Clinical Assessment Slides 17-85 Section 2

When will temp be higher?

In the afternoon

How do you assess remote memory? When is it lost?

In the context of the interview, ask the person verifiable past events; for example, ask to describe past health, the first job, birthday and anniversary dates, and historical events that are relevant for that person -is lost when cortical storage area for that memory is damaged, such as in Alzheimer disease, dementia, or any disease that damages cerebral cortex

Respirations in infants?

Respirations Watch infant's abdomen for movement, because infant's respirations normally more diaphragmatic than thoracic

What is a pulse?

The rhythmic expansion of an artery produced when a bolus of oxygenated blood is forced into it by a contraction of the heart

What happens to the pulse and respiratory rate in response to anxiety? What is dyspnea?

They increase Dyspnea is shortness of breath

You are visiting elderly clients with the home health nurse. The temperature for the past week has been over 92°F, with a heat index of 100°F+. The first client is a frail 84-year-old man who lives alone on the third floor in an apartment without air conditioning. What measures would you take to promote safe effective nursing care?-

- he needs to drink lots of water, at least have fan, bathing / sponging himself off to keep the temp down

What are the factors that affect normal temp? Explain them

-Diurnal cycle of 1° F to 1.5° F, with trough occurring in early morning hours and peak occurring in late afternoon to early evening -Exercise: moderate to hard exercise increases body temperature -Age: wider normal variations occur in infant and young child due to less effective heat control mechanisms; in older adults, temperature usually lower than in other age groups, with a mean of 36.2° C (97.2° F)

What is the rationale for the previous answer

-Thinking. Application of Theoretical Knowledge: What are the physiological changes that occur with aging that increase the risk of elderly adults' susceptibility to hyperthermia (e.g., impaired circulation, decreased functioning of sweat glands)? What is the relationship between environmental temperature and body temperature? What medications/drugs can effect thermoregulation (e.g., diuretics, alcohol)? -Doing. Nursing Process (Assessment): What signs and symptoms would you assess for? What site should be used to measure body temperature? How would you measure environmental temperature? What are other factors that should be assessed (e.g., circulating fan, working refrigerator, fluid intake, type of clothing he is wearing)? Nursing Process (Diagnosis): With a diagnosis of hyperthermia or impaired thermoregulation, what interventions would reduce body temperature? -Caring. Ethical Knowledge: The client does not have a fan or air conditioning. What concerns, if any, will occur if the nurse: Purchased a fan for the client? Purchased a window air conditioner? Transported the client to a cooling center (e.g., senior citizen center)? Contacted social services to provide resources for the client?

What constitutes alert and orientated vs disorientated?

Alert & Oriented x 3; can be Alert & Oriented to 4 (person, time, place, and situation) Disorientation occurs with dementia & delirium Orientation is usually lost in this order: time, then place, rarely to person

Why 30 secs instead of 15?

Although 15-second interval is frequently practiced, any one-beat error in counting results in a recorded error of four beats per minute The 30-second interval is most accurate and efficient when heart rates are normal or rapid and when rhythms are regular

factors that affect bp?

Age: gradual rise through childhood and into adult years Gender: after puberty, females show a lower BP than males; after menopause, females higher than males Race: African American adult's BP usually higher than White person's of same age The incidence of hypertension is twice as high in African Americans as in Whites; reasons for difference not understood fully but appear to be due to genetic heritage and environmental factors

What is hyperpyrexia?

Hyperpyrexia Abnormally high body temperature; fever greater than 105.8°F (41.0°C)

What is average pulse?

60-100 bpm

How would the nursing student assess abstract reasoning in an adult patient?

Abstract reasoning: Pondering a deeper meaning beyond the concrete and literal.

How dos gender influence pulse rate?

Adult women (after puberty) have a slightly higher pulse rate than do adult men

How does exercise influence pulse rate?

After exercise, a well-conditioned heart returns to a normal rate more quickly. People who are well-conditioned have lower heart rates, both before and during exercise, than those who are less conditioned. -Muscle activity normally increases the pulse rate

Measuring Blood pressure measured with stethoscope and aneroid sphygmomanometer

Aneroid gauge subject to drift and must be recalibrated at least once each year and must rest at zero Cuff is inflatable bladder inside a cloth cover Width of rubber bladder should equal 40% of circumference of person's arm; length of bladder should equal 80% of this circumference

How do you assess recent memory?

