NUR 2115 Fundamentals of Nursing Study Guide Exam 1 Latest Updated 2022,100% CORRECT

NUR 2115 Fundamentals of Nursing Study Guide Exam 1Latest Updated 2022 Know the different types of wellness: Wellness: an active state of being healthy, including living a lifestyle that promotes good physical, mental, and emotional health. Physical Dimension: The physical dimension includes genetic inheritance, age, developmental level, race, and gender. These components strongly influence the person’s health status and health practices. Emotional Dimension: How the mind affects body functions and responds to body conditions also influences health. Long-term stress affects body systems, and anxiety affects health habits; conversely, calm acceptance and relaxation can actually change the body’s responses to illness. Intellectual Dimension: The intellectual dimension encompasses cognitive abilities, educational background, and past experiences. These influence the person’s responses to teaching about health and reactions to nursing care during illness. Environmental Dimension: The environment has many influences on health and ill- ness. Housing, sanitation, climate, and pollution of air, food, and water are elements in the environmental dimension. Sociocultural Dimension: Health practices and beliefs are strongly influenced by a per- son’s economic level, lifestyle, family, and culture. In general, low-income groups, racial and ethnic minorities, and other underserved populations are less likely to seek medical care to prevent illness and have fewer treatment options, while high-income groups are more prone to stress-related habits and illness. Spiritual Dimension: Spiritual beliefs and values are important components of a person’s health and illness behaviors (see Chapter 45). It is important that nurses respect these values and understand their importance for the individual patient. o Three spiritual needs underlie all religious traditions and are common to all people: 1. Need for meaning and purpose 2. Need for love and relatedness 3. Need for forgiveness Know the definition of culture and what it means in healthcare: Culture: a shared system of beliefs, values, and behavioral expectations that provides social structure for daily living. Culture influences roles and interactions with others as well as within families and communities, and is apparent in the attitudes and institutions unique to particular groups. Culture in Healthcare: Nurses must be aware of, and sensitive to, the needs of a diverse patient population. Physiological variation: Studies have shown that certain racial and ethnic groups are more prone to certain diseases and conditions. Reactions to pain: Health care researchers have discovered that many of the expressions and behaviors exhibited by people in pain are culturally prescribed. Some cultures allow or even encourage the open expression of emotions related to pain, whereas other cultures encourage suppression of such emotions. Mental Health: Most mental health norms originate in research and observations made of White, middle-class people. But many ethnic groups have their own norms and acceptable patterns of behavior for psychological well-being, as well as different normal psychological reactions to certain situations. Gender roles: In many cultures, the man is the dominant figure and generally makes decisions for all family members. Knowing who is dominant in the family is important when planning nursing care. Language and Communication: Linguistic competence refers to the ability of caregivers and organizations to understand and effectively respond to the linguistic needs of patients and their families in a health care encounter. o Nurses who work in a geographic area with a high popu- lation of residents who speak a language other than English should learn pertinent words and phrases in that language. o To avoid misinterpretation of questions and answers, it is important to use an interpreter who understands the health care system; friends and family members often discouraged. o One of the most culturally variable forms of nonverbal communication is eye contact. • American dominant culture emphasizes eye contact while speaking, • Direct eye contact may be considered impolite or aggressive by many Asians, Native Americans, Indochinese, Arabs, and Appalachians. • Hispanics may look downward in deference to age, gender, social position, economic status, or authority. • Muslim–Arab women often indicate modesty by avoiding eye contact with men, and Hasidic Jewish men may avoid direct eye contact with women Orientation to Space and Time: Personal space is the area around a person regarded as part of the person. When providing nursing care that involves physical contact, you should know the patient’s cultural personal space preferences. Food and Nutrition: Food preferences and preparation methods often are culturally influenced. Certain food groups serve as staples of the diet based on culture and remain so even when members of that culture are living in a different country. o Dietary teaching must be individualized according to cultural values about the social significance and sharing of food. Family Support: In many cultural and ethnic groups, people have large, extended families and consider the needs of any family member to be equal to or greater than their own. Including the family in planning care for any patient is a major component in nursing care to meet individualized needs. Socioeconomic Factors: The amount of money a person or family has affects how they meet their basic needs and