VITAL SIGNS (TEMPERATURE)

VITAL SIGNS
(TEMPERATURE)
By: ROMMEL LUIS C. ISRAEL III

VITAL SIGNS
• Vital signs are measurements of the body's most
basic functions.
• Vital signs are useful in detecting or monitoring medical
problems.
• Vital signs can be measured in a medical setting, at
home, at the site of a medical emergency, or
elsewhere.
Reference:
Johns Hopkins Medicine. (2019). Vital signs (body temperature, pulse rate, respiration rate, blood pressure). Johns Hopkins Medicine
Health Library. https://www.hopkinsmedicine.org/health/conditions-and-diseases/vital-signs-body-temperature-pulse-rate-respiration-rate-
blood-pressure

VITAL SIGNS
• Vital signs are important for the early diagnosis of
disorders and diseases
• Vitals are also used to determine the correct medication
and dosage for each patient.
• Vitals are also taken after specific procedures, to check for disorders
like heart disease and when the individual is taking medication.
• Every time the patient visits the doctor, vital signs are taken to
reveal any trends in the health of the patient.
Reference:
What are the 6 Vital Signs? A Medical Assisting Guide – Gwinnett Colleges and Institute. (n.d.). https://www.gwinnettcollege.edu/what-
are-the-6-vital-signs-a-medical-assisting-guide/

VITAL SIGNS
There are six main vital signs that healthcare professionals routinely
monitor. These include;
• Temperature
• Pulse
• Respirations
• Blood pressure
• Pain
• Oxygen saturation
Reference:
naureen. (2021, October 29). Vital Signs Assessment | NurseBrain®. https://nursebrain.com/2021/10/vital-signs-assessment/

VITAL SIGNS
Mnemonic to remember :
TPRBP-Ox
Reference:

VITAL SIGNS
Normal vital signs change with :
• age
• sex
• Weight
• exercise capability, and
• overall health.
Reference:
Vital signs: MedlinePlus Medical Encyclopedia. (n.d.). Medlineplus.gov.
https://medlineplus.gov/ency/article/002341.htm#:~:text=Normal%20vital%20signs%20change%20with%20age%2C%20sex%2C%20weig
ht%2C

WHY DO WE ASSESS THE VITAL SIGNS?
Vital signs assessment helps in
disease prevention and early
intervention.
Reference:

• Vital signs give you a baseline when a patient is
healthy to compare to the patient’s condition when
they aren’t healthy.
• Abnormalities in vitals can also be a clue to illness or
disease that can be hurting the organ systems in the
patient’s body.
Reference:
Meridian College (2018). The Importance of Taking Vital Signs: A Medical Assisting Guide - Meridian College. [online] Meridian College.
Available at: https://www.meridian.edu/importance-taking-vital-signs-medical-assisting-guide/.

Measuring vital signs is important:
•This information shows healthcare practitioners how the
body is functioning and alert to possible medical
conditions, many of which are present without signs or
symptoms.
Reference:
How to Take Vital Signs – Step-by-Step Manual Instructions. (n.d.). USA Medical and Surgical Supplies. Retrieved January 22, 2023,
from https://www.usamedicalsurgical.com/blog/how-to-take-vital-signs-step-by-step-manual-
instructions#:~:text=Vital%20signs%20serve%20as%20a%20communicator%20of%20patient

BODY TEMPERATURE
Temperature [tem´per-ah-chur]
• The degree of sensible heat or cold
Reference:
temperature, body. (2023). TheFreeDictionary.com. https://medical-dictionary.thefreedictionary.com/temperature%2c+body

BODY TEMPERATURE
• It is measured by a clinical thermometer
placed in the mouth, the rectum, or the auditory
canal (for tympanic membrane temperature).
•It represents a balance between the heat
produced by the body and the heat it loses.
Reference:

BODY TEMPERATURE
• Heat production and heat loss vary with
circumstances, the body regulates them,
keeping a remarkably constant temperature.
• Measured by heat units called DEGREES
• An abnormal rise in body temperature is
called FEVER
Reference:

FEBRILE - with fever
AFEBRILE - no fever

BODY TEMPERATURE
HYPOTHALAMUS
• a region of the forebrain below the thalamus
• coordinates both the autonomic nervous system and the
activity of the pituitary, controlling body temperature,
thirst, hunger, and other homeostatic systems, and
involved in sleep and emotional activity.
Reference:
HYPOTHALAMUS - Google Search. (n.d.). Www.google.com. Retrieved January 22, 2023, from
https://www.google.com/search?q=HYPOTHALAMUS&oq=HYPOTHALAMUS&aqs=chrome..69i57j46i131i199i433i465i512j0i512j46i131
i199i433i465j0i433i512j46i131i199i433i465i512j0i433i512j0i512j46i131i433i512j0i271.2771j0j9&sourceid=chrome&ie=UTF-8

