Authors: Poplavets E.V.

Editor: V.V. Rednenko

Equipment for the practical skill:

  • Electronic thermometer in a plastic case
  • Gauze pads
  • Towel
  • Robot-patient / Patient
  • Patient observation sheet (temperature sheet)
  • Pen (with a blue shaft)
  • Antiseptic solution "Ultracid"

Description of the clinical situation:

You are a nurse in the therapy department. A patient with a diagnosis of "Acute bronchitis" was admitted to the department. Take thermometry and interpret the results.

The order of the skill:

Preparatory stage:

  • Introduce yourself and identify the patient (ask for the last name, first name, patronymic, date of birth (age))
  • explain to him the purpose and course of the upcoming procedure
  • get verbal informed consent
  • assess the patient's condition.
  • Patient position: lying on your back.

Main stage:

  • Perform hygienic handrub
  • Wear non-sterile gloves
  • Examine the patient's armpit for inflammation
  • If the skin of the armpit is moist, dry it with a towel
  • Take the thermometer out of the case
  • Check the integrity of the thermometer before use
  • Switch on the thermometer with the corresponding button
  • Place the thermometer in the armpit and ask the patient to press the shoulder against the chest
  • Position the thermometer so that the temperature sensor is completely covered by the skin
  • Measure the temperature for at least 5 minutes
  • Remove the thermometer, measure your body temperature
  • Record measurement data in a temperature sheet
  • Turn off the thermometer

Final stage:

  • Wipe the body and the measuring sensor of the thermometer twice with a napkin moistened with the Ultracid antiseptic solution
  • Dry the thermometer with a dry cloth
  • Place the thermometer in the case and place in storage
  • Take off your gloves
  • Dispose of them

  • Carry out the registration of the research result in the observation sheet (temperature sheet):

2

    • Check (specify) the name of the patient
    • In the appropriate box, indicate the date of the study
    • Indicate the day of illness
    • Determine the price of division in the column "T" (temperature) (the price of division is 2 beats per minute)
    • Use a blue pen to mark the measurement results according to the date and time of the study (morning or evening)
    • Connect the line with the results of previous measurements (if any).
  • Organize your workplace

 

Последнее изменение: воскресенье, 21 февраля 2021, 19:31