The client is comatose and the healthcare provider orders that the client's temperature is to be taken by the rectal route. The student nurse is assisting the more experienced nurse and volunteers to obtain the client's temperature
Which of the following statements by the student nurse indicate the need for further education? 1. "I will need to turn the client into the prone position.".
2. "The probe for a rectal thermometer is usually red.".
3. "I should insert the thermometer 1.5 to 4 centimeters into the client's anus.".
4. "This is an appropriate way to monitor a client's temperature if they are unable to close the mouth around the oral thermometer.".
1
Rationale 1: The client should be turned to the side, not the prone position.
Rationale 2: The rectal thermometer probe is usually red to signify that it is different from an oral thermometer probe.
Rationale 3: The thermometer should be placed 1.5 to 4 centimeters into the client's anus.
Rationale 4: This route may be used if the client is unable to close his or her mouth around an oral thermometer probe.
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