BODY TEMPERATURE
• Body temperature is adjusted by a section of the brain called the
hypothalamus.
• If there is a virus within the body, a signal is sent to this part of the
brain by the immune system to increase the temperature of the
body so the infection can be weakened.
• When the body is fighting a virus, the early signs include
clamminess and sweating. Monitoring the body temperature
enables preventative measures to be taken to detect and prevent
any potentially serious issues from spreading.
Reference:
What are the 6 Vital Signs? A Medical Assisting Guide – Gwinnett Colleges and Institute. (n.d.). https://www.gwinnettcollege.edu/what-
are-the-6-vital-signs-a-medical-assisting-guide/

BODY TEMPERATURE
HYPOTHALAMUS
• When you get too cold, it signals your body to
preserve heat by shrinking your blood vessels, and
to produce heat by shivering.
• When you get too hot, it signals your body to make
sweat to cool off.
Reference:
Cleveland Clinic. (2020, March 31). Body Temperature: What Is (and Isn’t) Normal? Health Essentials from Cleveland Clinic.
https://health.clevelandclinic.org/body-temperature-what-is-and-isnt-normal/

CORE BODY TEMPERATURE
It is the temperature of the deep
tissues of the body, such as the
cranium, thorax, abdominal cavity,
and pelvic cavity.

• The normal core body temperature range can vary
from individual to individual, and can also be influenced
by age, activity, and time of day: 36.1 C (97 F) to 37.2
C (99 F).
• During strenuous exercise, the temperature can rise
temporarily to as high as 40 C (104 F).
Reference:
Yousef, H., Ramezanpour Ahangar, E., & Varacallo, M. (2020). Physiology, Thermal Regulation. PubMed; StatPearls Publishing.
https://www.ncbi.nlm.nih.gov/books/NBK499843/#:~:text=The%20normal%20core%20body%20temperature

• When the body becomes exposed to extreme cold, the
temperature can fall below 35.6 C (98 F).
• An unclothed person can be exposed to temperatures
as low as 12.8 C (55 F) or as high as 54.4 C (130 F) in
dry air and still maintain almost constant core
temperature.
Reference:

• The circadian rhythm (the physical, mental, and
behavioral changes that follow a 24-hour cycle. These
natural processes respond primarily to light and dark.
Example of a light-related circadian rhythm is sleeping at
night and being awake during the day.), age, activity
levels, illness, pregnancy and hormonal contraceptives
can all affect our core temperature.
Reference:
Codingest. (n.d.). Body Temperature and How It Differs for Men and Women. Healthylife.
https://www.simplysupplements.co.uk/healthylife/general-health/body-temperature-how-it-differs-for-men-and-women

•An accurate measurement is usually
done using a pulmonary catheter
Reference:

BODY TEMPERATURE
DIFFERENCES BETWEEN MEN AND WOMEN:
• Several studies have found that women's hand temperatures tend to
be lower than men’s.
• One study published in The Lancet medical journal found that on
average women's hands were 2.8C lower than men’s.
• But why? It is thought that the basic physiological differences such as
size, weight and bodily proportions affect the ability of men and
women to conserve heat.
Reference:

BODY TEMPERATURE
DIFFERENCES BETWEEN MEN AND WOMEN:
• Women are typically smaller and have a higher ratio of
surface area to volume, which causes a rapid loss of
heat.
• Men tend to have a greater muscle mass than women
which helps them to generate heat.
Reference:

SURFACE BODY TEMPERATURE
Skin Temperature (Surface
Temperature)
•In contrast to the core temperature, the skin
temperature (shell), falls and rises with the
temperature of the surroundings.
Reference:

FACTORS THAT AFFECT
HEAT PRODUCTION

BASAL METABOLIC RATE
• The number of calories required to keep your body
functioning at rest, also known as your metabolism.
• These basal functions include circulation, breathing,
cell production, nutrient processing, protein synthesis,
and ion transport.
• In general, the younger the person, the higher the
BMR.

