Nursing Procedure 10.5
- Administering a Sitz Bath
- Promotes perineal and anorectal healing
- Reduces local inflammation and discomfort
Nursing Procedure 10.5
Assessment should focus on the following:
Nursing diagnoses may include the following:
Outcome Identification and Planning
Sample desired outcomes include the following:
Special Considerations in Planning and Implementation
Avoid sitz baths during the initial injury phase (first 12–24 hr), as they may contribute to post-trauma swelling. Inflatable rings or cushions are generally discouraged because they can cause stretching and tension on perineal or anorectal tissue, which impairs wound healing. Schedule the procedure for a time when the client can be checked frequently. If client cannot remain alone, plan to remain with client or find someone to do so.
Do not leave children unattended during this procedure.
Vasodilatation from exposure to warm water could cause severe changes in blood pressure and cardiac function in elderly clients with compromised cardiovascular status. The duration and temperature of the sitz bath might need to be decreased, and clients must be watched closely for adverse reactions.
Instruct client and family regarding the procedure. Emphasize the importance of a family member's checking on the client frequently if a potential safety hazard (e.g., falling in tub or on floor) exists.
See overview regarding hot/cold conditions and Table 10.1. Discuss therapy with client and relay any objections to doctor. Adhere to cultural preferences regarding same-sex or opposite-sex care providers; family member should be instructed on procedure for sitz bath if preferred by client.
Generally, this procedure may be delegated to unlicensed assistive personnel. Stress the importance of monitoring water temperature before contact with client's skin.
| Action | Rationale | |
|---|---|---|
| 1 | Explain procedure to client. | Reduces anxiety; promotes cooperation |
| 2 | Perform hand hygiene, organize equipment, and don gloves. | Reduces microorganism transfer; promotes efficiency; prevents contamination of hands; reduces risk of infection transmission |
| 3 | Check temperature of water with thermometer; water should be 40.5 C to 43 C (105 F to 110 F). If thermometer is unavailable, test water with the inside of wrist (water should be warm). | Prevents skin damage from high water temperature |
| 4 | Assist client to bathroom and close door. Proceed to Step 5 for either a tub or toilet sitz bath. | Provides privacy |
| For Tub Sitz Bath | ||
| 5 | Place rubber ring at bottom of tub and place bathmat on floor. | Prevents accidental falls |
| 6 | Assist client into tub, using footstool if necessary. | Prevents accidental injury |
| 7 | Ascertain client’s stability in the tub. Proceed to Step 8. | Prevents complications from falling or unusual reaction to therapy |
| For Toilet Sitz Bath | ||
| 5 | Prepare the equipment: | Allows client to sit in the water |
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| Promotes comfort and vasodilation; prevents leakage | |
| Higher heights may cause the water to leave the bag too quickly, creating a flow that is too forceful | |
| Ensures that water is properly directed toward injured area and prevents spillage | |
| 6 | After the client is seated on the basin, demonstrate how to unclamp tubing to begin and adjust water flow. | Allows client to adjust to comfort level |
| 7 | Cover the client’s lap with a towel or bath blanket. | Promotes warmth and privacy |
| 8 | Assess client’s reaction to the treatment: | Prevents complications from or unusual reaction to therapy |
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| 9 | Instruct client on use of call light, and place light within reach. | Facilitates communication and immediate response to emergency |
| 10 | Check client every 5–10 min. | Allows assessment of unusual reactions |
| 11 | After 15–20 min, help client out of the tub or up from the toilet. | Terminates treatment |
| 12 | Assist client with drying and dressing, then place linens in hamper. | Prevents chilling |
| 13 | Return client to room or bed. | Promotes comfort |
| 14 | Restore or discard all equipment appropriately and clean tub or sitz basin. | Reduces transfer of microorganisms among clients; prepares equipment for future use |
| 15 | Remove and discard gloves and perform hand hygiene. | Reduces microorganism transfer |
Were desired outcomes achieved? Examples of evaluation include:
The following should be noted on the client's record:
Transcultural