Temperature

Test items rarely make you define temperature — they make you pick the right route or read a trend. The “tell” is a clause that contraindicates a route: rectal is avoided in neutropenic, thrombocytopenic, cardiac, and recent rectal-surgery clients (mucosal trauma risks bleeding/infection; vagal stimulation risks bradycardia), so the answer shifts to temporal artery or tympanic. Recent hot/cold fluids or smoking invalidate an oral reading — wait 15–30 minutes. When a stem pairs rising fever with chills and rigors, read that as the chill phase before a temperature spike, not improvement — do not aggressively cool a shivering client.

Fever’s tachycardia and shivering reflect a hypothalamic set-point shift — physiologic thermoregulation, not anxiety or pain to medicate first (diaphoresis comes later, when the fever breaks). In hypothermia, rewarm the trunk/core before the extremities: limb-first rewarming returns cold blood to the heart, causing afterdrop and rewarming shock. In older adults and the immunosuppressed, a “normal” temperature can mask serious infection — trust the trend, not one number.