TEMPERATURE MEASUREMENT (AXILLA)

Description Examination of body temperature is an indicator to assess the

balance between formation and heat release. Body temperature
range can be measured by using mercury thermometer through
oral, rectal and axilla. And can also use digital’s termometer.
Purpose The Purpose of Temperature Measurement is to know the range
of body’s temperature
Tools 1. Termometer
2. 3 of bottle :
- Water Soap
- Desinfektan
- Clean Water
3. Crooked
4. Handscone
5. Tissue
6. Note Book of Nurse
Pre Interaction 1. Check the therapy progam
2. Washing hand
3. Prepare the tools
Orientation 1. Greeting to patient
2. Explain the procedures of temperature measurement
3. Ask about readiness of patient
Procedures 1. Use Handscone
2. Set the position of patient
3. Relegated the termometer until under 344̊ C – 354̊ C
4. Determine the location of axilla and clean it with tissue
5. Put termometer in axilla and the lenght of patient flexion
above her chest
6. After about 3 – 5 minutes take the termometer and read
the result
7. Write the result at the Note Book of Nurse
8. Clean the termometer with tissue
9. Wash the termometer with water soap, desinfektan , then
clean water
10. Dry the termometer
Termination 1. Evaluation of implementation
2. Ask for leave to patient
3. Tidy up the tools
4. Washing the hand
5. Documentation