Professional Documents
Culture Documents
L5 Hot and Cold Application
L5 Hot and Cold Application
FUNDAMENTALS OF NURSING
COURSE MODULE COURSE LAB WEEK
1 5 5
1. Implement safe and quality nursing care in the performance of hot and cold application.
2. Operate appropriate equipment/technology in the performance of hot and cold application.
3. Participate in research by analyzing possible problems in the application of hot and cold
compress
4. Demonstrate caring as the core of nursing, love of God, love of country, love of people.
5. Integrate being an A.C.H.I.E.V.E.R. in the performance of nursing procedures involving hot
and cold application.
Berman, A., Snyder, S.J., and Frandsen, G. (2020) Kozier and Erb’s Fundamentals of Nursing:
Concepts, process, and Practice, 11th Edition, Skin Integrity and Wound Care (pp.883-861).
Pearson
Perry, A.G., Potter, P.A., and Ostendorf, W. (2018). Clinical Nursing Skills and Techniques, 9th
Edition, Application of Moist Heat and Cold (pp.306-308). Mosby
Ctec Nursing Skills. (2017, March). Hot or cold application [Video File]. Retrieved from
https://www.youtube.com/watch?v=adFGvCoYXqw
George Elliot Hospital. (2016, December). Applying an icepack – physiotherapy advice [Video File].
Retrieved from https://www.youtube.com/watch?v=gJOMV2mZ1B0
Computer device or smartphone with internet access (at least 54 kbps; average data subscription
will suffice)
To facilitate the practice of students’ skills demonstration, the concepts found below must be read
and fully understood. Videos of the procedure found in the references section must be viewed.
Brief Overview
In anatomy and physiology, it is taught that temperature receptors in the body adapt to
temperature changes. Nurses and clients need to understand this because a hot application can
cause burn injuries while cold application can result to pain and severe circulation impairment.
1. Vasodilation 1. Vasocontriction
2. Sedative effect 2. Local anesthetic effect
3. Increase capillary permeability 3. Decrease capillary permeability
4. Increase cellular metabolism 4. Decrease cellular metabolism
5. Increase inflammation 5. Increase inflammation (slows
bacterial growth)
Therapeutic Application
Local application of heat and cold in the body can be beneficial. They can either be in moist or dry
forms. But before using these therapies, the nurse must understand the HOW and WHEN of their
usage. Table 1 summarizes this.
A. Heat Application
ü Dry heat:
- Hot water bottle/bag = mostly used, especially at home; accessible and economical
- Aquathermia pad (K-pad) = pad is attached by a tubing to an electrically powered
control unit (waterproof); has a temperature gauge
- Disposable heat pack or electric heating pad = provide constant, even heat; can be
molded to the body part (CAUTION! Can cause burns if the setting is too high)
Figure 1. Aquathermia pad (left) and a plastic single-client sitz bath (right)
(Courtesy: Hamilton Aquamatic)
ü Moist heat:
- Hot compress = use of gauze pads or roll or towels
- Hot pack = commercially prepared; provides heat for a designated time only; directions
for use are found on the package labels to initiate heating process; applied to a wound
or injury (water temperature = 40°C)
- Hot soak = requires immersing a body part in a solution or wrapping in gauze dressings
saturated with a solution (observe sterile technique for open wounds); use to soften or
remove crusted/dead tissues
- Hot sitz bath = also known as hip bath; soak perineal or rectal area into a solution (e.g.
Epsom salt, witch hazel, lavender oils) while the client sits on a special chair or tub
(water temperature = 40-43°C)
B. Cold Application
ü Dry cold:
- Cold pack = same as hot pack but, it initiates cooling process
- Ice bag, ice glove, ice collar = filled with ice chips or alcohol-based solution; must be
wrapped in a towel or cover when being used
ü Moist cold:
- Compress
- Cooling sponge bath = to reduce fever of over 40°C by heat loss through conduction
and vaporization accompanied by antipyretics (water temperature = 27-37°C)
Rebound Phenomenon – occurs at the time the maximum therapeutic effect of a hot
or cold application is achieved and the opposite effect begin (Berman, Snyder, and
Frandsen, 2020) Therefore, thermal applications must be halted before this
phenomenon begins.