Assess in context of interview by 24-hour diet recall or by asking time person arrived at agency Ask questions you can corroborate to screen for occasional person who confabulates or makes up answers to fill in gaps of memory loss

How to assess orientation with metal status?

Assess orientation through course of interview, or ask for it directly. Example: "Some people have trouble keeping up with dates while in the hospital; what is today's date?" Time: day of week, date, year, season Place: where person lives, address, phone number, present location, type of building, name of city and state Person: own name, age, who examiner is, type of worker Many hospitalized people normally have trouble with exact date but are fully oriented on remaining items

Average adult bp?

Average BP in young adult is less than 120/80 mm Hg; varies normally with many factors:

How to check respirations?

Because most people are unaware of their breathing, do not mention that you will be counting respirations, because sudden awareness may alter normal pattern Instead, maintain your position of counting radial pulse and unobtrusively count respirations Count for 30 seconds or a full minute if you suspect an abnormality **Avoid counting for 15 seconds, may not be as accurate due to smaller number Of resp. In each 15 second interval

What is blood pressure?

Blood pressure (BP) is force of blood pushing against side of its container, vessel wall -the strength of push changes with event in the cardiac cycle

Pulses of 1?

Caused by a decreased stroke volume (such as occurs with hemorrhagic shock) increased stroke volume, as with anxiety, exercise, and some abnormal conditions

Pulse rate of 4+ or 3+?

Caused by increased stroke volume, as with anxiety, exercise, and some abnormal conditions

What should the nurse do if the pulse is unable to be palpated?

Check for pulse with Doppler In many situations, pulse and BP measurement enhanced by using an electronic device, Doppler ultrasonic flow meter Technique works by a principle that sound varies in pitch in relation to distance between sound source and listener: pitch is higher when distance is small, and pitch lowers as distance increases

How do you assess attention span with mental status?

Check person's ability to concentrate by noting whether he or she completes a thought without wandering Attention span commonly is impaired in people who are anxious, fatigued, or intoxicated

How to take temporal artery temperature?

Clean the lens/probe Place probe flat on center of forehead Press and hold button while stroking thermometer medially to laterally across the forehead Keep holding the button and touch thermometer lens/probe behind the ear lobe Release button to read temperature

What happens if the cuff is too small for the person

If it's too small for the person- the reading will be abnormally high

What is the mini mental status exam and what is it useful for?

Concentrates only on cognitive functioning, not on mood or thought processes Standard set of 11 questions, requires only 5 to 10 minutes to administer Useful for both initial and serial measurement, so worsening or improvement of cognition over time and with treatment can be assessed Good screening tool to detect dementia and delirium and to differentiate these from psychiatric mental illness

What is hypothermia?

Core temperature below normal (less than 95°F or 35°C) Associated with extended exposure to cold (e.g., extreme weather, immersion in cold water, or lack of shelter and clothing)

What is temperature regulation?

Degree of heat maintained by the body Difference between heat produced by the body and heat lost to the environment Body maintains steady temperature through a thermostat, or feedback mechanism, regulated in hypothalamus of brain Thermostat balances heat production (from metabolism, exercise, food digestion, external factors) with heat loss (through radiation, evaporation of sweat, convection, conduction)

What is the difference between delirium and dementia?

Delirium is an acute confusional change or loss of consciousness and perceptual disturbance, may accompany acute illness (e.g., pneumonia, alcohol/drug intoxication), and is usually resolved when the underlying cause is treated. In contrast, dementia is a gradual progressive process—causing decreased cognitive function even though the person is fully conscious and awake—and is not reversible. For ex- Alzheimers' Delirium is temporary and and dementia and is permanent -one of the most common causes of delirium is interrupting the circadian rhythm -with dementia the alert anf orinetated times 3 and 2 is tell you what scale they are at with that

How does disease influence pulse rate?

Diseases, such as heart disease, hyperthyroidism, respiratory diseases, and infections, are generally associated with increased pulse rates

When would you take rectal temp? What are the disadvantages of this method?

Examples of when to take rectal temperature: comatose or confused persons, for persons in shock, or for those who cannot close mouth because of breathing or oxygen tubes, wired mandible, or other facial dysfunction or if no tympanic membrane thermometer equipment is available What are disadvantages to rectal route? patient discomfort and time-consuming and disruptive nature of activity -can cause a vagus basil response Ppl will fast heart rates you have them do manevours to stimulate the vagus nerve by holding your breath, bowl movement etc... -blue for mouth, red probe for rectal

What is fever or pyrexia?

