CASE STUDY You are working in the night shift and noticed the following temperature readings in your client’s chart. When you assess your client temperature at midnight, it is 101.2˚F. Discuss the management of the patient as a nursing student.

1. B Y :
R AB I ’ AT U L AD AW I YAH B T S U L AI M AN
3 0 6 7 1 4 1 0 0 4
B AC H E L O R O F S C I E N C E I N N U R S I N G ( H O N S )
K P J H E ALT H C AR E U N I V E R S I T Y C O L L E G E
M O N I TO R E D B Y :
M AD AM G E M ALY N S . M AL D I S A
CLIENT CARE 1
UNIT 8 : VITAL SIGNS
CRITICAL THINKING SKILLS

2. SCENARIO
 You are working in the night shift and noticed the
following temperature readings in your client’s chart :
 When you assess your client temperature at midnight,
it is 101.2˚F.
TIME TEMPERATURE
4.00 a.m 97.4˚F
8.00 a.m 97.9˚F
12.00 noon 98.4˚F
4.00 p.m 99.6˚F
8.00 p.m 100.9˚F
12.00 a.m 101.2˚F

3. LINE CHART OF TEMPERATURE IN ˚F
95
96
97
98
99
100
101
102
4.00 a.m 8.00 a.m 12.00 p.m 4.00 p.m 8.00 p.m 12.00 a.m
Temperature[˚F]
Time [12 hours]

4. TASKS
 What do you notice about the pattern of the
temperature readings?
 What is important in this scenario?
 As a nursing student, what should you do?
 Develop at least 1 possible nursing care plan for this
patient.

5. DISCUSSION
 From the question, plan what to do :
Find the formula to convert the temperature from
°F to °C
Sketch the graph showing the temperature to
determine the pattern of the temperature
readings
List the normal temperature in the normal person
Develop nursing care plan to help decrease
client’s body temperature from 38.4°C back to
normal range which are from 36.4°C to 37.5°C

6. FORMULA (FROM °F-°C AND °C-°F)
 °F = (°C × 9/5) + 32
If there are no calculator, use the following
formula :
°F = ( °C × 2) + 30
 °C = (°F – 32) × 5/9

7. TABLE OF TEMPERATURE IN °C
 From the formula, the temperature can be convert
from °F to °C :
TIME TEMPERATURE
4.00 a.m 36.3 °C
8.00 a.m 36.6 °C
12.00 noon 36.9 °C
4.00 p.m 37.6 °C
8.00 p.m 38.3 °C
12.00 a.m 38.4 °C

8. LINE CHART OF TEMPERATURE IN ˚C
35
35.5
36
36.5
37
37.5
38
38.5
39
4.00 a.m 8.00 a.m 12.00 p.m 4.00 p.m 8.00 p.m 12.00 a.m
Temperature[°C]
Time [12 hours]

9.  From the above chart, it shows that the client’s
temperature is increased gradually from 36.3°C to 38.4°C.
 There are several types of fever patterns but this client
has constant fever pattern which also called continuous or
sustained fever.
 Constant fever : body temperature remains consistently
elevated and fluctuates less than 2°C.
 Examples of constant fever are :
Lobar pneumonia, typhoid, urinary tract infection,
brucellosis.

10.  There are several factors which affecting the body
temperature which are :
Age and gender
Exercise
Hormones
Diurnal variations [Circadian rhythm]
Environmental temperature

11. BODY TEMPERATURE
BODY TEMPERATURE
Types Core Temperature
• temperature of deep
tissues of the body
[abdominal cavity, pelvic
cavity].
Surface Temperature
• temperature of the skin,
subcutaneous tissue and
fat.
Temperature Relatively constant [36°C
to 37.5°C]
Rises and falls in response
to the environment.
Measurement
site
i. Rectum
ii. Tympanic membrane
iii. Pulmonary artery
iv. Urinary bladder
i. Skin
ii. Oral
iii. Axilla

12. VARIATIONS IN TEMPERATURE BY AGE
Source : Lippincott 2011
Kozier&Erb 2008
AGE TEMPERATURE (°C)
Newborn 36.8 (axillary)
1-3 year 37.7 (rectal)
6-8 year 37 (oral)
10 year 37 (oral)
Teens 37 (oral)
Adults 37 (oral)
>70 year 36 (oral)

13.  It is varies among individuals with range of 0.3°C-0.6°C
Source : Lippincott 2011
AVERAGE NORMAL TEMPERATURE FOR HEALTHY
ADULTS
Site Temperature (°C)
Oral 37.0
Rectal 37.5
Axillary 36.5
Tympanic 37.5
Forehead 34.4

14. NURSING CARE PLAN
NURSING
DIAGNOSIS
GOAL NURSING INTERVENTION EVALUATION
Hyperthermia
related to
dehydration
Client body
temperature will
be reduced from
38.4°C to
normal range
(36.5°C -
37.4°C) within
24 hours during
hospitalization
• Assess client general condition
[general condition : skin warm
to touch, flushed face, mild
shivering, temperature 38.4°C]
® It is taken as a baseline data
Client body
temperature
reduced from
38.4°C to
normal range
(36.5°C -
37.4°C) within
24 hours during
hospitalization
• Monitor client vital sign every
two hours
® To detect any changes or
deteriorate
• Provide cold compress if client
temperature is higher than
37.5°C
® Heat loss through conduction

15. NURSING CARE PLAN
NURSING
DIAGNOSIS
GOAL NURSING INTERVENTION EVALUATION
Hyperthermia
related to
dehydration.
Client body
temperature will
be reduced from
38.4°C to
normal range
(36.5°C -
37.4°C) within
24 hours during
hospitalization.
• Encourage client to drink more
than 2L per day
® To encourage hydration
Client body
temperature
reduced from
38.4°C to
normal range
(36.5°C -
37.4°C) within
24 hours during
hospitalization.
• Encourage client to wear thin
clothes, do not wear sweater
® To release heat from the body
• Record all sources of fluid loss
such as urine, vomiting and
diarrhea
® To monitor or potentiates fluid
and electrolyte loses
• Administer antipyretic
(paracetamol) 1000mg orally as
prescribed by the doctor
® Help to reduce fever

16. NURSING CARE PLAN
NURSING
DIAGNOSIS
GOAL NURSING INTERVENTION EVALUATION
Hyperthermia
related to
dehydration
Client body
temperature will
be reduced from
38.4°C to
normal range
(36.5°C -
37.4°C) within
24 hours during
hospitalization
• Turn on the air conditioner or
the fan
® Heat loss through convection
Client body
temperature
reduced from
38.4°C to
normal range
(36.5°C -
37.4°C) within
24 hours during
hospitalization
• Inform the client condition to
the doctor
® For further intervention