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9 Cards in this Set
- Front
- Back
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Risk for Injury: Heat and Cold
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* 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 |
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Factors Affecting Heat and Cold Tolerance
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* 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 |
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The effect of heat: vasoldilation for 20 - 30 minutes
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* 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 |
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Heat and cold applications: checklist
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* 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 |
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Heat Interventions: 5 basic principles
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* 105F
* warm moist or dry compresses * not more than 20 min * do not lie on top of heat * never w epidural |
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The Effect of Cold
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* 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 |
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Cold Interventions: 4 basic principles
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* always cover area (wrap ice)
* 59F ice bags, cold compresses and soaks * not longer than 20 min * observe for burning or blue/red color |
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Basics of using a Hypothermia Blanket
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* 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 |
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7 General Nursing Implications of Heat/Cold Therapy
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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 |