maintain their health. o At highest risk are children, older people, families headed by single mothers, and the future generations of those now living in poverty. o Poverty has long been a barrier to adequate health care. It prevents many people from consistently meeting their basic human needs. Health Disparities: Health disparities refer to health differences between groups of people; they can affect how frequently a disease affects a group, how many people get sick, or how often the disease causes death. Know Asian/African American cultural preferences for health and who makes decisions: African American Family: o Close and supportive extended-family relationships o Strong kinship ties with nonblood relatives from church or organizational and social groups o Family unity, loyalty, and cooperation are important. o Usually matriarchal Folk and Traditional Healthcare: o Varies extensively and may include spiritualists, herb doc- tors, root doctors, conjurers, skilled elder family members, voodoo, faith healing. Values and Beliefs: o Present oriented o Members of the African American clergy are highly respected o Frequently highly religious Nursing Considerations: o Many African American families may still use various folk healing practices and home remedies for treating particular illnesses. o Special care may be necessary for the hair and skin. o Special consideration should be given to the sometimes extensive and frequently informal support networks of patients (e.g., religious and community group members who offer assistance in a time of need). Asian American Family: o Welfare of the family is valued above the person. o Extended families are common. o A person’s lineage (ancestors) is respected. o Sharing among family members is expected. o Patriarchal Folk and Traditional Healthcare: o Theoretical basis is in Taoism, which seeks a balance in all things. o Good health is achieved through the proper balance of yin (feminine, negative, dark, cold) and yang (masculine, positive, light, warm). o An imbalance in energy is caused by an improper diet or strong emotions. o Diseases and foods are classified as hot or cold, and a proper balance between them will promote wellness (e.g., treat a cold disease with hot foods). o Many Asian health care systems use herbs, diet, and the application of hot or cold therapy. Also, many Asians believe that there are points on the body that are located on the meridians or energy pathways. If the energy flow is out of balance, treatment of the pathways may be necessary to restore the energy equilibrium. Values and Beliefs: o Strong sense of self-respect and self-control o High respect for age o Respect for authority o Respect for hard work o Praise of self or others is considered poor manners o Strong emphasis on harmony and the avoidance of conflict Nursing Considerations: o Some members of Asian cultures may be upset by the drawing of blood for laboratory tests. They consider blood to be the body’s life force, and some do not believe that it can be regenerated. o Some members believe that it is best to die with the body intact, so they may refuse surgery except in dire circumstances. o Members of many Asian cultures seldom complain about what is bothering them. Therefore, the nurse must carefully assess the patient for pain or discomfort by observing for nonverbal signs of discomfort, such as facial grimacing or wincing and holding of the painful area. o Some Asians consider it polite to give a person the responses the person is expecting. Therefore, the client may transmit misinformation to the questioner in an effort to be respectful. o Some Asians may refuse diagnostic studies because they believe that a skilled and competent physician can diagnose an illness solely through a physical examination. o Some members may have a difficult time understanding the importance of a medication regimen because many folk treatments involve the ingestion of just one dose of herbal mixtures. o Dietary counseling may be necessary if the patient is on a salt-restricted diet because many Asian food contains soy cause. Food Preferences for different Religions: Muslims Offer a halal diet free of alcohol and pork or pork products; make sure medications are alcohol- and pork-free. During Ramadan, Muslims must fast from sunrise to sunset. Fasting includes abstaining from all substances, including pharmaceuticals and IV drips. However, illness is an exception. Jewish The word kosher is usually translated as "proper." Certain foods, notably pork and shellfish, are forbidden; meat and dairy may not be combined, and meat must be ritually slaughtered and salted to remove all traces of blood. Know the difference between the following cultural definitions: Stereotype: The assumption that all members of a culture or ethnic group act alike. This may be positive or negative. Negative stereotyping includes racism, ageism, and sexism. Bias: the negative evaluation of one group and its members relative to another. Ethnic Slur: an ethnic slur is a term designed to insult others on the basis of race, ethnicity, or nationality. Stigma: a mark of disgrace associated with a particular circumstance, quality, or person. World Health Organization (WHO) of health: Health: A state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity. Maslow’s Hierarchy of Needs: Abraham Maslow (1968) developed a hierarchy of basic human needs that describes which needs of a person are the most important at any given time. The hierarchy is based on the theory that something is a basic need if it has the following characteristics: Its lack of fulfillment results in illness. Its fulfillment helps prevent illness or signals health. Meeting it restores health. It takes priority over other satisfactions when unmet. The person feels something is missing when the need is unmet. The person feels satisfaction when the need is met. Level 1 – Physiological: for oxygen, water, food, elimination, temperature, sexuality, physical activity, and rest—must be met at least minimally to maintain life. These needs are the most basic in the hierarchy of needs, are the most essential to life and, therefore, have the highest priority. Level 2 – Safety and Security: Physical safety and security means being protected from potential or actual harm. Emotional safety and security involves trusting others and being free of fear, anxiety, and apprehension. Level 3 – Love and Belonging: Love and belonging needs include the understanding and acceptance of others in both giving and receiving love, and the feeling of belonging to groups such as families, peers, friends, a neighborhood, and a community. Level 4 – Self Esteem: The need for a person to feel good about oneself, to feel pride and a sense of accomplishment, and to believe that others also respect and appreciate those accomplishments. Positive self-esteem facilitates the per- son’s confidence and independence. Level 5 – Self Actualization: The need for individuals to reach their full potential through development of their unique capabilities. In general, each lower level of need must be met to some degree before this need can be satisfied. The process of self-actualization continues throughout life. Understand Evidence-Based Practice (EBP), its’ barriers, and how it is applied: Evidence-based practice (EBP) in nursing is a problem-solving approach to making clinical decisions, using the best evidence available. EBP blends both the science and the art of nursing so that the best patient outcomes are achieved. The information that is collected is analyzed and used to answer questions (the science of nursing), taking into consideration patient preferences and values, as well as the clinical experiences of the nurse (the art of nursing). How EBP is applied: Step 1: Ask a question about a clinical area of interest or an intervention. Step 2: Collect the most relevant and best evidence. Step 3: Critically appraise the evidence. o What were the results of the study? o Are the results valid (did the investigator measure what was intended to be measured) and reliable (were the measurements consistent across time)? o Will the results of the study improve patient care? Step 4: Integrate the evidence with clinical expertise, patient preferences, and values in making a decision to change. Step 5: Evaluate the practice decision or change. Barriers to EBP: institutional and/or cultural barriers, lack of knowledge, lack of motivation, time management, physician and patient factors, and limited access to up- to-date user-friendly technology and computer systems. Know the different components to P-I-C-O P = Patient, population, problem of interest Need for explicit description; may include setting, limiting to subgroups (such as by age). I = Intervention of interest The more defined, the more focused the search of the literature will be; may include exposure, treatment, patient perception, diagnostic test, or predicting factor. C = Comparison of interest The more defined, the more focused the search of the literature will be; may include exposure, treatment, patient perception, diagnostic test, or predicting factor. O = Outcome of interest Specifically identifying the outcome to enable a literature search to find evidence that examined the same outcome, perhaps in different ways. Know the different sources of knowledge: Scientific: Scientific knowledge is knowledge obtained through the sci- entific method (implying thorough research). Traditional: Traditional knowledge is that part of nursing practice passed down from generation to generation. Authoritative: Authoritative knowledge comes from an expert and is accepted as truth based on the person’s perceived expertise. Know the concepts that nursing theories have in common: A theory is composed of a group of concepts that describe a pattern of reality. Concepts, like ideas, are abstract impressions organized into symbols of reality. Concepts describe objects, properties, and events and relationships among them. Nursing theories are often based on, and influenced by, other broadly applicable processes and theories. The ideas and principles of the theories described briefly in the following sections are basic to many nursing concepts and are a part of the nursing literature. General Systems Theory: This theory describes how to break whole things into parts and then to learn how the parts work together in “systems.” It emphasizes relationships between the whole and the parts and describes how parts function and behave. o A system is a set of interacting elements, all contributing to the overall goal of the system. The whole system is always greater than the sum of its parts. Adaptation Theory: Adaptation theory defines adaptation as the adjustment of living matter to other living things and to environmental conditions. Adaptation is a continuously occurring process that effects change and involves interaction and response. Developmental Theory: Developmental theory outlines the process of growth and development of humans as orderly and predictable, begin- ning with conception and ending with death. o Erik Erikson based his theory of psychosocial development on the process