Fever (pyrexia) High body temperature (greater than 100°F or 37.8°C) Occurs in response to pyrogens (e.g., bacteria)

A nursing student is learning about the importance of performing a mental status assessment on patients so as to provide an adequate indicator of cognitive status. What information would be included in a mental status assessment for an adult patient?

From Textbook: Mental status cannot be scrutinized directly like the characteristics of skin or heart sounds. Its functioning is inferred through assessment of an individual's behaviors: Consciousness: Being aware of one's own existence, feelings, and thoughts and of the environment. This is the most elementary of mental status functions. Language: Using the voice to communicate one's thoughts and feelings. This is a basic tool of humans, and its loss has a heavy social impact on the individual. Mood and affect: Both of these elements deal with the prevailing feelings; affect is a temporary expression of feelings or state of mind, and mood is more durable, a prolonged display of feelings that color the whole emotional life. Orientation: The awareness of the objective world in relation to the self; ability to name own person, place, and time. Attention: The power of concentration, the ability to focus on one specific thing without being distracted by many environmental stimuli. Memory: The ability to lay down and store experiences and perceptions for later recall. Recent memory evokes day-to-day events; remote memory brings up years' worth of experiences. Abstract reasoning: Pondering a deeper meaning beyond the concrete and literal. Thought process: The way a person thinks; the logical train of thought. Thought content: What the person thinks—specific ideas, beliefs, the use of words. Perceptions: An awareness of objects through the five sense

Orthostatic vital signs procedure

Have person rest supine for 2 or 3 minutes, take baseline readings of pulse and BP, and then repeat with person standing For person who is too weak or dizzy to stand, assess BP supine and then sitting with legs dangling Record BP by using even numbers Also record person's position, arm used, and cuff size, if different from standard adult cuff Record pulse rate and rhythm, noting whether pulse is regular

Which client would the nurse need to monitor the body temperature most closely/frequently? With an infection Who is an infant Who has experienced a heat stroke With a head injury

Head injury bc of the hypothalamus

How does medication influence pulse rate?

Increase pulse rate= stimulant drugs (e.g., epinephrine) Decrease pulse rate= cardiotonic drugs (e.g., digitalis) and opioids (e.g., narcotic analgesics) or sedative drugs

How does fever influence pulse rate?

Increases about 10 beats/min for each degree Fahrenheit of temperature elevation -the metabolic rate increases -peripheral vasodilation occurs, causing a decrease in blood pressure. -The body then causes the heart to beat faster to compensate for the decreased blood pressure

Why is it important to screen for suicidal thoughts?

It is very difficult to question people about possible suicidal wishes for fear of invading privacy Asking about suicidal thoughts does not increase suicidal behavior Risk is far greater skipping these questions if you have the slightest clue that they are appropriate Share any concerns you have about a person's suicide ideation with a mental health professional -you may be the only professional to pick up on clues of a suicidal risk

What is pulse rate? Normal? tachy? Brady?

Measured in beats per minute (bpm) Normal range for healthy adults = 60 to 100 bpm Average = 70 to 80 bpm Bradycardia---heart rate less than 60 bpm Tachycardia---heart rate over 100 bpm

How does developmental level influence pulse rate?

Newborns have a rapid pulse rate Pulse rate stabilizes in childhood and gradually slows through old age

What is a normal score of the MMSE? Abnormal?

Normal mental status average 27; scores between 24 and 30 indicate no cognitive impairment Scores that occur with dementia and delirium: 18-23 for mild cognitive impairment 0-7 for severe cognitive impairment

The sounds you're hearing with BP? Korkoff's sounds?

Note points at which you hear first appearance of sound, muffling of sound, and final disappearance of sound (5th Korotkoff sound) These are phases I, IV, and V of Korotkoff's sounds For all age-groups, fifth Korotkoff phase now used to define diastolic pressure However, when a variance greater than 10 to 12 mm Hg exists between phases IV and V, record both phases along with systolic reading Clear communication is important because results significantly affect diagnosis and planning of care

Confusion is aging adults?

One third to one half of older adults admitted to acute-care medical and surgical services show varying degrees of confusion already present In the community, about 5% of adults over 65 and almost 20% of those over 75 have some degree of clinically detectable impaired cognitive function

How to take rectal temp?