SKILLS PROCEDURE
IMPORTANT! Ensure all your equipment and materials are at hand before going to the client.
I. Application of Moist Heat: Moist Compress and Sitz Bath/Soak (Based on Perry, Potter, and
Ostendorf, 2018)
v FIRST: Introduce self and identify the client by asking for at least 2 identifiers (e.g. name,
birthday, age, etc.)
Assessment:
1. Verify order for type of moist heat application, location and duration, and
desired temperature.
2. Review client’s chart for medical history and contraindications that may
prohibit the use of hot or warm therapy.
3. Assess client’s vital signs and mobility.
4. Assess client’s skin around the area to be treated and client’s temperature
and pain sensitivity.
5. Inspect wound, if any, for size, color, odor, tenderness, drainage.
6. Assess client and family’s awareness, understanding of the procedure, and
related safety factors.
Planning:
1. Identify expected outcomes
2. Assemble and prepare the equipment and supplies needed.
Implementation
v Provide privacy at all times.
a. Applying moist sterile compress:
Materials needed: Moist compress (e.g. commercially prepared,
aquathermia pad, etc.); Sterile gauze pads or roll (size and
number depends on the body part of client to be treated); Heating
equipment (to warm the water to the needed temperature), Water
proof pad or clean dry towel, Water container/ basin), Gloves (1
pair clean and 2 pairs sterile)
1) Explain the procedure and purpose to the client, sensations the
client would feel and precautions to prevent burning.
2) Heat water to the desired temperature for moist compress. (For
aquathermia pad use, prepare and set the desired temperature.)
3) Perform hand hygiene and put on a pair of clean gloves
4) Keep client’s body part in proper alignment, drape client as need, exposing only the body
part to be treated.
5) Place a waterproof pad under the client’s body part, if appropriate
6) Remove any wound dressing present, inspect condition of wound and surrounding skin.
7) Dispose gloves and dressing into a biohazard bag. Then perform hand hygiene.
8) Prepare the compress:
a) Pour the warm solution into a container
***Follow instructions for warming using commercially prepared compress.
b) Wear sterile gloves
c) Using the sterile technique, open the gauze
d) Immerse gauze into the container of water
9) Pick up one layer of gauze, wring out excess water and apply onto the wound and its
surrounding skin
10) Lift gauze to initially assess for redness due to the moist heat applied
11) Pack the moist gauze snugly if client tolerates the compress covering all wound surfaces.
12) Cover moist compress with dry sterile gauze and clean bath towel. Secure as appropriate;
use pin, tie, etc. (Apply aquathermia or water-proof heating pad if available)
13) Dispose gloves properly and perform hand hygiene.
14) Check back with client after 15 minutes and assess. Change moist compress using sterile
technique if heat pad is not used.
15) After 30 minutes, or as ordered, remove the moist compress using clean gloves.
16) Reassess wound and surrounding skin condition. (Replace with dry sterile dressing, if
ordered or as necessary, using sterile technique, i.e. use sterile gloves and sterile gauze)
17) Help client to preferred comfortable position.
18) Dispose all soiled material and equipment appropriately and perform hand hygiene.
Evaluation
1. Inspect the body part or wound condition for evidence of effectiveness of therapy and
sensitivity to touch.
2. Ask client to describe level of comfort and burning sensation following the treatment.
3. Obtain vital signs and compare with baseline.
4. Identify any unexpected outcome.
Recording and Reporting: Record, document, and report all pertinent information of the
procedure performed.
1. The use of search engines (e.g. Google, Yahoo), text/e-books, NANDA are allowed.
2. Use the above-mentioned required readings.
3. Students must submit this accomplished worksheet through email or Canvas upload.
Client C is a 16-year-old female complaining of lower abdominal and lower back pain. She
said it is her 2nd day of her menstrual period. She seldom experiences this and so far, this is the
worse. Initial assessment data: T = 36.8°C, BP = 120/80mmHg, PR = 80bpm, RR = 18cpm; pain
scale of 6/10, client presents abdominal muscle guarding. As the clinic nurse, how do you plan to
care for this client?
Client Q is a 28-year-old female who works in a BPO company. She is complaining of joint
stiffness of her right-hand fingers. She mentions working at home during the quarantine period and
now continues working in the office as part of the skeletal workforce. Her work requires responding
to client emails (around 100/day) and creating job orders for the company’s clients. As the clinic
nurse of this BPO company, how do you plan to care for this client?
