Tympanic temperature of children with CHF and on digoxin

[Enthused RN, BSN, RN]

What is the rationale behind frequently checking the tympanic temperature of a child with CHF and has been prescribed digoxin?

[umcRN, BSN, RN]

I work in a cardiac icu and have never checked a tympanic temp on any child (axillary, oral or rectal) whether they were on dig or not. Where did you hear this?

[meanmaryjean, DNP, RN]

Never heardof this -and we don't use tympanic thermometers, either. I'm curious, was this ordered for the patient by a cardiologist?

[KelRN215, BSN, RN]

I hate tympanic thermometers in pediatrics. Axillary or oral (for older kids) are my preferred methods.

[Enthused RN, BSN, RN]

I'm still a student and this question actually came up on on a test for my NCLEX prep class. Still can't really figure out a decent rationale to it.

Also, I've never checked tympanic temp either (usually do temporal for the kiddos).

[NicuGal, MSN, RN]

What are the answers they give? Tympanic isn't very reliable usually.

[JessicaMarie,RN]

Was it tympanic vs Rectal? Could be because of bleeding risk and vagal stimulation with rectal

[RedHeaded2bNurse16]

Our book said tympanic was the closet to core and preferred on children due to rectal damage.

[NotReady4PrimeTime, RN]

Tympanic temps are notoriously inaccurate in children. Their ear canals aren't straight and they don't hold still for having anything shoved in their ears. If the beam isn't properly reflected off the tympanic membrane the reading is going to be useless. I remember years ago when tympanic thermometers first started getting heavy use, a nurse in the peds ER took my immunosuppressed son's temp. The reading she got was 36.1C, which I knew couldn't be right since I had him there for fever... axillary temp of 38.6C at home. I asked if I could do it myself, having had lots of practice at getting him to sit still. My result was 38.4C. It made me wonder how many kids' temps were recorded incorrectly. Shortly after that, the hospital reverted to oral/axillary/rectal temps. I don't like to use those portable thermometers for rectal temps, but a nice, soft, pliable esophageal/rectal probe is pretty harmless.

[Enthused RN, BSN, RN]

I would have to retake the test in order to see the question and all available answers. I'm actually planning on doing that this week.

Checking their temperature was only one of the answers. The other 3 answers to choose from have nothing to do with temperature so the method of checking their temp was not the focus of the question; it was the actual act of doing it. When I retake it, I will select that as the answer and hopefully the test gives me a more clear rationale. When I do it, I'll repost on here.

[Enthused RN, BSN, RN]

So here's the full question with available answers and the rationale:

Question: A nurse is planning care for an infant who has heart failure and is receiving Digoxin. Which of the following actions should the nurse include in the plan of care?

1. Administer digoxin if the apical pulse is greater than 80/min.

2. Feed the infant every 1-2 hours.

3. Assess tympanic temperature frequently.

4. Place the infant in a supine position to sleep.

Rationale: Answer is #3 because hyperthermia or hypothermia can put additional stress on the heart.

Apparently, the part about giving Digoxin was a distracter and the question was looking to see how we handle CHF itself, not about medication administration/side effects.