Heat Therapy
What does applying heat therapy do to the body?
Vasodilation, which allows increased blood fow to the site
What are some illnesses/ injuries that may benefit from cold therapy?
-Fever
-Sprains
-Edema
It causes vasoconstriction
Describe the Difference between Acute, Chronic, and Intermittent Pain
Acute Pain: typically comes on suddenly and lasts less than 6 months
Chronic Pain: pain that lasts 6months or more
Intermittent: Pain that comes and goes in intervals
What are some factors that can affect pain?
Ethnic/cultural beliefs
Developmental Stage
Individual values
Previous pain
Personal support system
Emotions
Fatigue
When does a patient make their first impression of the nurse and hospital staff?
At the admission process
What are some indications for heat therapy?
Relaxation of muscle spasms
Pain Relief
Help with healing Process
Decrease Edema
Elevate body temperature
How does cold therapy help with pain?
It decreases swelling and pressure on nerves
What are some indications for Cold Therapy?
Prevention of edema
Control or stoppage of bleeding
Pain Relief
Numbing Sensation
Reduction of Muscle Spasm
Reduction of Fever
Describe how to conduct a Pain Assessment
P: Provoking factors
Q: Quality of the pain
R: Region/ Radiating Pain
S:Severity; 1-10
T: Time
When doing an assessment what should the nurse be aware of?
Their own judgment or bias. Remember the patient is the only person who can report their own pain.
When should discharge planning start?
At the start of Admission
What are some contraindications to heat therapy?
Bleeding wound/ injury
Newly injured joints
When should cold therapy be applied to a sprain?
In the first 48-72 hours for pain and swelling.
Name some types of Cold Application
Cold/ Ice packs
Cold Compresses
Tepid Baths
Describe the difference between Neuropathic and Nociceptive pain and give examples of each.
Neuropathic Pain: pain that occurs from the destruction of peripheral/ central nerves; EX: Diabetes neuropathy, phantom limb pain, Neuralgia
Nociceptive Pain: Pain caused by damage to the body tissue. 3 types (Cutaneous, Visceral, Deep Somatic Pain)
If you have an order for Hydromorphone 0.5mg-1mg IV every 6 hours PRN for pain. How should the nurse administer the medication?
Exactly as ordered; If a script is written and in the MAR Administer as prescribed
You are the nurse doing inventory on a patient at admission. The patient has a silver bracelet with emerald accents. How would the nurse document this on an inventory sheet?
A silver colored bracelet with green stones.
Name some methods of heat application.
Hot compresses
Heating Pads
warming blanket
Whirlpool baths
How long should a heating pad be applied for?
It should be placed no longer than 30 minutes
How long should ice packs be placed?
No more than 20-30 minutes
What are some objective signs of acute pain?
Elevated blood pressure, elevated pulse, elevated respiratory rate, grimacing, splinting, diaphoresis, and dilated pupils
What are some alternative pain relief options other than medications?
Hot and Cold Therapies
Massage
TENS
Acupressure/ Acupuncture
Relaxation
Distraction
What should the nurse do for a resident after completing her initial head-to-toe assessment?
Orient the patient to their room
What populations of patients should be monitored closely when applying heat therapy?
The geriatric population, pediatric population, patient's with diabetes, peripheral vascular disease, and circulatory diseases
Before applying hot or cold therapy, what should the nurse do first?
Assess baseline temperature and also ensure an order is in place to apply hot/ cold therapy.
What should a nurse do when applying cold therapy?
Place a thin barrier between the cold application and skin
Assess the skin 10-15 minutes after application for pallor or mottling.
Describe Gate Control Theory
the theory that pain comes from an impulse in the central nervous system. The idea is that if the gate is open then pain impulses can occur; if the gate is closed then the pain impulse is not felt
The nurse is discharging a patient home on a new narcotic medication. What education should be provided?
Educate the patient to keep the narcotic in the original package and keep a pain diary to assess effectiveness of medication.
What are some feelings a patient may feel at the start of admission? What populations are at a greater risk for these feelings?
Fear, Anxiety, Loss of control; Loss of identity
Children and elderly