Date Completed:
Date Submitted:
Activity #2: Nursing PressCom
Create your own video presentation for both hot and cold compress and sitz
bath based on the steps above-mentioned.
v Scope and Goals: Each student will work as the nurse for the above-
mentioned procedures and communicate hypothetical findings of a
chosen client living with the student (e.g. family member, friend,
significant other, relative) in a 4–7-minute video. This allows a student to
communicate and present clear and accurate information in an engaging
manner for an audience of your peers on the proper techniques of the
procedures following the nursing concepts, principles and client safety.
Note. This will be evaluated based on the rubrics found at the end of this module. The video will least
assess its technical merits (i.e. you will not get high scores because the final presentation is visually
impressive in a way that does not bear on effective procedure performance).
v Required elements for the video
ü Length. Your video should be 4–7 minutes in length, including the time for the “credit roll” to
show your references.
ü Style. You must follow the nurse-client set-up; hence, ask for a volunteer to be you “client”
for the video.
ü Title. The video should begin with a descriptive title, your name and section, the name of the
school, and the year in which it was created.
ü Originality. Aim to create your own resources. This means using your own materials that you
have at home.
ü Content. The procedure must be performed according to the steps seen in the said Checklist.
Since you will be using a real person as your “client,” contact them ahead of time to politely
request his/her role. Inform the person that it will be recorded and request his/her
consent/permission to do so (it’s the law!). Remember to be courteous and respectful of their
time; meaning, preparing and taking less than 10 minutes of their time.
ü Video release forms. Anyone who is featured and identifiable in your video must sign a
consent form, which you can obtain from your instructor. You must submit these completed
forms when you submit your video.
ü References and Credits. All images, videos, music, sound effect, people, etc. used in the
video must be cited and acknowledged at the end. You do not need to use a complete
reference. Simply include a brief description of the item and a web address where the item
was found (e.g., Picture of kitten www.spca.com). Be sure that all are subject to a Creative
Commons license. Include a separate section at the end of the video where you credit the
sources of information you used to create your video.
ü File format. Your video must be created in any of the following file formats: .mov, .mv4, mp4,
.wmv. Note that these are rendered movies, that is, files that will play on someone else’s
computer. Be sure to test your finished product ahead of the deadline.
Date Completed:
Date Submitted:
Berman, A., Snyder, S.J., and Frandsen, G. (2020). Kozier and Erb’s
Fundamentals of Nursing: Concepts, process, and Practice 11th ed.
Pearson
Ctec Nursing Skills. (2017, March). Hot or cold application [Video File]. Retrieved from
https://www.youtube.com/watch?v=adFGvCoYXqw
George Elliot Hospital. (2016, December). Applying an icepack – physiotherapy advice [Video File].
Retrieved from https://www.youtube.com/watch?v=gJOMV2mZ1B0
Perry, A.G., Potter, P.A., and Ostendorf, W. (2018). Clinical Nursing Skills and Techniques, 9th ed.
Mosby
RCH Kids Health Info Fact Sheet on Fever in Children. (2018). Retrieved from
https://www.rch.org.au/kidsinfo/fact_sheets/fever_in_children/
Sharma, N. (February 2015). Hot and cold application [Presentation]. Retrieved from
https://www.slideshare.net/NaveenSharma45/hot-cold-application
Thomas, M. (November 2017). Nursing Assessment (CPG (Nursing)) [Article], Royal Children’s
Hospital Melbourne (RCH)Retrieved from https://www.rch.org.au/rchcpg/hospital_clinical_guide
line_index/Nursing_assessment/
EVALUATION OF STUDENT’S PROCEDURAL SKILLS PERFORMANC
COLLEGE OF NURSING – SKILLS LABORAOTRY
NAME:
YEAR AND SECTION:
PROCEDURE PERFORMED:
WEIGHT
Prepares the necessary Excellent preparation and Good preparation of needed for Satisfactorily prepares and
materials needed for organization of materials the procedure, but disorganized. organizes the materials needed to
the procedure and needed for the procedure; none At least 2 client identifiers are perform the procedure 1 minor
10%
client identification missing. At least 2 client asked and verified material is lacking. At least 2
(CO1) identifiers are asked and client identifiers are asked and
verified. verified
Demonstrate principles Excellent maintenance of safe Good maintenance of a safe A satisfactory safe environment is
of safe client care in the environment throughout the environment throughout most of maintained throughout the
procedure performed entire procedure. Perfectly the entire procedure. procedure. Demonstrates less
10%
(CO2,4) demonstrates all safe client Demonstrates at least 75% of the than half of the safe client care
care measures during the safe client care measures measures correctly during the
performance of the procedure. correctly during the performance performance of the procedure.
of the procedure.
