Temperature Routine
A person`s internal and skin temperatures both show a systematic rise and fall over 24-hour period, a cycle difficult to alter in normal adults. Body temperature usually peaks between 4:00 P.M. and 6:00 P.M. and reaches it lowest point around 4:00 A.M. in people who are active by day and sleep at night.
When the internal temperature is normally peaking, other body functions such as pulse rate, blood pressure, and cardiac output (volume of blood pumped by the heart) are also changing. Pulse rate is high when the temperature is highest and drops during the night. Blood pressure shows a marked fall during the first hour of sleep, followed by a gradual rise during the remaining time. Cardiac output reaches minimum levels between 2:00 A.M. and 4:00., the period of lowest temperature findings.
The existence of a normal rhythm temperature pattern has been known for alsmost 200 years. Yet this knowledge has not been applied by hospital personnel when establishing time schedules for routine measurements of body temperature.
In most hospitals the schedule is based on considerations of tradition or convenience, such as the time of shift change. Since the primary reason for checking body temperature is to detect the presence of an elevation, the procedure should be done at the time when maximum temperature occurs. The implications of this for nursing practice include the importance of establishing routines for temperature measurements with circadian rhythms in mind, considering the time of day when evaluating temperature measurements, and considering the person`s preadmission rest and activity routine.
References :
Conroy, R.T.W.L ., and J.N Mills, Human Circadian Thythms. London: J. & A. Churchill, 1970.
United States Department of Health, Education, and Welfare, Public Health Service, Biological Rhythms in Psychiatry and Medicine. Chevy Chase, M.d.: National Institute of Mental Health, 1970.
DeRisi, Lucy, “Body Temperature Measurements in Relation to Circadian Rhythmicity in Hospitalized Male Patients”, American Nurses` Association Clinical Sessions. New York: Appleton-Century-Crofts, 1968.
Bassler, Sandra Furman, “The Origins and Development of Biological Rhythms”, Nursing Clinics of North America, 11: No.4, 1976.
Murray, RB and Zentner JP., Nursing Concepts for Health Promotion, Second Edtion, Prentice-Hall, Inc, Englewood Cliffs, N.J, 1979.
