Heat and Cold Therapy PDF

HEAT AND COLD NURS THERAPY 1090 HOT AND COLD THERAPY Assigned Pearson, Volume 3, p. Readings 207-216, 217-218 Unit Identify principles of heat Outcome: and cold application  Heat and Cold Therapy: OVERVIE Used for either: W Local or system...

HEAT AND COLD NURS THERAPY 1090 HOT AND COLD THERAPY Assigned Pearson, Volume 3, p. Readings 207-216, 217-218 Unit Identify principles of heat Outcome: and cold application  Heat and Cold Therapy: OVERVIE Used for either: W Local or systemic effects HEAT for stiffness, aches and pains COLD for injuries to limit swelling and  PHYSIOLOGIC EFFECTS OF HEAT AND COLD HEAT COLD Vasodilation Vasoconstriction Promotes muscle relaxation Promotes muscle relaxation and and decreases muscle increases muscle contractility contractility Decreases blood flow Increases blood flow Decreases capillary permeability Increases capillary permeability Slows cellular metabolism Increases cellular metabolism Decreases inflammation Reduces joint stiffness Local anesthetic effect  HEAT Local Effect Systemic Effect Vasodilation May cause excessive Increases blood flow to area peripheral vasodilation Promotes tissue healing by Drop in blood pressure - increasing metabolism and fainting, lightheadedness, capillary permeability; brings dizziness oxygen, nutrients, antibodies and leukocytes  Usually for musculoskeletal problems; arthritis, contractures, low back pain  COLD LOCAL EFFECT SYSTEMIC EFFECT Vasoconstriction Vasoconstriction causes Reduces blood flow to area- blood to shunt from pallor, coolness peripheral to internal  Prevention of swelling circulation (edema)  Decreases inflammation Blood pressure increases, Decreases pain shivering Used for sports injuries Prolonged – peripheral (sprains, strains, fractures); tissue damage due to lack reduce swelling and bleeding of oxygen & nourishment  METHODS OF APPLICATION: DryDRY HEAT  Aquathermia pad (K-pad) electric power unit Warm: 36.7o C to 40° C for 20-30 min. Hot: 40o C to 46.1°C Can also be used for moist heat Commercial Hot Packs follow package directions Hyper/hypothermia blanket Blanket placed under and/or over patient Blanket connected via hose to regulating machine Heats skin surface Warm Compress  Warmed towel or gauze Warm Soak  Immersion of body part in a warmed solution  40.5o C. (105oF)  May need to maintain sterility if skin broken METHODS OF APPLICATION: MOIST HEAT  Skin rash or burn Prolonged use of hot packs and heating pads, or application of a heat source that is overly hot without a barrier on the skin, can cause contact burns. SAFETY Decreased blood pressure. CONSIDERA Increased heart rate. TIONS: Increased swelling and HEAT inflammation at the site of THERAPY application If a complication occurs: Remove heat source and monitor patient Assess temperature  MOIST HEAT—SITZ BATH Used for perineal and rectal conditions Post- partum Hemorrhoids Perineal abscesses Perineal area immersed in water for 15-20 minutes Water temperature: 40-42 degrees Celsius Assess for orthostatic hypotension following sitz bath: dizziness, fainting  METHODS OF APPLICATION: COLD DRY COLD MOIST COLD Ice bag, gloves, collars Cooling (tepid) sponge Fill with ice chips bath Wrap in towel or cover Compresses/soaks Commercial ice packs 15-30 minute duration Follow package directions (check facility policy) May remain in place 1 Hypo/hyperthermia blankets to 2 hours Warms skin surface Must cool or warm slowly  The patient will experience 4 SAFETY stages of cold progression: Cold CONSIDER Stinging ATIONS: Burning COLD Numbness APPLICATI Discontinue cold therapy upon numbness ON Monitor patient every 5-10 minutes during therapy REBOUND PHENOMENON After maximum therapeutic effect is reached, the opposite effect may take place Stop heat/cold before rebound occurs Heat therapy maximum effect in 20-30 minutes then, vessels constrict, cannot dissipate heat - potential for burn Cold therapy maximum effect when skin temperature reaches 60 degrees F(15 degrees C) Vessels will then dilate to protect against freezing of tissues  Patient’s ability to tolerate treatment Identify contraindications NURSING  Active bleeding, circulatory CONSIDER impairment ATIONS Explain procedure to patient  Make sure call light is within FOR HEAT reach AND COLD Assess skin before/after treatment THERAPIES Reassess 5-10 minutes after starting and every 5-10 minutes during treatment  If any of the following occur: discontinue treatment Redness or pallor ASSESSM Pain or burning ENT Numbness DURING TREATME Shivering NT Blisters Decreased sensation Cyanosis  CONDITIONS THAT INCREASE RISK OF INJURY FROM HEAT/COLD Older adults: reduced sensitivity to pain; fragile skin Impaired mental status Neurosensory impairment Impaired circulation Open wounds, broken skin Active/potential hemorrhage