Demonstrates skills in a Excellently and appropriately Good and appropriate Satisfactorily correct and
precise and accurate assesses the client and assessment of the client and appropriate assessment of the
manner in the performs the entire procedure performs the entire procedure client is done and performs the
performance of the with perfect precision and with 75% precision and accuracy entire procedure with 50%
procedure utilizing the accuracy with evaluation to with evaluation to assess precision and accuracy with
20%
principles of the nursing assess effectiveness. effectiveness. Confidence is evaluation to assess
process. Confidence is very evident in somewhat evident in the effectiveness. Confidence is not
(CO2) the performance of the performance of the procedure; evident in the performance of the
procedure; no assistance is little assistance is needed. procedure; assistance is mostly
needed. needed.
Demonstrates clinical Excellent rationalization of all Good rationalization of most of Satisfactory in rationalization of
reasoning in caring for procedural steps, as necessary. the procedural steps, as half of procedural steps, as
client while performing Always document client care necessary. Minimal errors are necessary. Some errors are
the procedure with without errors and observed in documentation of observed in documentation of
15%
client education and reports/refers appropriately client care, reporting and/referring client care, reporting and/referring
appropriate when needed and/or when the when needed and/or when the when needed and/or when the
documentation/ referral. situation is beyond the scope of situation is beyond the scope of situation is beyond the scope of
(CO3,6,9) nursing practice. nursing practice. nursing practice.
Manage time, Excellent development of basic Good development of basic skills Satisfactory development of basic
equipment, and skills for time management, for time management, resource skills for time management,
resources to support 10% resource allocation, and allocation, and equipment use resource allocation, and
the procedure done to equipment use involved in client involved in client care. Mostly equipment use involved in client
client care. Always follows through follows through with instructors’ care. Usually follows through with
WEIGHT
(CO7, 8, 12) with instructors’ suggestions suggestions related to nursing instructors’ suggestions related to
related to nursing procedures. procedures. nursing procedures.
Demonstrate Speaks to client with excellent Speaks to client with good clarity Satisfactorily speaks to client with
appropriate clarity to allow understanding of to allow understanding of clarity to allow understanding of
communication information. Always uses information. Uses therapeutic information. Occasionally uses
techniques with the therapeutic communication communication skills mostly with therapeutic communication skills
10%
client skills with client to allow for client to allow for comfort and with client to allow for comfort and
(CO5, 6) comfort and comprehension comprehension (eye contact, comprehension (eye contact,
(eye contact, touch and space, touch and space, modesty). touch and space, modesty).
modesty).
Incorporates the Excellent display of Good display of professional and Displays of professional and
institutional and nursing professional and personal personal integrity. Mostly looks personal integrity satisfactorily.
profession core values integrity. Always looks and acts and acts in a professional Occasionally looks and acts in a
into practice. in a professional manner. manner. Mostly pleasant to client professional manner.
15%
Pleasant to client and and significant other(s). Places Occasionally pleasant to client
(CO13, 15) significant other(s). Consistently the client’s welfare first most of and significant other(s). Places
places the client’s welfare first. the time. the client’s welfare first
occasionally.
CO 10, 11 (10%) Excellent provision of age- Good provision of age-appropriate Satisfactorily provides age-
appropriate and culturally and culturally sensitive nursing appropriate and culturally
Promotes the other sensitive nursing care. care. Sometimes identifies a sensitive nursing care.
10%
dimensions of health Frequently identifies a client’s client’s risk for emotional or Occasionally identifies a client’s
(e.g. spiritual, risk for emotional or spiritual spiritual distress. risk for emotional or spiritual
emotional, and cultural). distress. distress.
DATE: _____________