SIGNS OF FAST METABOLISM:
• You have difficulty gaining weight or keeping
weight on, even though you eat regularly.
• You have a high body temperature, even when
you are resting.
• You are often hungry or have an insatiable
appetite, even after eating meals or snacks..
Reference:
Start tracking your period, ovulation and pregnancy with Flo! (2019). Flo.health - #1 Mobile Product for Women’s Health.
https://flo.health/menstrual-cycle/lifestyle/diet-and-nutrition/facts-about-high-metabolism

SIGNS OF FAST METABOLISM:
•You have an irregular menstrual cycle or you
miss your period even though you aren’t
pregnant.
•You may need to urinate frequently because
your body’s processing speed is increased.
Reference:
Start tracking your period, ovulation and pregnancy with Flo! (2019). Flo.health - #1 Mobile Product for Women’s Health.
https://flo.health/menstrual-cycle/lifestyle/diet-and-nutrition/facts-about-high-metabolism

MUSCLE ACTIVITY
•Shivering
•Walking
•Running
•Exercise
•Etc.

THYROXINE OUTPUT
Thyroid hormone is the hormone that controls
your body’s metabolism, the process in which
your body transforms the food you eat into
energy. The two main hormones your thyroid
releases — thyroxine (T4) and
triiodothyronine (T3) — collectively make up
thyroid hormone.
Reference:
Cleveland Clinic (2022). Thyroid Hormone: What It Is & Function. [online] Cleveland Clinic. Available at:
https://my.clevelandclinic.org/health/articles/22391-thyroid-hormone.

THYROXINE OUTPUT
Increase in thyroxine hormone increases
the rate of cellular metabolism throughout
the body. This is called Chemical
thermogenesis, the stimulation of heat
production in the body through increase
cellular metabolism.

SYMPATHETIC STIMULATION
The sympathetic nervous system is best
known for its role in responding to dangerous
or stressful situations. In these situations, the
sympathetic nervous system activates to speed
up the heart rate, deliver more blood to areas
of the body that need more oxygen or other
responses to help get out of danger.
Reference:
Sympathetic Nervous System (SNS): What It Is & Function. (2022, June 6). Cleveland Clinic.
https://my.clevelandclinic.org/health/body/23262-sympathetic-nervous-system-sns-fight-or-
flight#:~:text=Your%20sympathetic%20nervous%20system%20is%20best%20known%20for%20its%20role

SYMPATHETIC STIMULATION
Sympathetic nervous system uses chemicals called
neurotransmitters to communicate. Specifically,
these chemicals are norepinephrine, epinephrine
and acetylcholine.
The release of these increases cellular metabolism
too.
Reference:
Sympathetic Nervous System (SNS): What It Is & Function. (2022, June 6). Cleveland Clinic.
https://my.clevelandclinic.org/health/body/23262-sympathetic-nervous-system-sns-fight-or-
flight#:~:text=Your%20sympathetic%20nervous%20system%20is%20best%20known%20for%20its%20role

EVAPORATION
• Evaporation of water from your skin if it is wet
(sweating).
• If your clothing is wet, you will also lose some
body heat through evaporation
• Through respiration (breathing)
• During intense exercise, the body loses 85% of its
heat through sweating.
Reference:
myhealth.alberta.ca. (n.d.). Cold Exposure: Ways the Body Loses Heat. [online] Available at:
https://myhealth.alberta.ca/Health/pages/conditions.aspx?hwid=tw9037.

RADIATION
• Radiation (similar to heat leaving a wood stove).
• This normal process of heat moving away from
the body usually occurs in air temperatures lower
than 20°C (68°F).
• The body loses 65% of its heat through radiation.
Reference:

CONDUCTION
• Conduction (such as heat loss from sleeping on the cold
ground).
• Heat is lost in air temperatures lower than 20°C (68°F).
• The body loses about 2% of its heat through air conduction.
• However, water causes more heat loss from the body than
air does, so heat can be lost from the body very quickly
when it is placed in cold water.
Reference:

CONVECTION
•Convection (similar to sitting in front of a
fan or having the wind blow on you).
•The body loses 10% to 15% of its heat
through convection
Reference:

HEAT LOSS
•Heat loss through evaporation and
respiration increases in dry, windy weather
conditions.
•Wet clothing greatly increases heat loss
through conduction and evaporation.
Reference:

HEAT LOSS
• Heat loss in cold, wet weather increases the risk
for hypothermia and cold injury.
• Heat loss can occur in warm temperatures
through conduction.
• Swimming or sitting in cool or cold water can
cause the body to lose heat very quickly and
increase the risk for hypothermia.
Reference:

HEAT LOSS
•Hypothermia can occur quickly (within a
few hours) or gradually over days and
weeks depending on a person's age,
overall health, and environmental
conditions.
Reference:

FACTORS THAT
INFLUENCE BODY
TEMPERATURE

AGE
•Children tend to have very high metabolic
rates, i.e their bodies convert food to
energy at a much higher rate, on average,
compared to adults. This also translates
to kids, on average, having a higher
baseline body temperature, than adults.
Reference:
Finanger, R. (2019, November 26). 8 Factors that influence your body temperature - ONiO. Www.onio.com.
https://www.onio.com/article/factors-that-influence-your-body-temperature.html

AGE
• Older people, especially those older than 65, have
lower baseline temperatures than their younger
counterparts.
• In addition to having a lower baseline, older
people also have more muted immune responses,
all of which makes it very challenging to detect
infections.
Reference:

AGE
• That’s why continuous fever monitoring could be
crucial in geriatric care.
• Because they have lower baseline temperatures, using
standard benchmarks to detect fevers are bound to
fail.
• So, it is all the more important that a unique,
individualised baseline is established, against which
spikes can be caught more readily
Reference:

SEX
•Women, on average, tended to have a
slightly lower body temperature than
men.
•Woman’s body temperature is higher
during ovulation and pregnancy, and
lower at the start of the menstrual cycle.
Reference:

TIME OF THE DAY (DIURNAL VARIATION)
• Circadian Rhythm
• Body temperature is usually at its lowest early in
the morning and slowly climbs up after a person
wakes up, reaching its peak late in the afternoon.
• This variation corresponds to the level of
metabolic activity, which is lowest during sleep
and slowly climbs up as the day progresses.
Reference:

EXERCISE OR PHYSICAL EXERTION
• During strenuous physical activity, the muscles
generate a tremendous amount of heat, which
results in an increase in your body temperature.
• The body tries to dissipate the excess heat in
order to restore the body to a normothermic
state.
Reference:

•Training in hot/humid conditions makes it
harder for the body to keep its core
temperature within the normal range.
•This paves the way for dehydration
and/or heat illness, which is extremely
dangerous.
Reference:

• The more your body is conditioned to a certain
level of physical activity, the better it is at being
able to dissipate heat.
• So, the key takeaways from this should be to be
patient and take your time with conditioning
your body and to hydrate adequately before
intense workouts.
Reference:

STRESS
STRESS HORMONES: CORTISOL
• Cortisol is a steroid hormone that your adrenal glands, the
endocrine glands on top of your kidneys, produce and
release.
• Cortisol is a hormone that coordinate different functions in
the body by carrying messages through the blood to the
organs, skin, muscles and other tissues. These signals tell
the body what to do and when to do it.
Reference:
Cleveland Clinic. (2021, December 10). Cortisol: What It Is, Function, Symptoms & Levels. Cleveland Clinic; Cleveland Clinic.
https://my.clevelandclinic.org/health/articles/22187-cortisol

STRESS
STRESS HORMONES: ADRENALINE
• Epinephrine, also called adrenaline, is both a hormone and a
neurotransmitter.
• As a hormone, it’s made and released by the adrenal glands, which are hat-
shaped glands that sit on top of each kidney.
• As a central nervous system neurotransmitter, it’s a chemical messenger
that helps transmit nerve signals across nerve endings to another nerve cell,
muscle cell or gland cell.
•
Reference:
Cleveland Clinic. (2022, March 27). Epinephrine (Adrenaline): What It Is, Function, Deficiency & Side Effects. Cleveland Clinic.
https://my.clevelandclinic.org/health/articles/22611-epinephrine-adrenaline

STRESS
STRESS HORMONES: ADRENALINE
• Epinephrine is part of the sympathetic nervous system, which is part of the body’s
emergency response system to danger — the “fight-or-flight” response. Medically,
the flight-or-flight response is known as the acute stress response.
• Epinephrine is also called a catecholamine, as are norepinephrine and dopamine.
They’re given this name because of a certain molecule in its structure. As a
hormone, epinephrine is made from norepinephrine inside of the adrenal gland.
Reference:
Cleveland Clinic. (2022, March 27). Epinephrine (Adrenaline): What It Is, Function, Deficiency & Side Effects. Cleveland Clinic.
https://my.clevelandclinic.org/health/articles/22611-epinephrine-adrenaline

STRESS
• Body temperature increases in response to stressful
situations.
• This increase in temperature is an adaptive response of the
body to deal with perceived threats.
• Adrenaline, which mediates the body’s “fight or flight”
response, stimulates increased heat production in the liver, in
addition to driving other adaptive changes. The liver being
one of the body’s largest and most metabolically active organs,
has a notable impact on body temperature.
Reference:

STRESS
Stress causes PSYCHOGENIC FEVER:
• It refers to a rise in the body’s core temperature (Tc) in
response to an intensely stressful situation or a
persistent elevation in the core temperature, due to
chronically high stress levels.
• It is a psychosomatic disease, which means that it
occurs in the absence of any organic cause (i.e. a
bacterial or viral infection.)
Reference:
Can stress cause fever? | ONiO. (n.d.). Www.onio.com. Retrieved January 22, 2023, from https://www.onio.com/article/can-stress-cause-
fever.html

MEALS
• There is usually a slight increase in body
temperature shortly after a meal.
• There is a small increase in the temperature, 20-30
minutes after eating.
• This reflects an increase in the metabolic rate, to
facilitate digestion.
Reference:
Finanger, R. (2019). 8 Factors that influence your body temperature - ONiO. [online] www.onio.com. Available at:
https://www.onio.com/article/factors-that-influence-your-body-temperature.html.

DRUGS AND SMOKING
• Many pharmaceutical drugs, including several classes of
antibiotics (cephalosporins, penicillins etc), methyldopa,
phenytoin, among others, are known to cause an increase in
body temperature.
• Additionally, many commonly used recreational substances
such as MDMA (Ecstasy or Molly) and cocaine also cause body
temperature to rise.
• Smoking cigarettes has also been known to cause spikes in
body temperature.
Reference:

SITE OF MEASUREMENT
• Body temperature readings vary depending on the
site of measurement.
• As a rule, an axillary temperature is usually 0.3°C -
0.6 °C [0.5°F-1°F] lower than an oral temperature
and a rectal reading is 0.3°C-0.6°C [0.5°F -1°F]
higher than an orally measured reading.
Reference:

SITE OF MEASUREMENT
• Invasive methods are required to obtain an exact
measurement of the body’s core temperature.
• In many cases, it doesn’t make sense to opt for invasive
methods, despite their reliability and accuracy.
• Rectal readings have been considered a happy middle ground
between accuracy and convenience. but in recent years, rectal
measurement of temperature has increasingly gone out of
favour because of patient reluctance and concerns that it
spreads infections.
Reference:

REMEMBER:
REGULATION OF BODY TEMPERATURE:
Sensors in periphery and core. Most sensors
are in the skin
Integrator in hypothalamus
Effector system adjusting heat
production/loss

REMEMBER:
PROCESSES TO INCREASE BODY
TEMPERATURE:
Shivering
Sweating
Vasoconstriction

ALTERATIONS IN
BODY
TEMPERATURE

PYREXIA/HYPERTHERMIA
• Pyrexia – body temperature above normal
• Hyperthermia or commonly known as fever is present when the
body temperature is higher than 37ᴼC which can be measured
orally, but 37.7ᴼC if measured per rectum.
• In some events such as the covid-19 pandemic, acquiring
contactless temperature is advised using infrared temperature
taking devices such as Thermoscan or Thermoflash.
Reference:
RNspeak. (2017, December 28). Fever (Hyperthermia) Nursing Care Plan, Drugs, Diagnosis, Interventions. Nursing Journal - RNspeak.
https://rnspeak.com/fever-hyperthermia-nursing-care-plan/

HYPERPYREXIA
• Hyperpyrexia is a condition where the body temperature goes
above 106.7 degrees Fahrenheit (41.5 degrees Celsius) due to
changes in the hypothalamus.
• Hyperpyrexia is a life-threatening emergency that demands
urgent medical attention. Without prompt proper treatment,
hyperpyrexia can lead to long-term complications and death.
Reference:
What Is Hyperpyrexia? (n.d.). WebMD. https://www.webmd.com/a-to-z-guides/what-is-
hyperpyrexia#:~:text=%E2%80%8CHyperpyrexia%20is%20a%20condition%20where

HEAT CRAMPS
• Heat cramps are painful, involuntary muscle spasms that
usually occur during heavy exercise in hot environments.
• The spasms may be more intense and more prolonged than
are typical nighttime leg cramps.
• Fluid and electrolyte loss often contribute to heat cramps.
Reference:
Mayo Clinic. (2020). Heat cramps: First aid. [online] Available at: https://www.mayoclinic.org/first-aid/first-aid-heat-cramps/basics/art-
20056669#:~:text=Heat%20cramps%20are%20painful%2C%20involuntary.