Only used when other routes are not practical What are some examples of when to take a rectal temperature? What are disadvantages to rectal route? Slide thermometer into a protective sheath (probe cover) Positioning for rectal temperature Adult patient---to Sims position Small child---face down across student's lap or on a parent's lap Wear gloves, lubricate tip of rectal probe cover, and insert into rectum Adult patient---insert 2 to 3 cm (1-1.5 inches), directed toward umbilicus Small child---2.5 cm (1 inch) and infant---1.5 cm (0.5) inches Hold thermometer in place, remove thermometer when it beeps Discard probe cover and gloves

Oral temp?

Oral temperature accurate and convenient Normal oral temperature in a resting person is 37° C (98.6° F), with a range of 35.8° C to 37.3° C (96.4° F to 99.1° F) Rectal measures 0.4° C to 0.5° C (0.7° F to 1° F) higher

Pulse heart rate in infants and children?

Palpate or auscultate an apical rate with infants and toddlers In children older than 2, use radial site Count pulse for a full minute to take into account normal irregularities, such as sinus arrhythmia Heart rate normally fluctuates more with infants and children than adults from exercise, emotion, and illness

Palpating peripheral pulse and radial pulse?

Palpating peripheral pulse gives rate and rhythm of heartbeat Radial pulse usually palpated while vital signs measured Force flares arterial walls and generates pressure wave, felt in periphery as pulse

How often are vital signs taken? Hospital? Home health setting? Clinic? Skilled nursing facilities?

Performed on a regular basis Frequency determined by Provider's prescription and/or nursing judgment Client's condition Facility standards Hospital: Every 4 to 8 hours Home health setting: Each visit Clinic: Each visit Skilled nursing facilities (SNFs): Weekly to monthly

How do you do vital signs with infants? What order are we doing them in?

Reverse order that you would for adults. -Respiration pulse and then temperature.Measure vital signs with same purpose and frequency as you would in an adult

Considerations with axillary temp?

Safe and accurate for infants and young children when environment is reasonably controlled Document as axillary temperature; slightly lower than oral temperature (1 degree)

Verify BP Baseline: Two-step Method

Person may be sitting or lying, with bare arm supported at heart level Wrap BP cuff about 2.5 cm (1 in) above brachial artery and wrap it evenly Palpate brachial artery Inflate cuff until artery pulsation obliterated (systolic) and then 20 to 30 mm Hg beyond Deflate cuff quickly and completely Wait 15 to 30 seconds before reinflating to check BP & pump it 30 mmm HG above systolic or Inflate cuff until artery pulsation obliterated and then 20 to 30 mm Hg beyond This will avoid missing an auscultatory gap, when Korotkoff's sounds disappear during auscultation

Assessing perceptions with mental status?

Person should be consistently aware of reality; perceptions should be congruent with yours

BP Procedure: Arm Pressure?

Place diaphragm of stethoscope over site of brachial artery, making a light but airtight seal Rapidly inflate cuff to maximal inflation level you determined Then deflate the cuff slowly and evenly, about 2 mm Hg per heartbeat

How to take TMT?

Place disposable cover over lens Positioning for tympanic temperature Position patient's head to one side; right ear if right handed and left ear if left handed Adult patient---pull pinna up and back to straighten ear canal Small child---pull pinna down and back to straighten ear canal Gently place covered probe tip in person's ear canal; press and release the button to take temperature (read in 2 to 3 seconds) Remove thermometer when it beeps and discard probe cover

How to take temp with chemical strip thermometer?

Place strip on forehead or abdomen Leave in place for 15 seconds to 1 minute Observe for color changes on strip and read temperature Remove and discard strip

How to take axillary temperature?

Position patient to supine or sitting position Slide thermometer into a protective sheath (probe cover) Place the thermometer tip in the middle of the axilla Position the patient's upper arm down with lower arm across chest (hold it in place if needed) Remove thermometer when it beeps and discard probe cover

How to take oral temperature?

Slide thermometer into a protective sheath (probe cover) Place the thermometer under the tongue (posterior sublingual pocket) Ask patient to keep lips closed Remove thermometer when it beeps and discard probe cover

What is pulse pressure?

Pulse pressure: difference between systolic and diastolic Reflects stroke volume

How would the nursing student differentiate between recent and remote memory in an adult patient?

Remote memory- verify what they say with the chart (how many surgeries have you had?) Recent memory would be how did you get here today?

What is a normal respiratory rate for an adult? How does it sound?

