2-17. WHEN SHOULD I TAKE AN ORAL TEMPERATURE?

a. When an Oral Temperature Should Be Taken. When you are told to take a patient's temperature (either through spoken orders or through written orders), you will normally take the patient's oral temperature. Take the patient's temperature by the oral route if the following are met.

(1) The physician or nurse did not order that the temperature was to be taken by another method (that is, did not specify rectal temperature or axillary temperature).

(2) The patient is conscious and can follow directions, especially the direction "don't bite down."

(a) If a patient "bites down" on a glass thermometer, he could break the thermometer. A broken glass thermometer could cut the patient's mouth and lips. In addition, he could swallow broken glass and mercury.

(b) If a patient "bites down" on an electric thermometer probe, he could damage the probe, and he could be injured by the damaged probe.

(3) Make sure the patient can breath through his nose. (The patient must be able to breathe through his nose, since he must keep his mouth closed while the oral temperature is being taken.)

(4) There is no condition present to which make it undesirable to take the patient's temperature orally (see paragraph b).

b. When an Oral Temperature Should Not Be Taken. There are conditions, which indicate when an oral temperature should not be taken. (Conditions which indicate that a certain procedure or treatment should not be performed are called contraindications.) Do not measure the patient's temperature orally if one or more of the following contraindications are present.

(1) The patient has recently had facial or oral surgery. (The patient may not be able to adequately control his bite.)

(2) The patient is a child under 5 years of age. (An infant or very young child should not be expected

 to follow a "don't bite down" order.)

(3) The patient is confused, disturbed, heavily sedated, or has some condition (coughing, shaking chills, etc.) that makes it likely he might bite down on the thermometer.

(4) The patient is being administered oxygen by mouth or by nose.

(5) The patient has smoked, eaten hot or cold food, drank hot or cold beverage, or chewed gum within the last 30 minutes. (Hot smoke, hot foods, hot drinks, and vigorous chewing will probably result in an oral temperature reading that is higher than the actual oral temperature. Cold foods and cold drinks will probably cause the oral temperature reading to be lower than the actual oral temperature.)