there is any resistance, stop the procedure immediately, withdraw the probe carefully, and notify the medical professional. Do not force the probe into the rectum.
  10. 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.
  11. Gently remove the probe and eject the disposable probe cover into the waste bin.
  12. Use a tissue to wipe away any excess lubricant or feces found around the patient’s anus. Dispose of the tissue in the proper waste receptacle.
  13. Assist the patient back into a comfortable position and, if raised, return the bed to the lowest setting.
  14. Return the thermometer to its base unit.
  15. Remove gloves and perform hand hygiene.
  16. Record temperature, method used (rectal), date, and time in the patient’s chart.
  17. Alert the medical professional of any changes in the patient’s condition.

Important Information

A rectal temperature provides the most accurate core body temperature reading compared to other non-invasive methods [1]. This makes a rectal temperature desirable; however, this procedure comes with more patient discomfort and more safety risks (bowel perforation, mucosal damage, and/or vagus nerve stimulation) than the other temperature measurement methods [2]. In order to avoid these risks, the nurse’s assistant must communicate with the patient throughout the procedure, encouraging him or her to relax, take deep breaths, and remain still.

Prior to performing a rectal temperature, the nurse’s assistant should verify with the nurse that the patient does not have any of the following contraindications: diarrhea, hemorrhoids, rectal bleeding, rectal disease, recent rectal surgery, bleeding tendencies, neutropenia, or certain heart conditions [3].

References

1. https://www.ncbi.nlm.nih.gov/pubmed/7663592

2. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3440892

3. https://www.guideline.gov/summaries/summary/36842L

More Resources

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).

Removing Personal Protective Equipment

It is important to follow the correct procedure while removing personal protective equipment to avoid contaminating your skin or clothing. The most common source of contamination in this process stems from improper removal of gloves. Gloves are often the most soiled piece of equipment. To avoid contaminating your skin or the other equipment worn, gloves should always be removed first. Then remove the goggles, gown, and mask, in that order.

Nail Care (Fingers and Toes) for CNAs

Nail care of both the feet and the hands should be performed as part of the patient’s daily hygiene routine. The status of the patient’s nails can reflect their overall health. Nail issues can also lead to infection that can spread systemically (ex, ingrown nails or fungus). You should never clip a patient’s nails with nail clippers, and always review your institution’s policy about what nail care is allowed.

Logrolling the Resident

Logrolling is a technique used to roll a resident onto their side without the resident helping, and while keeping the resident’s spine in a straight line. This is especially important for residents who have had spinal surgery or injury.

Performing the Heimlich Maneuver

The Heimlich Maneuver, also known as abdominal thrusts, is used to remove an object that is blocking a resident’s airway and preventing air from reaching the lungs. It only takes four to six minutes for brain damage to occur from lack of oxygen, so prompt action is vital.

Assisting the Resident to Transfer from the Bed to a Chair or Wheelchair

It is important to remember on which side to place the chair when assisting a patient in transferring. Putting the chair on the resident’s unaffected side allows the resident to lead with his or her strong extremity. This eases the procedure for the resident and reduces the risk of falling.