Day-to-Day Care


Observation:  Temperature






Normal body temperature is usually considered to be in the range 36 to 37.2oC.  Infection or diseases may cause it to rise.  The onset may be abrupt or gradual.  Taking temperature is a useful guide to the person's condition.
Body temperature tends to be lower in person suffering from starvation or after exposed to excessive cold.  It is also a little lower when the person is asleep.  Body temperature may be slightly increased following muscular activity, dehydration, mental excitement or any other form of nervous tension.  These variations are very slight and usually they are only temporary and as soon as the individual returns to his usual level of activity or environment, his normal temperature will return.


If the person is having fever with unknown origin, you as the caregivers should observe him closely for the development of any signs and symptoms which may be helpful to the doctor in making a diagnosis.


To learn more about nursing a person with fever, please refer to Day-To-Day Care, Home Treatment: Fever Intervention.


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Signs and Symptoms of Fever


Fever occurs when the body temperature rises above its normal range.  As this range may varies in individuals, generally, a reading above  37.2oC measured in the mouth is considered febrile.


Other signs and symptoms may include the following:


Flushed face and hot skin

Headache and muscle aches

General weakness

Increase breathing

Increase heart rates

Sweating and thirst

Lack of appetite

Very high fevers may cause hallucinations, confusion, irritability and even convulsions

Shivering, chills, and rigors usually follow after profuse sweating in high fever and a sudden drop in body temperature

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When to Seek Medical Advice


Though most fever is part of a virus that will go away on its own, it could also be a signal of serious underlying diseases.  Consult your doctor if any of the following conditions exists:


Temperature remains at 39oC or more in adults, and 38.5oC or more in children below 12-year-old despite efforts in bringing down the fever.

Fever lasts more than 5 days in adults, and more than 3 days in children.

The signs and symptoms get worse.



You should seek immediate medical attention if a fever is accompanied by any of the following signs and symptoms:


Severe headache

Severe swelling of your throat

Unusual skin rash

Red, hot, or swollen area of skin

Unusual eye sensitivity to bright light

A stiff neck and pain when you bend your head forward

Mental confusion

Extreme irritability

Repeated vomiting

Difficulty breathing or chest pain

Abdominal pain or pain when urinating

Blood in stool

Any other unexplained symptoms, such as cough with yellowish or greenish phlegm, earache and severe back pain.

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Taking Body Temperature by Mouth (Oral)
The mouth is the most convenient place to take body temperature.  Make sure the person is at rest and that he has not just smoked, taken a hot or cold shower, or drunk anything hot or cold.  In these situations, temperature should be taken half an hour later.
To take the temperature by mouth, place the thermometer under the person's tongue at an oblique angle.  Ask him to keep his lips closed, not to talk  and not to bite the thermometer.  Leave the thermometer in place until the electronic signal sounds.

You should not take the temperature by mouth in the following cases:


the person cannot breathe through his nose or has breathing problems.

the person is a young child.

the person has a mouth injury or mouth infection.

the person might have a fit, is unconscious or confused.

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Taking Body Temperature by Armpit (Axilla)


Measuring body temperature through axilla is the safest method as it is non invasive.


To take temperature by armpit, dry the person's skin under the arm with a towel before placing the thermometer because perspiration may alter skin temperature.  Place the bulb of the thermometer into the centre of axilla.  Bring the arm across the person's chest and hold in position until the electronic signal sounds. 


Temperature taken under the arm will be slightly lower, so you should make a note of the method used. 


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