Question about normal temps being lower for some?

Posted
by jbrmdr (New) New

I have a child whose mother sent me an email and spoke with me because she said her child is sick with a sore throat and cold symptoms. He misses alot of school and many times parents send them to school so they can be counted present and then check them out early.

She said his normal temp is 96.7 so a temp of 98.7 for him is like a temp of 100.7. She wanted him to come all day long and have his temp checked and for me to call her every time he came in. Finally his temp did reach 98.7 and so she wanted to come and pick him up. He acted and seemed fine.

I realize not everyone runs a solid 98.6 as their normal and temps fluctuate at different times of day and are normally lower in the mornings. But can you really compare a temp of 98.7 to 100.7?

Anyone else had experience with this? And do you think there is any truth to this?

cooties_are_real

Specializes in School. Has 10 years experience. 326 Posts

Our policy states a fever 100.0 or greater is concidered a fever. I have had parents tell me that when their student is sick his/her temp will go down to below 96.0 and not up. I would instruct them to have the doctor send me documentation as such, but until I received such documentation I would follow school policy. Needless to say I never got such documentation.

Have a great weekend.

brithoover

244 Posts

I work in peds onc where fevers are very important and can kill a child. We have strict guidelines of what a fever is. I've never heard of this fluctuating

mappers

Specializes in Med/Surg/Tele/Onc. 437 Posts

I have had people tell me this type of thing. (I work oncology where we carefully watch for neutropenic fevers.) Our guideline is 100.5. I've had people tell me that they normally run 97 so 99 is a fever for them. I'm always suspicious, since the ones who tell me this seem to be a little on the dramatic side. I wonder, too, if there is any legitimacy to this, studies, etc.

pre-nurseshan

139 Posts

I can tell you that my 6 yo normally runs 97.9, and at 100.7 she is lethargic and glassy eyed. I have heard that a 1 degree F variance is normal in humans. *shrug*

pre-nurseshan

139 Posts

Oh, and I'm not sure about the correlation, but she is definitely on the dramatic side ;)

eatmysoxRN, ASN, RN

Specializes in Med/Surg,Cardiac. Has 1 years experience. 728 Posts

I'd also think a consistent use of the same thermometer would be important. It irks me at work that out of the 3 thermometers they all read differently if used within the same minute. I'd also think symptoms should accompany a supposed "fever" of anything less than 100.

~ No One Can Make You Feel Inferior Without Your Consent -Eleanor Roosevelt ~

brownbook

Has 37 years experience. 3,413 Posts

My first thought is what thermometer is being used! Exactly what eatmysox said. We used "ear" thermometers in our clinic and everyone was lowish. We changed to the "forehead" one (sorry for my lack of medical terminology I'm headachy and tired, better check my own temp, ha ha) and now everyone runs highish!

Wave Watcher

Specializes in Community Health/School Nursing. Has 7 years experience. 751 Posts

What happened to the good ole' fashion under the tongue thermometer? lol

SherluckyRN

102 Posts

Our guidelines in NYC is 99.9/100 temp is grounds to send home. No questions asked. Child may look and seem fine with a 100 temp just as a child with a 97 temp. To avoid any further problems we send them home. Give some water and ice lack to the neck and call parent

mc3, ASN, RN

Has 12 years experience. 931 Posts

Yup, I'd ask for MD documentation for that. I do notice some children are a bit low, but I always follow my school's guideline - if >100, they go home. Anything else, I'd request something!

mc3:nurse:

brillohead, ADN, RN

Specializes in Cardio-Pulmonary; Med-Surg; Private Duty. Has 5 years experience. 1,781 Posts

I'm hypothyroid, and particularly before my thyroid was diagnosed and treated, my "normal" was often in the low 96 range, and sometimes in the mid-95 range (based on physician's office thermometers). Since being placed on Armour Thyroid, I'm more likely to be in the high 97s or low 98s, but even with my TSH around 1.0, I'm still very sensitive to heat/cold.

If the child's "normal" temp is 96ish, then their well-child appts with the doctor would show that, so the doc's office should be able to confirm it. Alternately, you can take their temperature every day for a week or two and verify for yourself what their real "normal" is for future situations.