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9 Cards in this Set

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  • Back
Risk for Injury: Heat and Cold
* Neurosensory impairment (e.g. spinal cord, scarring, edema)
* Impaired mental status (may not communicate pain)
* Impaired circulation (can't dissipate heat through dilation)
* skin and tissue integrity
Factors Affecting Heat and Cold Tolerance
* Body Part (some body parts more sensitive than others)
* duration of application (30 min for therapeutic results)
* Area of body exposed--the larger the area, the lower the tolerance to temperature change
* Age: thinner skin layers in children and older adults increase the risk for burns
* Physical Condition/Level of Consciousness
* Uneven temperature distribution
The effect of heat: vasoldilation for 20 - 30 minutes
* decrease blood viscosity
* increase blood flow
* increase tissue metabolism
* increase capillary permeability, absorption of fluid and therefore decrease edema
* decrease muscle spasm and pain
* increase pulse, decrease bp
*after 30 minutes, constriction
Heat and cold applications: checklist
* MD order (includes site, type of therapy, frequency and duration)
* select temperature
* explain procedure and benefits to client
* assess client before, during and after treatment
(heat: pay special attention to skin condition, bleeding, inflatmmation--cold: pay special attention to edema, shivering, 5 p's)
* document client response
Heat Interventions: 5 basic principles
* 105F
* warm moist or dry compresses
* not more than 20 min
* do not lie on top of heat
* never w epidural
The Effect of Cold
* Vasoconstriction for 30 minutes
* increase blood viscosity
* local anesthetic
* decrease cell metabolism
* decrease muscle tension
* decrease edema
* increase bp, shivering
* decreases blood flow, facilitating clotting and control of bleeding
* raises threshold of pain receptors, decreasing pain
Cold Interventions: 4 basic principles
* always cover area (wrap ice)
* 59F ice bags, cold compresses and soaks
* not longer than 20 min
* observe for burning or blue/red color
Basics of using a Hypothermia Blanket
* cover client
* insert temp probe into anus
* monitor temp and vital signs q 15 min
* begin at 98.6F and adjust 2 - 3 degrees q15 minutes
* when off, monitor temp q2hr for 24 hours
7 General Nursing Implications of Heat/Cold Therapy
1) Patient Ed: Safety
2) Assess equipment
3) Assess level of consciousness
4) monitor v/s, fluid status, skin integrity
5) provide call light/do not leave unattended
6) provide clock/timer
7) temp. adjustment