Is your first temp on a new admit..

  1. always a rectal? We are getting away from this because it doesn't really mean that the anus is patent...it could be farther up that is closed. What do you do?
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  2. 17 Comments

  3. by   SteveNNP
    Ours is still a rectal. They do seem to be much more accurate. I've had a kid with an axillary of 98.4f come up with a rectal of 102f (same for low temps) You just have to make sure you use the "rectal" probe and not the oral/axillary one like a lot of people seem to use.

    Stevern21
  4. by   Jolie
    Quote from SteveRN21
    Ours is still a rectal. They do seem to be much more accurate. I've had a kid with an axillary of 98.4f come up with a rectal of 102f (same for low temps) You just have to make sure you use the "rectal" probe and not the oral/axillary one like a lot of people seem to use.

    Stevern21
    Haven't taken a "routine admission" rectal temp in years. I saw one case of a perforated intestine directly related to a rectal temp, and that was more than enough. If there is a question about patency, the doc is more than capable of checking him/herself, and a soft, flexible feeding tube is a much safer way of doing so.

    The thought of using those large, stiff rectal probes makes me shudder! Even when we did rectal temps (way, way back), we used a glass thermometer, and inserted only the silver bulb tip.
  5. by   prmenrs
    I've seen nurses take a rectal temp "to check for patency" even when the kid is smeared w/meconium from the middle of his back to his knees! Cuz that's the way they've always done it. Sheesh.

    I generally do axillary temps, even the 1st one.
  6. by   EricJRN
    I've never performed a rectal temp in nearly a year on our unit. All axilllary, all the time for us.
  7. by   Spidey's mom
    First temp on a newborn is always a rectal, per the docs. Some of the docs are just out of school too.

    I also don't think axillary are accurate.

    I don't like tympanic on older patients either but ya just can't do a rectal on them. We do have those new thermometers that supposedly get your core temp by swiping on your forehead and then behind the ear. I get a myriad of numbers on the same pt when I do that.

    steph
  8. by   cathys01
    Quote from prmenrs
    I've seen nurses take a rectal temp "to check for patency" even when the kid is smeared w/meconium from the middle of his back to his knees! Cuz that's the way they've always done it. Sheesh.
    So much for critical thinking, huh?

    I've done one rectal temp in two years, on a kid that had an axillary temp in the 95 range, to confirm the temp. Used a portable with LOTS of KY jelly and didn't go in far at all (full term baby)!
  9. by   Sweeper933
    We still do first temps rectally - according to our protocol that's what we are supposed to do. However, a few months ago, we got a transport from another hospital. Term baby that ended up having an imperforate anus. They didn't realize it at first, and the baby even got a few feedings before they realized what was going on. Now the most interesting thing about that was... was that The baby only had a vaginal opening... there was no anus of any shape or form down there... We get this kid and were wondering how in the world they could have missed that!
  10. by   wjf00
    Our protocol calls for an initial rectal temp. I have argued to get that practice changed.. and lost. Old habits die hard. Passing meconium is the only way to assess a patent anus, still nurses mark 'patent' after a rectal temp.
  11. by   walkingrock
    Our policy is rectal where I work currently. The last place I worked, that was not the case. I really think it is not the best policy.
  12. by   TiffyRN
    Our NICU admitted a patient once from General that had been marked down as having stooled and he barely had a dimple in the skin over that area. Interesting don't you think?

    He came to the NICU after General called a few times to assess the infant for tachypnea (overheated under a warmer), then finally for loops (they had been feeding the baby of course). So the joke for a while was that all Gen. Nsy kids checked by the NICU nurse for resp issues need to have anal patency checked.

    Anyway, our unit continues to do rectal temps on admission. Also if the axillary temp just doesn't make sense.

    Tell you what freaks me out; when the vet (or vet tech) takes that whole glass thermometer and sticks it all the way in my cat. Cat weighs <10lbs. I know, his tissues are mature and all that, but still freaks me out.
  13. by   dawngloves
    I've never taken a rectal temp. Saw it once, on a kid from the well nursery where the axillary was 95.Rectal was 97
  14. by   Mimi2RN
    We do a rectal for the first temp. Recently had a baby with what was termed a blind pouch, although it did start to have a smear of stool. The baby had multiple anomalies.

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