NURSING PROCEDURE – HOT APPLICATION

NURSING PROCEDURE – HOT APPLICATION (Definition, Purpose, Classification, Physiological Effects, Principles, Complications and General Instructions

Thermotherapy is the use of heat to treat symptoms of acute or chronic pain, especially those related to muscle tension or spasm. It is also a common treatment for arthritis, bursitis, tendonitis, back pain, shoulder pain and other kinds of joint pain. Hot applications result in an increase in molecular vibration and cellular metabolic rate. This form of treatment is divided into two categories, namely, superficial and deep heating modalities. These are further divided into chemical, electric or magnetic. Temperatures range from 105 to 170 degrees Fahrenheit (41 to 77 Degree celcius). Superficial modalities include infrared lamps, moist heat packs, paraffin baths, and warm whirlpools. Deep heating modalities include microwave diathermy, shortwave diathermy, and ultrasound. The body reacts with a series of local and systemic effects.

DEFINITION

Hot application means the application of an agent warmer than the skin. Heat is applied in either a moist or dry form.

PURPOSE

  • Heat decreases pain
  • To provide comfort
  • To promote circulation
  • To promote suppuration
  • To relax the muscles
  • To promote healing
  • To relieve deep congestion
  • To soften the exudates
  • To stimulate peristalsis
  • To counteract sudden drop in temperature
  • To decrease joint stiffness
  • To relieve bladder distention

CLASSIFICATIONS

Hot Applications – Local and General

Local – Dry Heat and Moist Heat

LOCAL

Dry Heat – hot water bottles, chemical heating bottles, infrared rays, shot wave diathermy, heating lamps, electric cradles, and electric heating pads

Moist Heat – warm soaks (local baths), hot fomentations (compresses), poultices (cataplasm), stupes (medical fomentations), paraffin baths, sitz bath and aquathermia pad

GENERAL

Dry Heat – sun bath, electric cradles, and blanket bed

Moist Heat – steam baths, hot packs and whirlpool bath (full immersion bath)

Physiological Effects

Primary Effects

  • Peripheral vasodilatations
  • Increased capillary permeability
  • Increased local metabolism
  • Increased oxygen consumption
  • Blood-flow is increased
  • Blood viscosity is decreased
  • Lymph flow is increased
  • Motility of leukocytes is increased
  • Muscle tone is decreased

Secondary Effect

The primary effect of hot application may last only for 20 to 40 minutes. After this time, the heat application must be discontinued and recovery time of one hour allowed, otherwise secondary effects (vasoconstriction) will take place.

Contraindications

  • Heat is not used because heat increases the metabolism
  • Heat is not used for the patients with impaired kidney, heart and lung functions
  • Heat should not be applied to acutely inflamed areas e.g. acute appendicitis and tooth abscess
  • Heat should not be applied on patient with paralysis weak and debilitated patients
  • Heat should not be applied when there is open wounds and bleeding
  • Heat should not be applied when there is edema associated with venous or lymphatic diseases
  • Heat should not be applied on patients with metabolic disorder. E.g. patients with diabetes, arteriosclerosis
  • Heat should not be applied on patients with high temperature

Principles

  • Heat causes dilation of blood vessels and increases the blood supply to the area
  • Heat stimulates metabolism and the growth of the new cells and tissues
  • The end organs of the sensory nerves in the skin convey the sensation of heat; the sensations are interpreted in the brain
  • Water is a good conductor of heat
  • The flow of heat is from the hotter area to the less hot area
  • Presence of stream increases the temperature of the hot applications
  • The temperature tolerance varies with individuals and according to the site and area covered
  • Friction produces heat

Complications

  • Pain
  • Burns
  • Maceration (with moist heat)
  • Redness of the skin
  • Edema
  • Hyperthermia
  • Pallor (secondary effect)

General Instructions

  • Protect damaged skin layers exposed layers of skin are more sensitive to temperature variations than skin layer
  • Check a patient frequently during hot application, the condition of the skin indicates whether tissue injury is occurring
  • Do not allow a patient to adjust temperature settings
  • Never position a patient in such a way that he cannot move away from the temperature source. This avoids the risk of injuries from temperature exposure
  • Never ignore the complaints of a patient however small they appear to be

COUNTERIRRANTS

HOT FOMENTATION

HOT WATER BAG

INFRARED THERAPY

SITZ BATH

SOAK OR LOCAL BATH

STEAM INHALATION

COLD APPLICATION

NURSING PROCEDURE – HOT APPLICATION (Definition, Purpose, Classification, Physiological Effects, Principles, Complications and General Instructions
NURSING PROCEDURE – HOT APPLICATION (Definition, Purpose, Classification, Physiological Effects, Principles, Complications and General Instructions

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