1. Chapter 12 Heat and Cold Applications

2. Copyright © 2007 Thomson Delmar Learning. ALL RIGHTS RESERVED.2 Heat and Cold Treatments Localized application –Delivers heat or cold to a specific area Generalized application –Delivers heat or cold to the entire body Heat dilates blood vessels, bringing oxygen and nutrients to the area

3. Copyright © 2007 Thomson Delmar Learning. ALL RIGHTS RESERVED.3 Heat and Cold Applications What you should know before applying heat or cold: –Type of application –Area to be treated –Length of time

4. Copyright © 2007 Thomson Delmar Learning. ALL RIGHTS RESERVED.4 Heat and Cold Applications What you should know before applying heat or cold: –Proper temperature –Safety precautions –Side effects

5. Copyright © 2007 Thomson Delmar Learning. ALL RIGHTS RESERVED.5 Heat and Cold Applications Use standard precautions Check the temperature Remove all metal Always cover applications Check the skin every 10 minutes

6. Copyright © 2007 Thomson Delmar Learning. ALL RIGHTS RESERVED.6 Heat and Cold Applications Make sure the patient can tolerate weight of the application Leave in place for 20 minutes

7. Copyright © 2007 Thomson Delmar Learning. ALL RIGHTS RESERVED.7 Heat Treatments Heat relieves –Muscle spasms –Pain and inflammation –Increases drainage

8. Copyright © 2007 Thomson Delmar Learning. ALL RIGHTS RESERVED.8 Heat Treatments Dry heat penetrates to 1 cm Moist heat penetrates deeper Heat speeds healing and decreases blood vessel congestion

9. Copyright © 2007 Thomson Delmar Learning. ALL RIGHTS RESERVED.9 Heat Treatments Hydrocollator –Rectangular tank containing very hot water –Handle packs with tongs and use a thick cover when applying treatment Therapeutic baths used for skin problems –Use tepid water (lukewarm - between 80  F and 93  F)

10. Copyright © 2007 Thomson Delmar Learning. ALL RIGHTS RESERVED.10 Sitz Bath Use hot water, 105  F to 110  F, or as instructed Keep water temperature constant Drape patient's lower body with towel Teach patient to stand before flushing toilet

11. Copyright © 2007 Thomson Delmar Learning. ALL RIGHTS RESERVED.11 Cold Applications Cold constricts blood vessels Cold relieves pain, slows circulation, and reduces drainage Always cover cold packs Check skin frequently Apply treatment for 20 minutes Cover the patient, if cold

12. Copyright © 2007 Thomson Delmar Learning. ALL RIGHTS RESERVED.12 Hypothermia Hypothermia is a lowering of core body temperature to 95  F or below –Mild: 93  F to 95  F –Moderate: 86  F to 93  F –Severe: less than 86  F Primary is a result of cold stress Secondary is part of other conditions

13. Copyright © 2007 Thomson Delmar Learning. ALL RIGHTS RESERVED.13 Hypothermia Perioperative develops in operating room Greatest area of heat loss is from the head Highest mortality is in infants and elderly

14. Copyright © 2007 Thomson Delmar Learning. ALL RIGHTS RESERVED.14 Hypothermia Males are at higher risk Nonwhite persons are at high risk Hypothermia may be difficult to identify in some patients

15. Copyright © 2007 Thomson Delmar Learning. ALL RIGHTS RESERVED.15 Nursing Care Keep the patient NPO Cover the head Avoid rubbing the skin Provide intensive care Use special, gradual warming techniques Use a hypothermia-hyperthermia blanket

16. Copyright © 2007 Thomson Delmar Learning. ALL RIGHTS RESERVED.16 Hypothermia-Hyperthermia Blanket Keep head away from the blanket Apply lanolin to exposed skin Monitor vital signs every 5 to 15 minutes Monitor output hourly After the blanket is discontinued, check vitals and I&O every 30 minutes

17. Copyright © 2007 Thomson Delmar Learning. ALL RIGHTS RESERVED.17 Heat-Related Illness Heat exhaustion –Overexposure to heat Heat stroke –Profound disruption of the body Heat stroke –Extended exposure to heat, especially when there is little or no air movement

18. Copyright © 2007 Thomson Delmar Learning. ALL RIGHTS RESERVED.18 Nursing Care for Heat Exhaustion Keep the patient in a cool environment If the patient can swallow and is not NPO, give IV fluids and increase fluid intake Monitor vital signs frequently Bath may be ordered or use the hypothermia-hyperthermia blanket

19. Copyright © 2007 Thomson Delmar Learning. ALL RIGHTS RESERVED.19 Nursing Care for Heat Stroke Heat stroke is a medical emergency –Monitor the patient's airway, breathing, and circulation –Keep the patient NPO

20. Copyright © 2007 Thomson Delmar Learning. ALL RIGHTS RESERVED.20 Nursing Care for Heat Stroke Treating heat stroke –Cool patient's body rapidly by immersing patient in cool water (if awake and alert) –Sponge with tepid water –Use hypothermia-hyperthermia blanket