HA question about elevated temp

Nursing Students Student Assist

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My first nursing student assistance thread! Yay! :laugh:

My health assessment lab partner told me at the beginning of the semester that they "run high" on temps and sure enough, their temperature has been high - in fact, outside of the range of normal all but once. The charting asks me to explain any finding outside the range of normal. I have no reason (nor do I think it's within my scope of practice as a nursing student) to diagnose any kind of infection. Can anyone give me any tips about how to explain a high temp?

I meant who are you talking about? patients? coworkers? all the people at this clinical site? Who's temp were you taking? Did he mean everyone at this facilty has high temps?

We are not in clinical yet - we are just learning health assessment skills with fellow nursing student lab partners. My lab partner told me, during our first VS lab, that "his/her" (i.e., my lab partner's) temps normally run high.

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Specializes in Acute Care, Rehab, Palliative.

Oh I see.Our charting doesn 't require a comment on the temp.I wouldn't consider 100 degrees high.

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Oh I see.Our charting doesn 't require a comment on the temp.I wouldn't consider 100 degrees high.

Ok, thank you. In the charting (really, just a lab write-up form for the class) it does indicate that a temp of 100 is a problem. I've tried emailing my instructor but she hasn't responded yet. It's not really a big deal - if the charting is unsatisfactory the instructor will return it with comments for editing. Thank you all for your input!

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Specializes in Pedi.
Our text lists the normal range as 96.4 - 99.1; the temp was 100.0.

100 degrees isn't a fever in my book. We don't consider anything to be a fever until 38 degrees Celcius (100.4 Fahrenheit) and usually no interventions until 38.5 Celcius (101.3 Fahrenheit). The text lists the range in which most people fall, there are always people who lie outside of that who are still within normal limits for them. For example, your text will probably list a normal adult heart rate as 60-100. Olympic Athletes and Marathon runners will have resting heart rates in the 40s and that will be perfectly normal for them. I have also known many people with baseline temps in the 95-96 range. That falls outside of what your text lists as normal but it is still normal for them. In nursing we don't just go by what the text says. Your client reports that this is his baseline and he has no other symptoms of a problem so there's no reason to think that there necessarily is one. I would simply note on the flowsheet "Temp 100 F, per client this is baseline."

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100 degrees isn't a fever in my book. We don't consider anything to be a fever until 38 degrees Celcius (100.4 Fahrenheit) and usually no interventions until 38.5 Celcius (101.3 Fahrenheit). The text lists the range in which most people fall, there are always people who lie outside of that who are still within normal limits for them. For example, your text will probably list a normal adult heart rate as 60-100. Olympic Athletes and Marathon runners will have resting heart rates in the 40s and that will be perfectly normal for them. I have also known many people with baseline temps in the 95-96 range. That falls outside of what your text lists as normal but it is still normal for them. In nursing we don't just go by what the text says. Your client reports that this is his baseline and he has no other symptoms of a problem so there's no reason to think that there necessarily is one. I would simply note on the flowsheet "Temp 100 F, per client this is baseline."

I get that, I do. :yes: (and actually they've got the normal adult heart rate at 50-90) My instructor said the same thing you said re: normal for some individuals being outside the normal range. She also said that there has to be some kind of cut off point, so we should just go by what it says in the book. I did note it the way you suggested, although the client did not give me a numerical standard for themselves, just a range of "high."

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I'm trying to be as non-specific as possible, and unfortunately the English language does not have a gender-neutral singular pronoun. ;)

Yeah, the "they" confused me too. All, "they" and "themselves" are plural words and although done depressingly often, are never properly used to refer to a single person. Use "the patient/person," if you need a gender-neutral word (why, in this case?), "he," or "she." Or you can recast your sentence so all plurals apply: "They all told me that everyone in their family runs a high temperature."

As to the temp, a normal range is a range. 98.6•F is not the only normal temperature there is in the world.

While you may not be diagnosing an infection, you may very well be the first person to pick up the signs of one, which you are qualified to recognize. For example, a person with an unsuspected oral, axillary, or rectal infection may record a higher temp at those sites due to local inflammation. It is perfectly acceptable to look in there and see what there is to be seen or ask him about pain & swelling, unless as in this case the patient tells you "99.2•F is normal for me." Then you just note that.

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I prefer to be as non-specific as possible to be as unidentifiable as possible. I cringe to use incorrect grammar, and I apologize for making my question unnecessarily confusing. His/her seemed clunky to me, but I will use it from now on.

I know there is a range of normal temps - this temp is outside the range, and I am unsure how far outside normal is normal when the pt has stated that his/her normal is already outside, or on the high side, of normal. I previously noted the pt's initial statement about what is normal for him/her, but the temp has been progressively increasing for each of the following two weeks.

Thank you for reminding me that I may well be in a position to pick up on an abnormal sign and point a pt to a need for further evaluation. My question arose because this is all so new to me, that things I wouldn't give a second thought in regular life seem to take on a greater significance now that I'm in the position of holding another human's health and life in my hands, for however short a time. It seems sort of like being a parent - it looks a lot easier from the cheap seats ;)

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