Although you may choose to omit measuring the temperature in ambulatory patients, it should be checked whenever you suspect an abnormality. The average oral temperature, usually quoted at 37°C (98.6°F), fluctuates considerably. In the early morning hours it may fall as low as 35.8 °C (96.4°F), and in the late afternoon or evening it may rise as high as 37.3°C (99.1°F). Rectal temperatures are higher than oral temperatures by an average of 0.4 to 0.5°C (0.7 to 0.9°F), but this difference is also quite variable. (In contrast, axillary temperatures are lower than oral temperatures by approximately 1 degree, but take 5 to 10 minutes to register and are generally considered less accurate than other measurements.)
Fever or pyrexia refers to an elevated body temperature. Hyperpyrexia refers to extreme elevation in temperature, above 41.1 °C (106°F), while hypothermia refers to an abnormally low temperature, below 35°C (95°F) rectally.
Most patients prefer oral to rectal temperatures. However, taking oral temperatures is not recommended when patients are unconscious, restless, or unable to close their mouths. Temperature readings may be inaccurate and thermometers may be broken by unexpected movements of the patient's jaws.
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