PROCEDURE. Taking a rectal temperature is an intrusive procedure representing an invasion of the child’s body; it may cause an increase in fear of body mutilation

Taking a rectal temperature is an intrusive procedure representing an invasion of the child’s body; it may cause an increase in fear of body mutilation, especially in toddlers and preschoolers. Take a rectal temperature only when necessary.

1. Select thermometer: glass with rectal bulb (usually red tipped) or electronic.

3. Provide privacy for a child.

4. Prepare a thermometer as in Oral Temperature, step 3 of Procedure.

5. Lubricate the tip of the thermometer with a water-soluble gel. It reduces friction and promotes ease of insertion, and minimizes irritation of mucus membranes in the anal canal.

6. Place tissues in easy reach to wipe anus after removal of thermometer.

7. Put on nonsterile gloves as it reduces transmission of microorganisms, and protects a nurse from contact with body fluids.

8. Position child so as to ensure visualization of anus.

a. Infant: prone position or supine, grasping ankles with one hand and elevating the legs.

b. Older child: on side with upper knee flexed. Flexing of the knee relaxes muscles and promotes ease of insertion.

9. Separate buttocks to expose anal opening and gently insert thermometer. Instruct older child to take a deep breath. Gentle insertion decreases discomfort and prevents trauma to mucous membranes. Taking a deep breath relaxes the anal sphincter. (Figure 3)

FIGURE 3 Infant position when taking a

rectal temperature

NOTE: If resistance is felt do not force. Remove thermometer and check temperature by another route.

a. Infant: insert 1/4 to 1/2 inch. Inserting more than ½ inch may cause rectal perforation.

b. Older child: insert 1–11/2 inches.

10. If electronic, turn on scanner and follow manufacturer’s instructions.

11. Leave thermometer in place required amount of time. Hold thermometer in place and do not leave the child alone to reduce the risk of injury.

a. Glass thermometer: 3–4 minutes as specified by agency policy, it allowing sufficient time for the thermometer to register results in a more accurate assessment of body temperature.

b. Electronic thermometer: will sound a tone or beep when finished.

12. Remove thermometer gently in a straight line.

13. Wipe anal area to remove any lubricant and/or fecal material.

14. Read temperature as in Oral Temperature.

15. Reposition child in a comfortable position.

16. Clean and store thermometer as in Oral Temperature.

NOTE: Need to remove gloves before washing hands.

Ex.3 Make up all kinds of questions (5-10) to the instruction given below: