hot application in fundamental of nursing, include of definition,purpose,therapeutic effect,effect on physiology,and sencondery,procedure of appplying hot application on patient with the intervention

1. HOT APPLICATION
PRESENTED BY
KOYEL THANDER
2ND PBBSC OF NHCON

2. HOT APPLICATION
Application of a hot agent , warmer than skin
which may be applied in either moist or dry from on
the surface of the body to produce local or general
effect or both.

3. PURPOSES OF HOT APPLICATION
To relieve pain and stiffness of muscle spasm by relaxing muscles and increase blood flow to
the area.
To relieve swelling (facililate wound healing).
To relieve inflammation and congestion.
To relieve stasis of blood.
To increase absorption of inflammatory products.
To increase blood circulation.
To provide warmth to the body (to relieve chilling) and give comfort.

4. PHYSIOLOGICAL EFFECT OF HOT APPLICATION
Peripheral vasodilation .
Increased capillary permeability.
Increased oxygen consumption.
Increased local metabolism.
Decreased blood viscosity.
Decreased muscle tone.
Increased blood flow.

5. SECONDARY EFFECTS OF HOT APPLICATION
• With local heat application , the maximal increase in the circulation and tissue
temperature occurs after 20-40 min of exposure .
• After this time ,the heat application must be discontinued and recovery time of
one hour allowed otherwise secondary effect will take place.

6. THERAPEUTIC USES OF LOCAL HOT
APPLICATION
Heat decrease pain: Heat application stimulates the thermo receptors of skin and
black transmission of pain receptors . It has very soothing effect on muscles
promote blood circulation by dilating blood vessel.
Promotes comfort: by providing oxygen and nutrients to cell having accelerated
rate.
Reducing edema: Through vasodilation blood flow is increased to area , helps in
flow of fluid from intracellular space to intra vascular space with this ,fluid amounts
decrease to normal level gradually in the intercellular space.

7. CONTD:
Hot application
Vasodilation
Blood flow –removes waste products
Shifting of fluid from intercellular to intravascular space
Less fluid in intercellular space
edema

8. CONTD:
• Heat promotes healing: increased blood flow enhances oxygen supply leukocytes
antibodies and nutrients , helps in healing. Increased circulation, stimulates formation of
new tissue ,increased blood flow removes waste products from increased cellular
activity.
• Heat promotes suppuration: heat stimulates circulation and there by increase action of
phagocytic cells that ingest moisture and other foreign material and promotes suppuration.
• Heat relieves deep congestion: vasodilation of the skin reduces the blood supply to the
deeper viscera and relieve the deep congestion.

9. CONTD:
• Heat softens the exudates: moist heat in the form of hot compress softnes the
exudates and removes the crust formation.
• Heat provides warmth : heat is transferred to the body tissue by conduction
convection and radiation.
• Heat stimulates peristalsis: heat is the form of a hot drink ,hot enema etc
.stimulates the peristalsis by producing vascular changes in the intestines.

10. PRECAUTIONARY MEASURE TO BE TAKEN FOR
HOT APPLICATION:
Always be alert while applying hot application as heat is potential source of tissue
damage leakage of hot fluid from bottle packs may cause skin burn .
Moist heat is causes more burn than dry as water is good conductor. Nurse must
be alert for observing the client.
Hot application increases cellular activity should never be applied on area with
malignant cell mass.
Amount of heat to be applied varies from person to person while applying heat ,
nurse must consider the age ,medical problem and comfort level of client.

11. MEDICAL PROBLEM:
Client with circulatory problem—
 Check the temperature of hot application frequently , to guard against inadequate
or excessive heat.
 Always cover the hot packs with clothes as it protect the client skin from burns or
discomfort.
 Collect the subjective as well as objective information to detect the possibility of
excessive heat or burning as well as inadequate heat.

12. CONTD:
 Monitor the signs of burning like pain, extreme redness.
 Never forget to explain the procedure as well as rationale to client keeping in
mind educational and learning needs.
 Always keep in mind the malfunctioning or in accurancy of the mechanical
equipment used for hot application . Thus ,assessment plays an important role to
detect my fault.

13. CONTRAINDICATION OF HOT APPLICATION
Malignancy :`heat increases metabolism of cells and may deteriorate condition of client with
malignancy.
Impaired renal cardiac and lung functions: as hot application enhances vasodilation of cutaneous
vessels , blood supply to vital organs may be affected.
Acute inflamed area such as acute appendicitis , tooth abscess heat may rupture it and spread the
infection to surrounding tissue .
Never apply heat over the open wounds because it may causes bleeding.
Application of heat for headache increased discomfort because of vasodilating effect.
Never apply heat to client with pyrexia.

14. CONTD:
Hot application may enhance edema associated with venous or lymphatic
disease.
Heat should not applied on clients with paralysis , weak and debilirated clients
because they have impaired perception and they may not be able to respond to
hot applications and resulting in burns.
Heat should not be applied on clients with metabolic disorders because of the
increased hazards of tissue damage eg-DM
It should not be applied for very young and very old people because of risk of
tissue.

15. CLASSIFICATION OF HOT APPLICATION
Hot application
Local heat
Dry heat Moist heat
General
heat
Dry heat Moist heat

16. Local dry heat
hot water bag
Chemical healing bottles
Infarad rays
ultraviolet
Electric healing pads
Local moist heat
Warm soaks
Sitz bath
Hot compresses
stupes

17. General dry heat
Sun bath
Electric cradle
Blanket bed
General moist heat
Steam bath
Hot packs
Whirlpool bath

18. PREPARATION OF THE CLIENT CARE
Identify the client and explain the procedure to the client to win the confidence
and co-operation.
Provide privacy if needed.
Drape the part according to need and expose only the part that needs treatment.
Prevent draughts provide warmth by covering all non treatments areas with both
blanket or bed covers.
Place the client in a comfortable position.

19. LOCAL DRY HEAT APPLICATION:
APPLICATION OF HOT WATER BOTTLE
Equipment
Articles purpose
Hot water bag (1)
Jug (1) To take hot water
Duster (1) To wipe the outside of the jug
Towel (1) To insulate the hot water bag from the heat loss
Vasline or oil To apply on the skin ,if the skin is reddened
Lotion thermometer (if
possible)
To check the temperature of the hot water

20. PROCEDURE
Sl no steps rationale
01 Wash hands To prevent cross infection.
02 Screen the patient To maintain privacy.
03 Collect the supplies from the
treatment room
To economise time energy and material &
organization.
04 Mix hot and cold water & check the
temperature or keep the boiling still
steam disappears.
To prepare application with in the acceptable
range convention.
05 Put some in to the hot water bottle
and empty it
To warm the hot water bottles so that very
little heat is lost . Warm the rubber through
the conduction and convection
06 Pour water to fill the ½-2/3 0f the
capacity of hot bottle
To avoid un necesarry weight on body part
especially if applied on abdomen allows to
mould over the body area to provide even
heat

21. Sl
no steps
rationale
07 Expet the air placing bag over a
flat surface cork it tightly
Air in the bag will interference with the
conduction of heat.
08 Dry outside of the bottle and
hold the side down for checking
leakage
To prevent scalding of the patient .
09 Cover the bag with hot water
bottle cover or other protector
and apply to hot water bottle to
prescribed area.
Protect skin from direct contact with
hot rubber.
10 Keep the bottle in place for
about 20-30 min . changes its
position as necessary.
Maximum therapeutic effects from
application of heat occurs with in 20-
30 min .extended use of heat cause
tissue congestion and vasodilation
11 Inspect the area occasionally for
redness pain swelling
Inspection and changing the position
prevents burns.

22. AFTER CARE OF THE CLIENTS AND ARTICLES
Remove the hot water bag when the treatment is completed.
Dry the area if moist with perspiration.
Position the patient client comfortably.
Take all the articles to the utility room remove the cover of hot water bottle and put
in the laundry bag .
Empty the bag wash the outside of the bag with soap and water .
dry the bag inside by hanging it upside down.

23. CONTD:
When dried fill it with air and cork it .
 store it in its proper place .
Replace all the articles.
Wash hands.
Record procedure with date and time ,the area or where it is applied ,the purpose
of the application and reaction of any tim

24. REFERENCE:
• A text book of “Fundamental of nursing” by ‘‘Dr. s. Anuradha ’’ by vijayamma
publication page no 7.24-7.33
• Text book of “Fundamental of nursing” by Nancy 2nd edition page no 72 -78