Fundamentals of Nursing, Heat and Cold – Flashcards

Moist heat helps to relieve the pain from

Cold applications reduce the acute pain from

Use large ice cubes covered with a cloth, a nurse or the patient applies the ice with firm pressure to the skin, then use a slow steady circular massage over the area, apply cold within a 6 inch circular area near the pain site, on the opposite side of the body corresponding to the pain site, limit application to 5 minutes or when the patient feels numbness. You can apply these 2 to 5 times a day.

Stimulates nerve endings in the skin, sends impulses from periphery to the hypothalamus causing awareness temperature sensation, triggers adaptive responses for maintenance of normal temperature

Responses occur through heat loss mechanisms such as sweating and vasodilation

Mechanisms promoting heat conversion such as vasoconstriction and piloerection and heat production shivering

Local produces vasodilation to affected area can promote soft tissue healing. Systemic produces excessive vasodilation drop in blood pressure, sweating.

Local produces vasoconstriction to affected area, this constriction pulls nutrients back from outer tissues. Systemic - excessive vasoconstriction produces a rise in blood pressure.

Vasodilation, increases capillary permeability, increased cellular metabolism, increases inflammation, sedative effect, reduces blood viscosity, lowers viscosity of synovial fluid.

Vasoconstriction, decrease capillary permeability, decrease cellular metabolism, slows bacterial growth, decreases inflammation, local anesthetic effect, blood viscosity increased, decreases bleeding, numbs area, increases pain threshold.

Be aware of, Alert to specific conditions: neurosensory impairment, impaired mental status, impaired circulation, immediately after surgery, open wounds.

Certain areas of body are more sensitive to heat and cold. Open areas with no skin are more sensitive. Pay attention to body part sensitivity, size of exposed body part, individual tolerance, length of exposure, intactness of skin.

1. Abrupt change in temperature causes thermal receptors to be strongly stimulated initially. 2. The strong stimulation declines rapidly then slowly next half hour or more as receptors adapt to new temperature change. Reaches maximum effect or usefulness 20 to 30 minutes after application.

1. Occurs at the time of Maximum therapeutic effect of hot or cold application is achieved and the opposite effect begins. After 30 minutes it starts constricting and body can't remove heat as easily.

Hot water bottle, aquathermia pad, disposable heat pack, or electric pad. 110 - 115 degrees F no longer than 20 to 30 minutes.

Compress, hot pack, soak or sitz bath (no longer than 20 minutes). 105 - 110 degrees F sitz

Cold pack, ice bag, glove, or collar

Compress or cool sponge bath

- explain expected Sensations that they might feel during a procedure - protect the skin with an application such as a cloth or towel between the patient and the cold or heat. - assess the skin where about to put heat or cold - explain to the family the procedure - stop procedure if patient complains of hot or cold - know policy or procedures of health care facility on hot and cold - don't let patient self treat - stop treatment on seeing changes in skin color or numbness - don't use on people who have had a stroke, neural, cognitive, or mental issues, that can't sense temp. changes.

Muscle spasms, inflammation, pain, contracture, joint stiffness, traumatic injury

Muscle spasms, inflammation, pain, traumatic injury, tooth and mouth pain.

Extreme softening

Reduces skin drying, softens wound exudate, conform to body parts, penetrates deep tissue layers.

Maceration of skin, moist heat cools rapidly, risk of burns because moisture conducts heat

Less burn risk than moist, no skin maceration, retains temperature longer because there's no evaporation.

Increases body fluid loss through sweating, doesn't penetrate deep into tissues, increases drying of skin.

Do not use heat first 24 hours after traumatic injury or surgery, active Hemorrhage, non-inflammatory edema, localized malignant tumor, skin disorder that causes redness or blisters.

Do not use cold for open wounds, impaired circulation, allergy or hypersensitivity to cold.

They have decreased sensitivity and they might not know if the application is too hot or too cold.

These patients are much more sensitive and they do not like cold and they may be non-compliant.

The time applied, electric equipment failure, the setting, patient education, didn't get a Baseline, contraindications, no doctor's order, put directly on the skin, non-intact skin, used lotions or sprays, had patient lie down on treatment, didn't give them an escape.

Assess skin integrity before applying, the type of application, how long it was used, how did they tolerate it, assess the site after completion, check after treatment 15 minutes later, patient knowledge