By:

Dr.Yosreah Mohamed

Lecturer of Medical –Surgical Nursing Department Part (I(

Definition of body temperature

Body temperature is the balance between the heat produced by the body and the heat lost from the body.

The measuring unit of body temperature

Normal range of body temperature is

36 Co → 37.4 Co “oral”.

Body temperature measured in units called “degrees”. It may be Fahrenheit or Centigrade.

Kinds of body temperature

1-Core temperature: Is the temperature of the

deep tissues such as thorax, abdominal cavity,…………… it remains relatively constant, about 37Co.

.

Kinds of body temperature

2-Surface temperature: Is the temperature of the

skin, and the subcutaneous tissues and fats; it rises and falls in response to the environment

Heat Production Factors that affect the body’s

heat production are :1. Basal metabolic rate “BMR” 2. Muscular activity3. Epinephrine, Nor epinephrine,

and sympathetic stimulation4. Thyroxin output5. Fever

Heat loss1. Radiation2. Conduction3. Convection4. Vaporization

RadiationRadiation

ConductionConduction

Convection

Regulation of body

temperature

A. Physiological A. Physiological controlcontrol

B. Behavioral B. Behavioral controlcontrol

Factors affecting body temperature1. Age 2. Emotional states 3. Exercise 4. Hormonal influences 5. Diurnal variations6. Environment7. Ingestion of hot/cold liquids8. Smoking

Alterations in body temperature

FeverDefinition A body temperature above the

normal range is called pyrexia, hyperthermia, or fever.

A very high fever, such as 41 Cº is called hyperpyrexia.

Fever is usually caused by pyrogens such as bacteria.

Types of fever

1. Low grade fever : 37.5 CCoo – 38CCoo

2. Pyrexia : 38.1CCoo – 41CCoo

3. Hyperpyrexia : above 41CCoo

Body temperature above Body temperature above 4343CCoo is fatal. is fatal.

Clinical signs of fever

Onset (cold or chill stage(:1. Increased heart rate. 2. Increased respiratory

rate. 3. Shivering. 4. Pall, cold skin .

Onset (cold or chill stage(:

5. Complaints of feeling cold.

6. Cyanotic nail beds . 7. Rise in body

temperature.

Clinical signs of fever Course of fever Absence of chills. Warm Skin. Feelings of being neither hot nor cold. Increased pulse and respiratory rates. Increased thirst.

Course of fever

Mild to severe dehydration. Simple drowsiness, restlessness, and convulsions Herpetic lesions of the mouth. Loss of appetite .Malaise, weakness, and aching muscles.

Defervescence (fever abatement (

Skin flushed Feels warm. Sweating. Decreased shivering. Possible dehydration.

Nursing interventions for clients with fever

Monitor vital signs. Assess skin color and temperature.Monitor white blood cell count, Remove excess blankets when the client feels warm, but provide extra warmth when the client feels chilled.

Nursing interventions for clients with fever

Provide adequate food and fluids (e.g., 2500-3000mL per day) Measure intake and output. Maintain prescribed intravenous fluids. Reduce physical activity to limit heat production,

Nursing interventions for clients with fever

Administer antipyretics as ordered. Provide oral hygiene to keep the mucous membrane moist. Provide a tepid sponge bath Provide dry clothing and bed linens

Heat strokeDefinition:It is a dangerous heat emergency which occur due to prolonged exposure to the sun or high environmental temperature, this can depress the hypothalamic function.

Signs and symptoms of heat stroke

Confusion,. Excess thirst. Nausea. Muscle cramps. Visual disturbances. Hot, dry skin. Incontinence may occur.

First aid for victims with heat stroke

Moving the client to a cooler environment. Reducing the clothing.Placing wet towels over the skin. Using oscillating fans to increase heat loss.

HypothermiaDefinition:Decrease body temperature

below the normal range, this condition occur when the

body exposed to cold, which usually develop gradually. (core body temperature less than [35]. C Coo

Types of hypothermia

1.Mild hypothermia:34- 35Co

2.Moderate hypothermia:30-33.8Co

3.Sever hypothermia:>30Co

Signs and symptoms of hypothermia

Uncontrolled shivering. Depression and poor judgment. Cold, pale skin. Decreased heart rate and

respiration. Cyanotic skin. If the hypothermia progress,

cardiac dysrhythmias, loss of consciousness and become unresponsive to painful stimuli.

First aid for patients with hypothermia

If the patient is wet, remove the wet cloths and replace them with dry ones.

Warp the client in blankets. Give him hot fluids to drink. Place the client near a fire or in a

warm room. Place heating pads next to area of the

body.

Assessment of body temperature

SitesThe sites used for taking temperature should be :Closed to prevent air currents.

Have abundant blood supply.

Sites for measuring body

temp1-Oral temperature2-Rectal temperature** Rectal=-0.5 Co

3-Axillary temperature **Axillary= +0.5 Co

4-Aural temperature

Types of thermometers

1- Electronic thermometer

Types of thermometers 2.Mercury Glass thermometer

Types of thermometers3. Tympanic membrane thermometer

Types of thermometers

44--Chemical Chemical thermometerthermometer

Contraindications for use of the four sites of temperature

measurement Oral site: Children under 6 years. Confused or convulsive clients. Drinking or eating very hot or cold fluid or food “for 15 minutes”.

Patients with oral or nasal surgery.

Rectal site Rectal surgery: or inflammations.

Constipation: or diarrhea. In newborns and infants “it may cause ulcerations and rectal perfusions”.

Axillary site

Surgery or inflammation in the axilla.

Injury or fracture to the chest or the arm.

Tympanic membrane “aural site”

Ear and tympanic membrane inflammation or surgery.