All of the following precautions are true while recording oral temperature of a patient, except?

BHU NO - 2015

Nursing Foundation

Medium

Appeared in: BHU NO - 2015

Explanation

The statement suggests stopping a patient's oxygen supply, which is a prescribed and often life-sustaining medical treatment.
Interrupting oxygen therapy can lead to a rapid drop in blood oxygen levels (hypoxia), causing respiratory distress and other serious complications.
The correct nursing action when the oral route is compromised (e.g., by oxygen administration) is to select an alternative measurement site like the tympanic, temporal, or axillary route.
Patient safety dictates that essential therapies should never be discontinued for routine measurements.

Option A: This is a true and standard precaution. Measuring temperature at the same time each day helps in monitoring for trends and accounts for the body's natural circadian rhythm, where temperature is typically lowest in the early morning and highest in the late afternoon.
Option B: This is a true statement, particularly for traditional glass thermometers. It ensures the thermometer has enough time to accurately reflect the body's core temperature by being in contact with the blood vessels under the tongue.
Option C: This is a true and important precaution. Smoking, along with consuming hot/cold food or drink, alters the temperature in the mouth. Waiting 15-30 minutes is necessary to get a reading that reflects the body's actual temperature.

Clinical Relevance

Nursing practice connection: Knowing Precautions and contraindications for oral temperature measurement helps nurses interpret findings accurately and avoid errors in routine assessment, medication administration, and patient teaching.
Patient safety is paramount. This question highlights a critical safety rule: never discontinue a prescribed therapy like oxygen for a routine assessment. Doing so can have immediate and severe consequences.
This scenario requires clinical judgment. The nurse must recognize the contraindication and adapt the procedure by choosing a safer, alternative method for temperature measurement.
What if the patient is also unconscious? If the patient is unconscious and on oxygen, both oral and rectal routes may be contraindicated (depending on stability). The safest and most accessible routes would be temporal artery or tympanic measurement.

How to Approach the Question

First, identify the core of the question: it's an 'except' question, so you are looking for the false statement or incorrect action.
Read each option carefully and evaluate it based on standard nursing principles and safety guidelines for measuring vital signs.
Option A: Is measuring at a fixed time standard practice? Yes, for trend monitoring.
Option B: Is a 3-minute duration a valid principle for accuracy? Yes, especially for older thermometers.
Option C: Does smoking affect oral temperature? Yes, a waiting period is required.
Option D: Is it safe to stop a patient's oxygen? No, this is a critical safety violation.

Concept Tested & Keywords

Concept Tested: Precautions and contraindications for oral temperature measurement.
Stem keywords: oral temperature, precautions, patient
Lead-in keywords: except
Clinical cues: patient on oxygen inhalation
Negative lead-in flag: The question asks for the EXCEPTION, meaning the statement that is FALSE or not a true precaution.

QnHS4AXEe0dtXaW1TfGOZQ

E6 Nursing Fundamentals Potter Perry 12e Part 3 pp. 13-15, 35-37

E6 Nursing Fundamentals Taylor p. 121-123