CNA · Basic Nursing Skills · 7 min read
Measuring Temperature, Pulse and Respirations
- Identify normal adult ranges, appropriate measurement sites, and vital safety rules for taking body temperature.
- Demonstrate how to measure radial and apical pulses, identify pulse rhythm and force, and recognize when pulse rates must be reported.
- Describe how to observe and count respirations discreetly, noting breathing characteristics and urgent changes that require immediate reporting to the nurse.
Introduction to Vital Signs and Body Temperature
Vital signs are fundamental measurements that include body temperature, pulse, respirations, and blood pressure. The role of the nurse aide is to measure and record these vital signs accurately, keep the resident safe and comfortable, and report abnormal findings promptly to the nurse. The nurse aide does not diagnose medical conditions, interpret clinical results, or change care plans. Instead, the aide serves as careful eyes and ears for the healthcare team by collecting precise measurements and recognizing when a value falls outside expected boundaries.
Body temperature represents the balance between the heat produced and the heat lost by the body. Common sites used for measuring body temperature are oral, rectal, axillary, tympanic, and temporal. When using an electronic thermometer, the nurse aide must pay close attention to the equipment color coding. A blue-tipped electronic thermometer probe is used for oral and axillary temperature readings. In contrast, a red-tipped electronic thermometer probe is used strictly for rectal temperature readings. To maintain infection control and equipment accuracy, the nurse aide must always use the disposable probe cover specified for the thermometer, following the manufacturer's instructions and facility policy.
Selecting the right site and understanding normal ranges ensures that the nurse aide provides safe care. The table below outlines common temperature sites and their normal ranges for an adult.
| Measurement Site | Normal Adult Range | Probe Color / Equipment Used |
|---|---|---|
| Oral | Approximately 97.6°F to 99.6°F | Blue-tipped electronic probe with disposable cover |
| Rectal | Approximately 98.6°F to 100.6°F | Red-tipped electronic probe with disposable cover |
| Axillary | Approximately 96.6°F to 98.6°F | Blue-tipped electronic probe with disposable cover |
Common mistakes
- Using the thumb instead of the index and middle finger pads to measure a pulse, which risks counting the aide's own pulse instead of the resident's.
- Letting go of a rectal thermometer probe or leaving the resident unattended while the probe is inserted into the rectum.
- Measuring an oral temperature immediately after the resident has consumed a hot or cold beverage, without waiting at least 20 minutes.
- Telling the resident aloud that you are about to count their breathing, which causes them to alter their natural respiratory rate.
Key points
- Vital signs consist of temperature, pulse, respirations, and blood pressure; measure routine resting vital signs with the resident comfortable, and follow the nurse’s instructions when another position is needed.
- The nurse aide uses blue-tipped probes for oral and axillary temperatures, red-tipped probes strictly for rectal temperatures, and always applies disposable probe covers.
- Normal adult resting ranges are approximately 97.6°F to 99.6°F for oral, 98.6°F to 100.6°F for rectal, 96.6°F to 98.6°F for axillary, 60 to 100 beats per minute for pulse, and 12 to 20 breaths per minute for respirations.
- When measuring a radial pulse, use the index and middle finger pads on the thumb side of the wrist; count for 60 seconds if irregular or required by the skills exam or facility policy, and double a 30-second count for a regular pulse only when permitted.
- Respirations are counted discreetly immediately after the pulse, noting rate, depth, rhythm, and effort.
- The nurse aide must perform hand hygiene before and after care, record values accurately according to policy, and report any abnormal findings, labored breathing, or discoloration promptly to the nurse.
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