HEAT EXHAUSTION
• Heat exhaustion is a condition whose symptoms may include heavy sweating
and a rapid pulse, a result of your body overheating. It's one of three heat-
related syndromes, with heat cramps being the mildest and heatstroke being
the most severe.
• Causes of heat exhaustion include exposure to high temperatures,
particularly when combined with high humidity, and strenuous physical
activity. Without prompt treatment, heat exhaustion can lead to heatstroke,
a life-threatening condition. Fortunately, heat exhaustion is preventable.
Reference:
Mayo Clinic. (2017). Heat exhaustion - Symptoms and causes. Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/heat-
exhaustion/symptoms-causes/syc-20373250

HEAT STROKE
• Heatstroke is a condition caused by the body overheating, usually as a
result of prolonged exposure to or physical exertion in high
temperatures.
• It can occur if your body temperature rises to 104 F (40 C) or higher.
The condition is most common in the summer months.
• Heatstroke requires emergency treatment. Untreated heatstroke can
quickly damage your brain, heart, kidneys and muscles. The damage
worsens the longer treatment is delayed, increasing your risk of
serious complications or death.
Reference:
Mayo Clinic. (2017). Heatstroke - Symptoms and causes. Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/heat-
stroke/symptoms-causes/syc-20353581

FEVER VS. HYPERTHERMIA
• Fever is a voluntary, adaptive response of the body’s
immune system against physiological stress and it typically
results from an illness or infection.
• When a pathogen enters the body, the hypothalamus signals
the body to generate more heat to make the core
environment uninhabitable for the foreign invader.
Reference:
eMediHealth. (2020). Fever: Stages, Causes, Symptoms, & Medical Treatment. [online] Available at:
https://www.emedihealth.com/respiratory-health/cough-cold-flu/fever-causes#different_stages_of_fever.

• Hyperthermia, on the other hand, is a sudden involuntary
rise in body temperature without any involvement of the
hypothalamus.
• This condition results when the body’s ability to lose excess
heat becomes impaired.
Reference:

• Fever serves to protect and not harm your
body, whereas hyperthermia is regarded as a
dangerous side effect of thermoregulatory
dysfunction that can pose a serious threat to
the body.
Reference:

HYPOTHERMIA (HI-POE-THUR-ME-UH)
• Hypothermia is a medical emergency that occurs when your
body loses heat faster than it can produce heat, causing a
dangerously low body temperature. Normal body
temperature is around 98.6 F (37 C). Hypothermia (hi-poe-
THUR-me-uh) occurs as your body temperature falls below
95 F (35 C).
Reference:
Mayo Clinic Staff (2022). Hypothermia - Symptoms and Causes. [online] Mayo Clinic. Available at: https://www.mayoclinic.org/diseases-
conditions/hypothermia/symptoms-causes/syc-20352682#:~:text=Hypothermia%20is%20a%20medical%20emergency.

HYPOTHERMIA
• When the body temperature drops, the heart, nervous system
and other organs can't work normally.
• Left untreated, hypothermia can lead to complete failure of the
heart and respiratory system and eventually to death.
• Hypothermia is often caused by exposure to cold weather or
immersion in cold water. Primary treatments for hypothermia
are methods to warm the body back to a normal temperature.
Reference:

HYPOTHERMIA
3 PHYSIOLOGIC MECHANISMS
1. Excessive heat loss
2. Inadequate heat production
3. Impaired hypothalamic thermoregulation

HYPOTHERMIA
Accidental hypothermia as a result of:
- exposure to a cold environment
- immersion in cold water
- •Lack of adequate clothing, shelter, or heat

CLINICAL MANIFESTATIONS OF
HYPOTHERMIA
Shivering is likely the first thing you'll
notice as the temperature starts to drop
because it's your body's automatic defense
against cold temperature — an attempt to
warm itself.
Reference:
Hypothermia - Symptoms and causes. (n.d.). Mayo Clinic. Retrieved January 22, 2023, from https://www.mayoclinic.org/diseases-
conditions/hypothermia/symptoms-causes/syc-20352682#:~:text=Drowsiness%20or%20very%20low%20energy

HYPOTHERMIA
•Shivering
•Slurred speech or mumbling
•slow, shallow breathing
•Weak pulse
•Clumsiness or lack of coordination
Reference:

HYPOTHERMIA
•Drowsiness or very low energy
•Confusion or memory loss
•Loss of consciousness
•Bright red, cold skin (in infants)
Reference:

HYPOTHERMIA
• Someone with hypothermia usually isn't aware of his
or her condition because the symptoms often begin
gradually.
• Also, the confused thinking associated with
hypothermia prevents self-awareness. The confused
thinking can also lead to risk-taking behavior.
Reference:

COMPLICATIONS OF HYPOTHERMIA
People who develop hypothermia because of exposure to cold
weather or cold water are also vulnerable to other cold-
related injuries, including:
• Freezing of body tissues (frostbite)
• Decay and death of tissue resulting from an interruption in
blood flow (gangrene)
Reference:

NURSING INTERVENTIONS FOR
HYPOTHERMIA
•Provide a warm environment.
•Provide dry clothing.
•Apply warm blankets.
•Keep limbs to the body.

