Assessing an individual’s ability to maintain body temperature

The reader is reminded that the assessment of body temperature is part of a holistic nursing assessment and should not be undertaken in isolation without reference to or consideration of the client’s other activities of living.

Specific points to consider when assessing an individual’s body temperature include:

• Physical
Actual physiological measurement (ºC)
Assessment of possible routes (oral, rectal, axillary, tympanic, surface)
excluding those that are injured, uncomfortable, infected or inappropriate Metabolic rate
Shivering
Body excretions (air, urine, faeces)
Hormonal influences (women have a slightly higher temperature than men at particular times in the menstrual cycle)
Circadian rhythm
Gender (see hormonal influences above)
Age, infants and older people are more susceptible to temperature
changes in the environment
Has the client recently had a hot or cold drink?
Is the client obese or very thin?
Have they recently been smoking?

• Psychological
Emotion
Stress
Anxiety
Behaviour including ability to put on/take off clothing appropriately, and degree of compliance
Confusion (mercury thermometers should not be used for clients who are confused as they may try to bite or swallow the thermometer)

• Sociocultural
Climate
Exercise
Housing/shelter
Smoking
Drugs
Environmental
Room temperature
Severe heat
Severe cold
Exposure
Food and drink
Time of day

• Politico-economic
Occupation
Poor housing, heating
Poor diet
Lack of finances for adequate heating

• Past history
Past medical history
Recent exposure to infection/illness
Recent holiday abroad