Does anyone else like reading through old (pre 1980s) nursing text books for directions of how and when to take rectal temperatures?
They were a lot more matter of a fact about using rectal thermometers and much quicker to recommend their routine use in adults in a variety. Using rectal temperatures instead of oral in patients with breathing difficulty or on oxygen seemed to be a common solution.
They seemed to be less prudish and more concerned with getting a reliable reading.
Here are few examples that I came across.
The Health Aide by Jane Henry Stolten, RN, from 1972 says
“A rectal temperature is always taken when there is any interference with a person’s ability to breath, when a patient is confused, and on a child.”
I can just imagine coming in with a heavy cough.
It also has a section on the care of psychiatric patients and recommends only rectal temperatures:
“TPR
Rectal temperatures are taken on psychotic patients. The attendant remains with the patient and holds the thermometer while it is inserted. Disturbed patients are apt to bite mouth thermometers.”
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The Fundamentals of Nursing and the Sciences in Nursing, Fifth Edition from 1974 says that “A rectal temperature is more accurate than an oral or axillary temperature.”
It also recommends taking a rectal temperature if an oral temperature shows a considerable change. And that “Some hospitals require rectal readings on patients having an elevated temperature.”
It also says that oral temperatures are contraindicated in patients receiving nasal oxygen therapy.
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In the 4th edition of The Medical Office Assistant administrative and clinical from 1974 it says “Rectal temperatures are taken on the very young patient, the patient with breathing difficulty, the uncooperative patient, and the unconscious patient.”
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The Illustrated Manual of Nursing Techniques, has multiple pictures in the Techniques for Adult Clients showing the preparing of the thermometer, spreading the buttocks, inserting the thermometer, and holding it in place. It is all very matter of a fact and natural.