Which client should have a rectal thermometer obtained by an assistive personnel to ensure accurate temperature monitoring?

• A. A A toddler with diarrhea
• B. B A client 1 day postoperatively after hemorrhoidectomy receiving PCA analgesia
• C. C An infant receiving intravenous fluids
• D. D A client who is diaphoretic and frequently chewing ice to relieve dry mouth

Answer: (D)

Measuring temperature via the rectal route gives the most reliable indication of core body temperature, because it is less influenced by external factors and what’s happening in the mouth or on the skin. In a patient who is diaphoretic and frequently chewing ice to relieve dry mouth, oral readings can be unreliable due to sweating and the altered condition of the oral cavity from ice chewing. A rectal reading bypasses these issues and provides a true core temperature, making it the best choice for accurate monitoring in this situation. Assistive personnel who are trained can perform rectal thermometry to obtain this accurate measure. The other scenarios involve conditions or circumstances where an oral or other route may still be usable or where rectal access is less appropriate (for example, potential irritation or risk with a recent rectal procedure or in a patient with ongoing diarrhea), so they don’t require or justify the rectal route for accuracy.