of socialization, emphasizing how individuals learn to inter- act with the world. o Abraham Maslow developed his theory of human needs in terms of physical and psychosocial needs considered essential to human life, rather than by chronologic age as Erikson did. Know the Nursing Process: Nurses implement their roles through the nursing process, which integrates both the art and the science of nursing—that is, the nursing process is nursing made visible. The nursing process is used by the nurse to identify the patient’s health care needs and strengths, to establish and carry out a plan of care to meet those needs, and to evaluate the effectiveness of the plan to meet established outcomes. Assessment: The registered nurse collects comprehensive data pertinent to the patient’s health or the situation. Diagnosis: The registered nurse analyzes the assessment data to determine the diagnoses or issues. Planning: The registered nurse develops a plan that prescribes strategies and alternatives to attain expected outcomes. Implementation: The registered nurse implements the identified plan, coordinates care delivery, employs strategies to promote health and a safe environment. Evaluation: The registered nurse evaluates progress toward attain- ment of outcomes. Know how to identify reliable resources: You can ask the following questions to determine if a source is credible. Who is the author? o Credible sources are written by authors respected in their fields of study. Responsible, credible authors will cite their sources so that you can check the accuracy of and support for what they've written. How recent is the source? What type of sources does your audience value? o If you are writing for a professional or academic audience, they may value peer-reviewed journals as the most credible sources of information. o Never use Web sites where an author cannot be determined, unless the site is associated with a reputable institution such as a respected university, a credible media outlet, government program or department, or well-known non-governmental organizations. Know client and bed positions: Know safe handling of patients and proper body mechanics: Lifting Use the major muscle groups to prevent back strain, and tighten the abdominal muscles to increase support to the back muscles. Distribute the weight between the large muscles of the arms and legs to decrease the strain on any one muscle group and avoid strain on smaller muscles. When lifting an object from the floor, flex the hips, knees, and back. Get the object to thigh level, keeping the knees bent and the back straightened. Stand up while holding the object as close as possible to the body, bringing the load to the center of gravity to increase stability and decrease back strain. Use assistive devices whenever possible, and seek assistance whenever it is needed. Guidelines to Prevent Injury Know your agency’s policies regarding lifting and safe patient handling. It is preferred that two or more personnel assist with any positioning. Plan ahead for activities that require lifting, transfer, or ambulation of a client, and ask others to be ready to assist at the planned time. Prepare environment to remove obstacles prior to procedure. Explain process to client and assistants to clarify roles. Be aware that the safest way to lift a client may be with the use of assistive equipment. Rest between heavy activities to decrease muscle fatigue. Maintain good posture and exercise regularly to increase the strength of arm, leg, back, and abdominal muscles, so these activities will require less energy. When standing for long periods of time, flex the hip and knee through use of a foot rest. When sitting for long periods of time, keep the knees slightly higher than the hips. Maintain good posture (head and neck in straight line with pelvis) to avoid neck flexion and hunched shoulders, which can cause impingement of nerves in the neck. Avoid twisting the spine or bending at the waist (flexion) to minimize the risk for injury. Know what scoliosis looks like: Scoliosis – a lateral curvature of the spine with no apparent cause. Screening: Inspect and palpate the spine from the back for any lateral deviations or scoliosis. o Instruct the client to bend at the waist with the arms reaching for the toes. o Inspect and palpate down the spine using the thumb and forefinger. o Inspect and palpate the spine again with the client standing. o Expected finding: no tenderness, with spinal vertebrae that are midline. Know fall prevention measures: General measures to prevent falls include the following: Be sure the client knows how to use the call light, that it is in reach, and encourage its use. Use fall-risk alerts, such as ID wristbands per facility protocol. Orient the client to the setting (grab bars, call light) to ensure he knows how to use all assistive devices and can locate necessary items. Ensure that bedside tables and overbed tables and frequently used items (telephone, water, tissues) are within the client’s reach. Maintain the bed in the low position. Provide the client with nonskid footwear and nonskid bath mats for use in tubs and showers. Use gait belts and additional safety equipment, as needed, when moving clients. Keep the floor free from clutter with a clear path to the bathroom (no scatter rugs, cords, furniture). Educate the client and family/caregivers on identified risks and the plan of care. Clients and family who are aware of risks are more likely to call for assistance. Lock wheels on beds, wheelchairs, and carts to prevent the device from rolling during