NCM 101 RLE - Tepid Sponge Bath

Tepid Sponge Bath

• Used to reduce a patient's fever by dilating superficial blood vessels, thus releasing heat and lowering body temperature
• Involves the use of lukewarm water with a temperature range of 26.7°C to 33.9°C
• No longer recommended for children due to the risk of extreme chilling and shock to the immature nervous system

Assessment and Planning

• Assess the patient's condition by obtaining vital signs (temperature, pulse, respirations, and blood pressure) as baselines for comparison
• Inspect all equipment and supplies, including a basin of tepid water, bath utility thermometer, bath blanket, fluid impermeable pad, washcloths, patient thermometer, bath towel, clean hospital gown, vital signs monitoring equipment, clean gloves, prescribed antipyretic, and ice bag with cover
• Remove any expired or defective equipment from patient use and report accordingly

Implementation

• Verify the practitioner's order and review the patient's medication record for recent administration of an antipyretic
• Administer an antipyretic as ordered 15-20 minutes before the sponge bath to achieve more rapid fever reduction
• Gather and prepare necessary equipment, perform hand hygiene, confirm patient identity, and provide privacy
• Raise the patient's bed to waist level to prevent caregiver back strain
• Place a fluid impermeable pad under the patient to catch any spills and the bath blanket on top for privacy
• Remove the patient's gown and top linen to avoid getting them wet
• Place a covered ice bag on the patient's head if needed

Procedure

• Wring out each washcloth before using it
• Place moist washcloths over the patient's major superficial blood vessels in the axillae, groin, and popliteal areas
• Bathe each of the patient's extremities separately for 5 minutes, then bathe the chest and abdomen for 5 minutes
• Turn the patient and bathe the back and buttocks for 5-10 minutes
• Pat each area dry using a towel after sponging, avoiding rubbing the patient's skin
• Monitor the patient's temperature, pulse, respirations, and blood pressure every 10 minutes or as needed
• Observe the patient for signs of adverse effects such as chills, shivering, pallor, mottling, cyanosis of the lips or nail beds, or vital sign changes

After the Procedure

• Ensure the patient is dry and comfortable
• Dress the patient in a clean gown and cover them lightly
• Return the patient's bed to the lowest position