The document outlines the TPR (temperature, pulse, respiration) procedure for checking a patient's vital signs, including necessary equipment and steps for executing the procedure. It emphasizes using digital thermometers over mercury due to environmental concerns, and provides detailed instructions on preparing the patient and recording results. Proper hygiene and cleaning practices are also highlighted throughout the procedure.

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2.  TPR is a procedure to check temperature pulse
and respiration of a patient. It is also known as
checking vital signs when we include checking
of blood pressure in the procedure.

3.  TPR tray should contain-
1.One jar with 3-4 thermometers which
contains 1:40 antiseptic solution
2.Another jar which contains 1:40
antiseptic solution

4. 3.Third jar with clean water to rinse the
thermometers
4.Cotton swabs in a container.
5.Kidney tray
6.Paper bag
7.Pen and TPR chart.

5. If we are using digital thermometer than take a
digital thermometer with few probe covers. Than
you can skip articles no. 1 to 5. now a days digital
thermometer is recommended as mercury is a
big environmental hazard

7.  Explain the procedure to patient or relative of the
patient.
 Ensure that client have not eaten anything cold or
hot food or fluid 15 minute prior to the procedure.
 The patient should be in comfortable position
preferably in lie down position.

8.  Wash hands before starting the procedure.
 Take out a thermometer from antiseptic solution
jar and rinse in water.
 Clean the bulb of thermometer from bulb to stem
with cotton swab.
 Discard the swab in kidney tray

9.  Read the mercury level by holding thermometer
against light. It should be below 95 degree F.
 If it is above 95 degree F than shake the
thermometer and read the level of mercury again.

10.  Ask the patient to open the mouth and place bulb of
thermometer under the tongue.
 Ask the patient to hold the thermometer using lips
not the teeth for 2 minutes.
 For taking temperature by axilla place thermometer
(for 5 minutes) in axilla after cleaning the axilla by a
clean cloth.

11.  Now count radial pulse for full one minute if pulse is
irregular or for half minute and multiply by 2 if pulse
is regular.
 Now start counting respiration by watching rise and
fall of the chest while still holding the hand without
knowing the patient that you are counting the
respiration.

12.  count respirations for full one minute if breathing is
irregular or for half minute and multiply by 2 if
breathing is regular.
 After 2 minutes remove the thermometer from oral
cavity or after 5 minutes from axilla.
 Clean the thermometer from stem to bulb

13.  Check temperature by holding the thermometer at eye level.
 Place the thermometer in another jar with antiseptic solution.
 Wash hands and record the temperature, pulse and respiration
in patient’s TPR chart.
 If you are using a digital thermometer than you can change
some steps as -

14.  Switch on the thermometer and wait till it show Lo in
the screen.
 Put probe cover on the probe and place in axilla or
oral cavity.
 Wait till beep sound.
 Remove thermometer, discard probe cover in paper
bag and read the temperature.

15.  Wash hands and record the temperature, pulse
and respiration in patient’s TPR chart.
 Explain result of procedure to the patient.
 place all the instruments to their proper place
after cleaning and disinfecting.

16. By – SURESH KUMAR ( Nursing Tutor )