transfers or stops. Know the consequences of immobility: Immobility is the inability to move freely and independently at will. The risk of complications increases with the degree of immobility and the length of time of immobilization. Changes occurring in the body include the following: Know current trends in health-care: Critical challenges to nursing practice in the 21st century: a growing population of hospitalized patients who are older and more acutely ill, increasing health care costs, and the need to stay current with rapid advances in medical knowledge and technology. Complicating these challenges are an existing shortage of nurses, an aging nurse workforce postponing retirement because of the country’s recent economic downturn, and prospects of a worsening nurse shortage. Know activities of daily living (ADL’s): There are six basic ADLs: eating, bathing, dressing, toileting, transferring (walking) and continence. Know the role of the nurse when a patient is being transferred in and out: A scheduled admission to the hospital usually begins in the admitting office. Admitting office staff obtain information about the patient and input that information into the computer. Preparing the room for admission: o Although the nurse might delegate most of the activities in preparing the room for an admission, it is a nursing responsibility to ensure that other personnel do them. • Position the bed. • Open the bed by folding back the top bed linens. • Assemble routine equipment and supplies. A • Assemble special equipment and supplies. • Adjust the physical environment of the room. Admitting the patient to the unit: o Although other members of the health care team may assist in the admitting procedure, the nurse is responsible for ensuring the patient’s safety, comfort, and well-being upon arrival in the unit. o The admission assessment is used to develop the nursing care plan for the patient and also is used as a database for discharge plan- ning and home care. o A medication reconciliation form is completed on admission. The form is checked and filled out again with each transfer and on discharge to ensure that all medications have been correctly ordered or discontinued as the patient moves through the system. The nurse may not be responsible for the actual physical move but is responsible for ensuring that the comfort, safety, and teaching needs of the patient and family are met. Transfer within the hospital: o When a patient is transferred within the hospital, personal belongings must be moved to the new room. o The patient’s records are moved to the new unit or made available electronically. o Other hospital departments (e.g., dietary, pharmacy, physical therapy) must be notified of the transfer. o When a patient is transferred to another unit, the nurse in the original area gives a verbal report about the patient to the nurse in the new area using the approved handoff technique. • The report should include the patient’s name, age, physicians, admitting diagnosis, surgical procedure (if applicable), cur- rent condition and manifestations, allergies, medications and treatments, laboratory data, and any special equipment that will be needed to provide care. o Nursing care priorities are identified, and the existence of advance directives is noted. Transfer to an extended care facility: o The patient is discharged from the hospital and a copy of the medical record may be sent to the extended care facility (depending on hospital protocol). o The original record, which is a legal document, remains at the hospital. o All of the patient’s belongings are sent to the facility with the patient. o A detailed assessment and care plan is sent from the hospital to the extended care facility. o In addition, the nurse at the hospital often provides a verbal report to the nurse at the new facility using the approved handoff technique. Know continuity of care: Continuity of care is a process by which health care providers give appropriate, uninterrupted care and facilitate the patient’s transition between different settings and levels of care. Continuity depends on excellent communication as patients move from one caregiver or health care site to another. Know how to sign your name as an RN: Sign your first initial, last name, and title to each entry. Know to ID mistakes in documentation: Documentation is the written or electronic legal record of all pertinent interactions with the patient—assessing, diagnosing, planning, implementing, and evaluating. Aim: Complete, accurate, concise, current, factual, and organized data communicated in a timely and confidential manner to facilitate care coordination and serve as a legal document. Use correct grammar and spelling. Use standard terminology, only commonly accepted terms and abbreviations and symbols (see Box 16-3 on page 345). Date and time each entry Record nursing interventions chronologically on consecutive lines. Never skip lines. Draw a single line through blank spaces. Do not use dittos, erasures, or correcting fluids. Draw a single line through an incorrect entry, and write the words “mistaken entry” or “error in charting” above or beside the entry and sign. Then rewrite the entry correctly. Know why we do incident reports: An incident report is used by health care agencies to document the occurrence of anything out of the ordinary that results in, or has the potential to result in, harm to a patient, employee, or visitor. Incident reports improve the management and treatment of patients by identifying high- risk patterns and initiating in-service programs to prevent