Nurse's Pocket Guide

HYPERTHERMIA
(heat loss by convection); cool/tepid sponge baths or immersion
(heat loss by evaporation and conduction); local ice
packs, especially in groin and axillae (areas of high blood
flow). Note: In pediatric clients, tepid water is preferred.Alcohol
sponge baths are contraindicated because they increase
peripheral vascular constriction and CNS depression; coldwater
sponges/immersion can increase shivering, producing
heat.
• Monitor use of hypothermia blanket and wrap extremities
with bath towels to minimize shivering. Turn off hypothermia
blanket when core temperature is within 1 to 3 degrees of
desired temperature to allow for downward drift.
• Administer medications (e.g., chlorpromazine or diazepam),
as ordered, to control shivering and seizures.
• Assist with internal cooling methods to treat malignant
hyperthermia to promote rapid core cooling.
• Promote client safety (e.g., maintain patent airway; padded
siderails; skin protection from cold, such as when hypothermia
blanket is used; observation of equipment safety measures).
• Provide supplemental oxygen to offset increased oxygen
demands and consumption.
• Administer medications, as indicated, to treat underlying
cause, such as antibiotics (for infection), dantrolene (for
malignant hyperthermia), beta blockers (for thyroid storm).
• Administer replacement fluids and electrolytes to support
circulating volume and tissue perfusion.
• Maintain bedrest to reduce metabolic demands/oxygen consumption.
• Provide high-calorie diet, tube feedings, or parenteral nutrition
to meet increased metabolic demands.
NURSING PRIORITY NO. 4. To promote wellness (Teaching/
Discharge Considerations):
• Review specific risk factor/cause, such as underlying conditions
(hyperthyroidism, dehydration, neurologic diseases,
nausea/vomiting, sepsis, use of certain medications [diruetics,
blood pressure medications], alcohol/other drugs [cocaine/
amphetamines]), environmental factors (exercise or labor in
hot environment, lack of air conditioning, lack of acclimatization),
reaction to anesthesia (malignant hyperthermia),
other risk factors (salt or water depletion, elderly living
alone).
• Identify those factors that client can control (if any), such as correction
of underlying disease process (e.g., thyroid control medication),
ways to protect oneself from excessive exposure to envi-
Information in brackets added by the authors to clarify and enhance
the use of nursing diagnoses.
386 Cultural Collaborative Community/Home Care