NURSING INTERVENTIONS FOR
HYPOTHERMIA
•Cover the client's scalp with a cap
•Supply with warm oral or intravenous
fluids.
•Apply warming pads.

Reference:
https://www.emedihealth.com/respiratory-health/cough-cold-flu/fever-causes#different_stages_of_fever [Accessed 22 Jan. 2023].

Reference:
NON-INFECTIOUS CAUSES OF FEVER
• Vaccination
• Overheating of the body due to overdressing, exercise, or excessive sun
exposure, which may lead to a sunburn or a heatstroke
• Dehydration
• Rheumatoid arthritis
• Certain medications, particularly antihistamines and antibiotics
• Cancer
• Autoimmune diseases and disorders

Reference:
NON-INFECTIOUS CAUSES OF FEVER
• Drug abuse
• Alcohol withdrawal
• Hyperthyroidism
• Atropine and other drugs, which have anticholinergic properties
that may interfere with thermoregulation by blocking sweating
and vasodilation – the mechanisms whereby the body attempts
to dissipate heat and may also raise core temperature
• Certain neuroleptic medications and clinical use of serotonergic
drugs

Reference:
INFECTIOUS CAUSES OF FEVER
• Bacteria
• Viruses
• Fungi
• Parasites
• Spirochetes
• Mycobacteria

5 TYPES OF FEVER
Reference:

INTERMITTENT FEVER
•This fever has a fluctuating baseline
between normal temperatures and
fever levels over the course of the day.
Reference:
MedicineNet. (n.d.). What Are the 5 Types of Fever? [online] Available at:
https://www.medicinenet.com/what_are_the_5_types_of_fever/article.htm.

REMITTENT FEVER
•This type of fever may come and go,
and the temperature fluctuates, but
though it falls, it never falls all the
way back to normal.
Reference:

HECTIC FEVER
•Either an intermittent or a remittent fever is
considered hectic if the temperature range
swings widely throughout the day, with a
difference of at least 1.4 degrees Celsius
between the highest and lowest
temperatures.
Reference:

CONTINUOUS FEVER
•Also called a “sustained” fever, this is
a prolonged fever with little or no
change in temperature over the
course of a day.
Reference:

RELAPSING FEVER
•This is a type of intermittent fever that
spikes up again after days or weeks of
normal temperatures.
•This type of fever is common with
animal bites and diseases like malaria.
Reference:

PHASES OF FEVER
The clinical signs of fever vary with the onset, course, and
abatement phase - these signs occur as a result of changes in the
set point of the temperature control mechanisms regulated by the
hypothalamus.
• Onset {cold or chill Phase}
• Course {Plateau phase}
• Defervescence {fever abatement/Flush phase}

NURSING
INTERVENTIONS
FOR FEVER

TWO TYPES OF THERMOMETER
1.Touch, or contact, thermometers - must
touch the body in order to measure
temperature.
2.Remote, or no contact, thermometers - can
measure body temperature without
touching the skin.
Reference:
Mayo Clinic. (n.d.). Thermometers: How to choose the right tool for the job. [online] Available at: https://www.mayoclinic.org/diseases-
conditions/fever/in-depth/thermometers/art-20046737#:~:text=In%20general%2C%20there%20are%20two [Accessed 22 Jan. 2023].

CONTACT THERMOMETER
1. The most common kind of contact
thermometer uses electronic heat
sensors to record body
temperature. These thermometers
can be used on the forehead,
mouth, armpit or rectum. Most
electronic thermometers have a
digital display that shows you the
temperature reading.
Reference:

CONTACT THERMOMETER
• Rectal temperatures provide the most-accurate readings for infants,
especially those 3 months or younger, as well as children up to age 3.
• Temperatures taken from the armpit are usually the least accurate.
• For older children and adults, oral readings are usually accurate —
as long as the mouth is closed while the thermometer is in place.
Reference:

CONTACT THERMOMETER
The pros:
• Most electronic contact thermometers can record temperatures from
the forehead, mouth, armpit or rectum — often in less than one
minute.
• An electronic contact thermometer is appropriate for newborns,
infants, children and adults.
Reference:

CONTACT THERMOMETER
The cons:
• Parents may worry about causing discomfort when taking a child's temperature
rectally.
• You need to wait 15 minutes after eating or drinking to take an oral temperature.
Otherwise, the temperature of your food or drink might affect the thermometer
reading.
• It can be difficult for children — or anyone who breathes through the mouth — to
keep their mouths closed long enough to get an accurate oral reading.
Reference:

