Administering Heat Therapy: Aquathermia Pad

Nursing Procedure 10.1

Administering Heat Therapy: Aquathermia Pad

Stimulates circulation, thus providing nutrients to tissues
Reduces muscle tension

Aquathermia module (K-module) with pad (K-pad)
Overbed or bedside table
Nonsterile gloves
Pillowcase
Distilled water
Tape
Timer
Thermometer
Pen

Assessment should focus on the following:

Treatment order and response to previous treatment, if used
Status of treatment area (redness, tenderness, cleanliness, dryness, sensation, integrity, and vascularity)
Temperature, pulse rate and rhythm
Degree of pain and position of comfort, if any
Ability of client to maintain appropriate position without assistance
Client's ability to perceive and report pain or burning sensation
Presence of medical conditions that may impair sensation
Proper functioning and safety of heating device
Sensitivity of skin to heat treatment

Nursing diagnoses may include the following:

Acute pain related to joint pain
Ineffective tissue perfusion related to vaso-occlusive process

Outcome Identification and Planning

Desired Outcomes

Sample desired outcomes include the following:

Client verbalizes increased comfort after treatment.
Client demonstrates increased mobility of affected extremity after treatment.
Client does not experience any injury to skin integrity.

Special Considerations in Planning and Implementation

General

Schedule procedure for a time when the client can be assessed frequently. If the client is confused or cannot remain alone with a heating device, remain with the client or find someone to do so. Clients with decreased peripheral sensory perception, such as clients with diabetes, must be monitored closely for heat overexposure.

Pediatric

Assess children more frequently because their epidermis is thin and fragile. Their ability to communicate discomfort associated with this procedure may be impaired.

Geriatric

Elderly clients may be extremely sensitive to heat therapy. Assess frequently.

Home Health

If a homebound client will be using a K-module when a nurse is not present, teach the client or family how to use the module safely. Ensure that the home environment is safe (e.g., electrical outlets are intact and not overloaded).

Transcultural

Determine the client's cultural perspective regarding the use of heat to treat the condition. Discuss objections and incorporate hot/cold perception of illness and treatment into the plan of care. Omit treatment if client objects, and consult doctor.

Delegation

Generally, this procedure may be delegated to unlicensed assistive personnel. Check agency policy. Emphasize importance of monitoring local skin area and maintaining time limits for therapy.

[Outline]

Desired Outcomes
Special Considerations in Planning and Implementation

Action		Rationale
1	Perform hand hygiene and organize equipment.	Reduces microorganism transfer; promotes efficiency
2	Explain procedure to client.	Reduces anxiety; promotes cooperation
3	Place heating module on bedside or overbed table at a level above the client’s body level (Fig. 10.1).	Facilitates flow of fluid
4	Fill module two-thirds full with distilled water.	Enables unit to function properly
5	Turn module on low setting and allow water to begin circulating throughout the pad and tubing.	Detects leakage of fluid or improper functioning before initiating therapy
6	After water is fully circulating through the pad and tubing, check the pad with your hands to ascertain that it is warm and that there is no fluid leakage.	Checks for proper functioning and heating of unit
7	Ensure that the water has reached the appropriate temperature (103 F to 110 F) on thermometer.	Avoids thermal injury
8	Don gloves, if indicated by risk for exposure.	Prevents contamination of hands; reduces risk of infection transmission
9	Lower side rails, and position client appropriately to apply pad.	Promotes comfort
10	Place pillowcase over the heating pad and position pad on or around (if an extremity) treatment area.	Prevents direct skin contact with pad, minimizing danger of burn injury
10	If pad needs to be secured, use tape. Do NOT use pins.	Prevents puncture of pad and leakage of water
11	After 60 s, assess for heat intolerance by:	Prevents burn injury and complications of heat therapy
	Observing client’s facial expression
	Asking if heat is too high
	Noting any dizziness, faintness, or palpitations
	Removing pad and assessing for redness or tenderness; readjust temperature if necessary
12	Replace pad and secure with tape, if needed.	Resumes treatment
13	Instruct client NOT to alter placement of pad or heating module and to call if heat becomes too intense.	Promotes client cooperation and continued optimal functioning of unit; prevents burn injury
14	Place call light within client’s reach.	Facilitates communication
15	Recheck client every 5 min.	Prevents burn injury
16	After 20 min of treatment, turn module off, remove pad, and place pad on table with module.	Terminates treatment; avoids reflex vasoconstriction
17	Position client for comfort and raise side rails.	Promotes comfort; promotes safety
18	Restore or discard all equipment appropriately.	Reduces transfer of microorganisms among clients; prepares equipment for future use
19	Remove and discard gloves and perform hand hygiene.	Reduces microorganism transfer

Were desired outcomes achieved? Examples of evaluation include:

Desired outcome met: Following treatment, client reports pain reduced from a 9 to a 5 on a scale of 1 to 10.
Desired outcome met: Client demonstrates increased mobility of affected extremity after treatment.
Desired outcome met: Skin remains intact with no evidence of injury.

The following should be noted on the client's record:

Location and appearance of treatment area
General response of client (weakness, faintness, palpitations, diaphoresis, extreme tenderness, if any)
Duration of treatment
Position of client during and after procedure
Status of pain

section name header

Purpose ⬇

Equipment ⬆ ⬇

Assessment ⬆ ⬇

Nursing Diagnoses ⬆ ⬇

Outcome Id ⬆ ⬇

Implementation ⬆ ⬇

Evaluation ⬆ ⬇

Documentation ⬆