Resp. Rate for adult=12-20 resp/minute Normally, person's breathing is relaxed, regular, automatic, and silent

Normal respiratory rate for a child?

Resp. Rate for child=30-60 resp/minute

How does blood loss influence pulse rate? What is cardiac output?

Small blood loss is generally well-tolerated and produces only a temporary increase in pulse rate -However, research suggests that vital signs are limited in their ability to detect large blood losses; thus, a stable pulse and blood pressure are unreliable measures of the amount of loss -Cardiac output: is blood pumped out of heart through aorta in L per min

How does position change influence pulse rate?

Standing and sitting positions generally cause a temporary increase in pulse rate as a result of blood pooling in the veins of the feet and legs Causes decreased blood return to the heart, decreasing blood pressure and increasing heart rate

How does stress influence pulse rate?

Stress triggers the fight or flight sympathetic nervous response. Stress increases both pulse rate and strength of the heart contractions (stroke volume)

How does stress influence pulse rate?

Stress triggers the fight or flight sympathetic nervous response. Stress increases both pulse rate and strength of the heart contractions (stroke volume) this makes sense bc our body thinks stress is telling us to get ready to save ourselves from a situation and it does so accordingly by increasing the blood pumping in our body. but in reality a lot of our stress is unnecessary.

What is stroke volume

Stroke volume amount of blood every heart beat pumps into aorta with each beat, thus requiring fewer beats per minute to maintain a stable cardiac output Stronger, more efficient heart muscle pushes out a larger stroke volume Stroke volume: about 70 mL in adult (lower if large blood loss) Example: For a person with a pulse of 80 beats/min and an average stroke volume (70 mL), the cardiac output would be about 5600 mL (or 5.6 liters) per minute.

Stroke volume? How it works / average

Stronger, more efficient heart muscle pushes out a larger stroke volume (amount of blood every heart beat pumps into aorta) with each beat, thus requiring fewer beats per minute to maintain a stable cardiac output Stroke volume: about 70 mL in adult (lower if large blood loss) Example: For a person with a pulse of 80 beats/min and an average stroke volume (70 mL), the cardiac output would be about 5600 mL (or 5.6 liters) per minute.

What's the difference between surface temperature and core temperature?

Surface temperature is the skin Lower than core temperature Use oral and axillary method Core temperature An adult's internal temperature is called the core temperature. Rectal and tympanic sites measure core temperature.

What is systolic pressure and diastolic pressure?

Systolic pressure: maximum pressure felt on artery during left ventricular contraction, or systole Diastolic pressure: elastic recoil, or resting, pressure that blood exerts constantly between each contraction

What's the preferred method of temperature with infants and why?

Taking a rectal temperature may cause infant to cry, thus masking normal resting values Preschooler's normal fear of body mutilation increased with any invasive procedure Whenever possible, avoid rectal route and take a tympanic or axillary temperature

What are the vital signs? (order for adults and adolescents)

Temperature Pulse Respirations Blood Pressure Pain is the 5th vital sign

Vital signs in aging adult?

Temperature: changes in body's temperature regulatory mechanism leave aging person less likely to have fever but at greater risk for hypothermia Temperature is less reliable index of older person's true health state; sweat gland activity is also diminished Pulse: normal range of heart rate is 60 to 100 bpm, but rhythm may be slightly irregular Radial artery may feel stiff, rigid, and tortuous in older person, although does not necessarily imply vascular disease in heart or brain Increasingly rigid arterial wall needs faster upstroke of blood, so pulse is actually easier to palpate

A 65-year-old female has been having continued difficulty remembering phone numbers for several months' duration and comes to the physician's office out of concern-

The 65-year-old patient should be evaluated for dementia, as this is an ongoing problem.

The student nurse is reviewing comparative differences between delirium and dementia. Based on these observations, how would the student nurse characterize the following presentations?A 78-year-old male presents with new onset confusion in the physician's office-

The 78-year-old patient should be evaluated for delirium, as this is a "new onset" confusion.

An 89-year-old male has a urinary tract infection and is confused on admission to the hospital-

The 89-year-old patient should be evaluated for delirium due to the comorbid condition of a urinary tract infection.

What happens if the cuff is too big for the person?