CONTACT THERMOMETER
• If you plan to use an electronic contact thermometer to
take both oral and rectal temperatures, get two
thermometers and label one for oral use and one for
rectal use.
• Don't use the same thermometer in both places.
Reference:

REMOTE/INFRARED THERMOMETER
• A remote thermometer that doesn't require skin
contact allows people to remain further apart.
• Remote thermometers can be used on the forehead
(temporal artery) or the ear (tympanic).
Reference:

DIGITAL ‘STICK' THERMOMETER
• Digital thermometers are quick to use and reasonably
accurate.
• They can be used under the arm (in the armpit) or
under the tongue.
Reference:
Australia, H. (2020). Types of thermometer. [online] www.healthdirect.gov.au. Available at: https://www.healthdirect.gov.au/types-of-
thermometer.

Under the arm (axillary) digital thermometer is the
preferred method for babies younger than 3 months of age.
• Place thermometer tip in the centre of the armpit, when the skin is dry.
• Place the baby's arm securely against their body.
• Turn thermometer on, and leave the thermometer in place for the time
stated in the manufacturer's instructions.
Reference:
thermometer.

Under the tongue (oral)digital thermometer is useful if your child is old enough
to understand how to keep the thermometer under their tongue. Oral thermometers should not be used if
your child is shivering.
• Check that your child hasn't had anything hot or cold to eat or drink for 20 minutes before you take an
oral temperature.
• Place the tip under your child's tongue, ask your child to close their mouth and lips to keep the
thermometer in place.
• It is important to disinfect your thermometer before and after use with an alcohol wipe.
Reference:
thermometer.

TEMPORAL ARTERY THERMOMETER
•Remote forehead thermometers use an
infrared scanner to measure the
temperature of the temporal artery in
the forehead.
Reference:

The pros:
• A remote temporal artery thermometer can record a
person's temperature quickly and are easily tolerated.
• Remote temporal artery thermometers are appropriate for
children of any age.
Reference:

The cons:
• A temporal artery thermometer may be more expensive than other types
of thermometers.
• This type of thermometer may be less accurate than other types. Direct
sunlight, cold temperatures or a sweaty forehead can affect temperature
readings. Variations on user technique, such as holding the scanner too
far away from the forehead, also may affect accuracy.
Reference:

EAR TYMPANIC THERMOMETER
Remote ear thermometers, also called
tympanic thermometers, use an infrared
ray to measure the temperature inside
the ear canal.
Reference:

• Ear thermometers take the child's temperature very quickly, so
they are useful if you child finds it difficult to sit still.
• They can be expensive and the reading may not be accurate if the
thermometer is not placed correctly in the ear.
• Follow the manufacturer's instructions carefully to get an
accurate temperature reading.
Reference:
thermometer.

• Gently insert the probe into ear canal with the tip facing the
inside, towards the inner ear.
• Press the thermometer button and wait for the beeps.
• If ears have been covered (headphones/beanie), remove items and
wait until ear canal is cool before you measure the ear
temperature. If your baby's ear canals are too small to properly
insert the probe, chose another type of thermometer.
Reference:
thermometer.

The pros:
• When positioned properly, infrared ear thermometers are
quick and generally comfortable for children and adults.
• Infrared ear thermometers are appropriate for infants
older than age 6 months, older children and adults.
Reference:

The cons:
• Infrared ear thermometers aren't recommended for
newborns.
• Earwax or a small, curved ear canal can interfere with the
accuracy of a temperature taken with an infrared ear
thermometer.
Reference:

STRIP-TYPE THERMOMETER
Strip-type or plastic tape thermometers
• placed on the forehead, are not an accurate way of
taking temperature.
Reference:
thermometer.

MERCURY THERMOMETER
• Once a staple in most medicine cabinets, mercury thermometers
use mercury encased in glass to measure body temperature.
• Mercury thermometers are no longer recommended because they
can break and allow mercury — which is toxic — to escape.
• If you have a mercury thermometer, don't throw it in the trash.
Contact your local trash collection program to see if there's a
hazardous waste collection site in your area.
Reference:

• Exergen TAT-5000
TemporalScanner™ Temporal
Artery Thermometer

• Extech IR200: Non-Contact
Forehead InfraRed
Thermometer

• Braun ThermoScan 7
Digital Ear
Thermometer with
Age Precision

• Forehead
Thermometer Strip

• 30 Second Digital
ORAL Thermometer

• Digital Rectal
Thermometer

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