Reflective Account 2 : Temperature measurement
Description
My mentor asked me to take the body temperature of a patient. The patient was a 32 years old female, Mrs W .
I confirmed to my mentor that I am confident to carry out the procedure. I started by introducing myself to the patient and asked for consent to carry out the procedure; Mrs W said that she is happy with the fact that I will take her body temperature as part of the routinel observations( Lefrant et al. 2003,cited in Dougherty & Lister 2015).
I washed my hands before I checked the equipment. I also made sure Mrs W is sitting comfortable; I asked and then checked if she was wearing hearing aids (– she was not wearing hearing aids . The patient was not lying on neither of the
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ears but standing in a vertical position while sitting in the chair (Bridges & Thomas 2009). The route to be used is by ear. I started by checking the mode from LCD display on the tympanic membrane thermometer and placed a disposable probe on the thermometer probe tip. I have gently inserted the probe tip in the ear canal until I nearly sealed the opening and pressed the scan button. After a few seconds the thermometer indicated the temperature reading by a beep signal and afterwards I removed the probe tip in order to record the reading of the temperature. Mrs W's temperature was 37.7°C . I recorded as appropriate to my mentor who supervised me throughout the procedure . Feelings Because I have performed this procedure before and I was confident to perform it again. I was anxious at the beginning because I was afraid of doing something wrong or missing one stage of the procedure. Afterwards I focused on what I was doing and at the end I realised I was prepared enough and there was no need for me to worry in the beginning. The patient was worried about her health condition so I reassured her everything was going fine throughout the procedure. Evaluation The body temperature procedure overall was performed in accordance to the standards, starting by introducing myself, asking for patient's consent and explaining the procedure(NMC 2015), as well as washing my hands for prevention and control of infection (Fraise & Bradley 2009, cited in Dougherty & Lister 2015) and checking the equipment if in working order followed by asking the patient if she was wearing hearing aids as part of the specific patient’s preparation. I also made sure that the probe fitted snugly within the ear canal in order to achieve an accurate reading of temperature(Covidien 2011, cited in Dougherty & Lister 2015) ; the result was recorded as per The Code (NMC 2015 ). I removed and discarded the probe cover, wiped the thermometer and washed hands to prevent cross-contamination (Fraise & Bradley 2009, cited in Dougherty & Lister 2015) .I forgot to check for cerumen, ear drainage, blood and to ask for any form of pain in the ear which could indicate an ear infection (Covidien 2011, cited in Dougherty & Lister 2015). I have not performed a reading from both ears as recent evidence showed that it is no difference if using a tympanic thermometer( Bridges & Thomas 2009). Analysis When a patient’s temperature is different then the normal range which is 36-37.5°C it is necessary to look for causes and factors that could influence the normal body temperature.
A higher value of the temperature indicates the presence of a cold or infection or that homoeostasis is not maintained.
Age is a factor that can influence the temperature as old people tend to have a lower body temperature due to being less active and due to the lack of the fat layer below the skin which makes it hard to indicate the presence of an infection ( Medline plus 2015 ). the body temperature is Also higher in the evening then in the morning (Marieb & Hoehn 2010, cited in Dougherty & Lister 2015). Another factor that can influence the body temperature is food consumption including coffee and alcohol or the amount of exercise done (Marieb & Hoehn 2010, cited in Dougherty & Lister 2015). The body surface that is exposed to the environment like cold or heat for example when having a shower or wearing inappropriate clothing ( Wilson's Temperature Syndrome 2016) .As a non-invasive method temperature measurement can be performed using different sites like oral, axillary and tympanic. The rectal has been demonstrated to be the more accurate one but due to his invasive nature and the fact that not only dignity but also privacy of the patients need to be considered , it is not always the first choice. Therefore, although the ear canal route does not provide the most accurate reading as the procedure might not be performed correctly , the tympanic thermometer tents to be preferred not only by the nurses but also by the patients as it is non-invasive, easy to use, safe (Haugan et al. 2013) and the disposable cover is used for prevention and control of infection( Dougherty & Lister
2015). As all these need to be taken into account when dealing with body temperature outside the normal range. Further investigations like urine or blood tests are recommended in order to link the body temperature with the real issue and avoiding assumptions. “ Gold standards” need to be followed when performing these procedures in order to avoid errors and false diagnostics. Conclusion After the procedure I talked with my mentor and she said that I have performed a good body temperature measurement but that it wassnoticeable that I was a little bit tense at the beginning but not any more starting with the middle of the procedure onwards. Action Plan My action Plan includes expanding my knowledge by reading more about the factors that could influence the body temperature and always review the “gold standard” as I have skipped a few steps when preparing the patient prior the procedure.
Temperature in most office rooms are kept within 69°F to 73°F which is far too cold for an acceptable sample. A sample with a temperature out of the normal range may be immediately received with suspicion because urine will hold temperature in this range as long as it is received in 4 minutes or less.
In this circumstance the nurse will perform a neurological assessment first and then a head to toe assessment. The nurse first of all needs to find a space that is private and comfortable before she undertakes the assessment. She needs to use therapeutic communication, build a rapport with Alice, and also have permission from Alice. The nurse needs to complete a number of individual assessments in order to see the function of Alice’s nervous system. Before the nurse can begin she needs to wash her hands and make sure that they are warm before touching Alice.
Moreover, I will let the patient become familiar with any instruments such as a speculum, and demonstrate the tools that will be used to obtain tissue samples that would be used during the examination. Explaining the procedure is also a significant step; this will allow the patient have a sense of control during the examination as we ask and answer questions about their current state, that would help disseminate any concern they may have. Meanwhile, they can learn about what may happen, related to any body sensations or feelings they can experience during the procedure, all while the provider continues to develop rapport and patient’s trust
The thermometer’s original temperature before coming in contact with an outside object is represented by T. ∆T/∆t is the average temperature of the digital thermometer. represents the temperature of the heat flowing object. In this lab, the temperature of the air is represented by Tair=T. To= Thand is the temperature of the hand.
clear understanding of the procedure and the issue science vs ethics. She points out the role
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