Pediatric Temperature Measurement
This is a draft cheat sheet. It is a work in progress and is not finished yet.
Temperature measurement in ill infants and children is a vital assessment parameter. Generally, the measurement of body temperature is used to determine the presence or absence of fever. Fever can be used to gauge the severity of illness by both parents and healthcare providers. However, many factors such as age, activity level, time of day, disease/illness, ambient temperature, and clothing can influence body temperature.
A normal temperature is not a specific number but instead can range from 97 to 100.4 degrees Fahrenheit. According to the American Academy of Pediatrics (AAP) many fevers do not need treatment and are simply an indicator that the immune system has been activated as the result of a bacterial or viral illness. Fevers can actually help shorten a child’s illness (AAP, 2006). The need for immediate assessment, septic workup, and treatment for infants less than 90 days old with fever must be recognized as the infant’s condition can deteriorate quickly (Graneto, 2016).
SPN recommends the following best practice implications for measuring temperature, or fever, in pediatric clients:
1. The nurse is aware that temperature measurement is a common concern for healthcare providers and parents and is knowledgeable as to the various modes/methods available for measuring temperature in children.
2. Documentation accurately reflects mode/method of temperature measurement.
3. Temporal artery thermometry is accurate with infants younger than 90 days without fever as well as for all patients greater than 3 months of age with or without fever, ill or well.
4. The rectal method should be used for infants younger than 90 days unless contraindicated by diagnosis.
5. The tympanic or oral methods may be used in children 6 months of age or older, with correct positioning of the ear (tympanic) and if the patient can cooperate (oral).
6. The patient assessment includes etiologies that influence temperature/fever in children.
7. Evidence-based practice determines the best method for evaluating temperature/fever in any given setting, based on the age and condition of the client.
8. Evidence-based practice is utilized to determine best practice in policy development.