The reading will be abnormally low

3.0 scale for pulse

Using a 3 point scale 3+ Full, bounding pulse 2+ Normal pulse 1+ Weak, thready pulse 0 Absent pulse

4.0 scale for pulse

Using a 4 point scale 4+ Bounding pulse, sometimes visible 3+ Full, brisk pulse 2+ Normal pulse 1+ Faint, but detectable pulse- thready 0 Absent pulse

How to check radial pulse?

Using pads of the first three fingers, palpate radial pulse at flexor aspect of wrist laterally along radius bone Push until strongest pulsation is felt---assess for rate, rhythm, force, and elasticity Counting the pulse Regular rhythm---count number of beats in 30 seconds and multiply by 2 Irregular rhythm---count for full minute How to count---as you begin counting interval, start your count with zero for first pulse felt, second pulse felt is one, etc.

What is the procedure for checking temperature?

Wait 15 minutes if person has just taken hot or cold liquids and 2 minutes if he or she has just smoked Select thermometer type -Electronic (digital) thermometer Most commonly used Has the advantages of quick and accurate measurement (usually in 20 to 30 seconds) make sure it's charged and calibrated, kids like this one Safe, unbreakable, disposable probe covers -Chemical strip thermometer Disposable and easy to use

Assessing thought processes with mental status?

Way person thinks should be logical, goal directed, coherent, and relevant; should complete thoughts

When do you use the thigh pressure procedure?

When BP measured at arm is excessively high, compare it with thigh pressure to check for coarctation of aorta (congenital form of narrowing) -Particularly done in adolescents and young adults -Normally, thigh pressure higher than that in arm

How do you take temperature with infants / children?

When axillary route used, place tip well into axilla, and hold child's arm close to body Use oral route when child old enough to keep mouth closed; usually at age 5 or 6, although some 4-year-old children can cooperate When available, use an electronic thermometer because it is unbreakable and it registers quickly

How do you screen for suicidal thoughts?

When the person expresses feelings of sadness, hopelessness, despair, or grief, it is important to assess any possible risk of physical harm to himself or herself Begin with more general questions; if you hear affirmative answers, continue with more specific probing questions Example question: "Have you ever felt so blue you thought of hurting yourself or do you feel like hurting yourself now?" Example question: "Do you have a plan to hurt yourself? How would you do it? -the more detailed the plan the more likely they are to do it

When do you take serial measurements of pulse and blood pressure? Orthostatic / postural vital signs

You suspect volume depletion Person is known to have hypertension or taking antihypertensive medications Person reports fainting or syncope Position changed from supine to standing, normally slight decrease (less than 10 mm Hg) in systolic pressure may occur

Denver 2 screening?

assessment for mental status of child designed to detect developmental delays in infants and preschoolers within four functional groups: gross, motor, lang, fine motor-adaptive, personal social skills -avoids diagnostic criteria and simply labels normal or abnormal -parent health history is best indication for child mental status

Significant elevation in blood pressure measurements from one day to the next could be attributed to: a decrease in cuff size. an increase in cuff size. new onset of pain or anxiety. both 1 and 3.

both 1 and 3

Mini Cog

brain on fire -looks for cognitive impairment takes 3-5 mins -tests for their execuitve functioning with planning, managing time, organize activites and working memory -consists of clock drawing and 3 item recall

What is sinus arrhythmia?

common in children and young adults- slight irregularity in respirations

What if rhythm is irregular?

if rhythm is irregular, count for full minute As you begin counting interval, start your count with "zero" for first pulse felt Second pulse felt is "one," and so on

In the clinical setting, what if the temp doesn't seem accurate?

if the temp doesn't seem accurate in an adult take the rectal temp

What is mean arterial pressure / MAP

pressure forcing blood into tissues, averaged over cardiac cycle

What does cellular metabolism require as a stable?

requires a stable core, or "deep body," temperature of a mean of 37.2° C (99° F)

What is a tympanic membrane thermometer (TMT)?

senses infrared emissions of tympanic membrane (eardrum) Tympanic membrane shares same vascular supply that perfuses hypothalamus (internal carotid artery) Probe tip is shape of otoscope

What are the advantages of a TMT?

speed, convenience, safety, noninvasive, reduced risk of injury and infection, and noninvasiveness, minimal chance of cross-contamination with tympanic thermometer because ear canal is lined with skin and not mucous membrane Tympanic thermometer used with unconscious patients or with those who are unable or unwilling to cooperate with traditional techniques (i.e., those in critical care units, emergency departments, recovery areas, labor and delivery units)

Assessing thought content with mental status?

what the person says should be consistent and logical