future problems. Know what SOAP Charting is: The SOAP format (Subjective data, Objective data, Assessment [the caregiver’s judgment about the situation], Plan) is used to organize entries in the progress notes of the POMR (problem-oriented medical record). The POMR is organized around a patient’s problems rather than around sources of information. Know how to identify open-ended questions: Use communication techniques that enhance your ability to think critically and get the facts: Ask open-ended questions, for example, “How are you feeling?” rather than “Are you feeling well?” Avoid close-ended questions—those requiring a one-word answer—unless the person is too ill to elaborate or you are trying to clarify a response by getting a yes or no. Know special modifications for the visually impaired: Communication Call clients by name before approaching to avoid startling them. Identify yourself. Stay within clients’ visual field if they have a partial loss. Give specific information about the location of items or areas of the building. Explain interventions before touching clients. Before leaving, inform clients of your departure. Carefully appraise clients’ clothing, and suggest changes if soiled or torn. Make a radio, television, CD player, or digital audio player available. Describe the arrangement of the food on the tray before leaving the room. Know barriers to effective communication: Language and cultural barriers Nurse burn-out Family interference Patient discomfort Know how to identify short-term vs. long-term goals: Long- term outcomes require a longer period (usually more than a week) to be achieved than do short-term outcomes. Short-term goal supports achievement of long-term goal but are not the same goal. Know what you are measuring when taking a blood pressure: The principal determinants of blood pressure (BP) are cardiac output (CO) and systemic vascular resistance (SVR). CO is determined by: Heart rate Contractility Blood volume Venous return Systemic (peripheral) vascular resistance (SVR) reflects the amount of constriction or dilation of the arteries. Know how to read a blood glucose monitor: For blood glucose testing, clients who have diabetes mellitus use a glucometer or a blood glucose meter with small test strips to “read” the blood sample. These systems require proper calibration, storage of supplies, and matching of lot numbers. Interpretation of Findings Usually, a blood glucose level greater than 250 mg/dL indicates hyperglycemia. Usually, a blood glucose level less than 70 mg/dL indicates hypoglycemia. Poor storage of glucose test strips can lead to falsely high and low readings. Typically, these test strips come in a vial to store at room temperature or as the manufacturer directs. Alcohol can interfere with the results of the test as well. Know alternative sites for blood glucose readings: Most common site is the lateral side of the index finger. Alternative sites can include the palms, upper arms or forearms, thighs, and calves. Know S/S of infection: The signs and symptoms, identifiable in the nursing assessment, of generalized or systemic infection: Fever Presence of chills, which occur when temperature is rising, and diaphoresis, which occurs when temperature is decreasing Increased pulse and respiratory rate (in response to the high fever) Malaise Fatigue Anorexia, nausea, and vomiting Abdominal cramping and diarrhea Enlarged lymph nodes (repositories for “waste”) Older adults have a reduced inflammatory and immune response, and thus may have an advanced infection before it is identified. Atypical symptoms such as agitation, confusion, or incontinence may be the only symptom. Inflammation is the body’s local response to injury or infection. The inflammatory response has three stages. Signs and symptoms during the first stage of the inflammatory response (local infection): o Redness (from dilation of arterioles bringing blood to the area) o Warmth of the area on palpation o Edema o Pain or tenderness o Loss of use of infected area In the second stage, the micro-organisms have been killed. Fluid containing dead tissue cells and WBCs accumulates and exudate appears at the site of infection. The exudate leaves the body by draining into the lymph system. In the third stage, damaged tissue is replaced by scar tissue. Gradually, the new cells take on characteristics that are similar in structure and function to the old cells. Laboratory results indicating infection include: Leukocytosis (WBCs greater than 10,000/μL). Increases in the specific types of WBCs on differential (left shift = an increase in neutrophils). Elevated erythrocyte sedimentation rate (ESR) over 20 mm/hr. An increase indicates an active inflammatory process or infection. Presence of micro-organisms on culture of the specific fluid/area. Know what a regular heart beat is and what it’s called: The normal pulse rate for adolescents and adults ranges from 60 to 100 beats/min. The amplitude of each pulse beat is normally strong at all areas where an artery can be palpated. Know the different ways to assess body temperature: The sites most commonly used to assess body temperature are oral (sublingual), tympanic, temporal artery, rectal, and axillary. An electronic probe is placed under the tongue (sublingual area) of a person’s mouth to assess an oral temperature, in the anal canal to assess a rectal temperature, or in an axilla (armpit) to assess an axillary temperature. A probe is placed in the ear to assess a tympanic temperature. Temporal artery thermometers are swiped over the skin covering the temporal artery.