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OBJECTIVES:
After 4 hours of varied teaching learning activities, the level II students will be able to:
Definition of Terms:
Perilite Exposure
– application of dry heat to perineal area in order to provide comfort and increase blood circulation and
hasten wound healing by means of perineal lamp.
- 20-50 centimeters or 18-24 inches away from the body to be exposed.
Heat application
– is a process of applying heat through radiation and convection
Dry heat
– requires a higher temperature and a longer period of heating
Moist heat
- utilizes hot air that is heavily laden with water vapor
Episiotomy
– refers to an incision through the perineum that allows for less pressure on the fetal head during
delivery and prevents lacerations of the perineum.
Episiorraphy
-operation for repairing the episiotomy
Perineorrhaphy
– Operation for repairing laceration of perineum usually following delivery
Process of Heat transfer
CONDUCTION
-the transfer of heat from a warm object to cooler object or vice versa by contact
-is the transfer of thermal energy from a region of higher temperature to a region of lower temperature
through direct molecular communication within a medium or between mediums in direct physical
contact without a flow of the material medium.
CONVECTION
-heat transfer by means of movement of liquid or gas
-is a combination of conduction and the transfer of thermal energy by fluid circulation or movement of
the hot particles in bulk to cooler areas in a material medium.
-this transfer occurs in sitz bath.
RADIATION
- is the transfer of heat through electromagnetic radiation. For anybody the reflectivity depends on the
wavelength distribution of incoming electromagnetic radiation and therefore the temperature of the
source of the radiation.
• Relaxation of muscles
• Softening of exudates
• Increase peristalsis
• Increase body temperature
1. Individual tolerance
– tolerance is influenced to some degree by age, condition of skin, the
condition of nervous and circulatory system. Young children, elderly clients, diabetic clients and
individuals with circulatory or sensory alterations have low tolerance for heat.
- The very young and the very old generally have the lowest tolerance. Persons who have neurosensory
impairments may have a high tolerance, but the risk of injury is greater.
6. Environmental temperature
– in warm or in humid environment, heat can’t be dissipated through
evaporation to some degrees that it can dry or cool circumstances.
7. Length of Exposure
- People feel hot applications most while the temperature is changing. After a period of time, tolerance
increases.
- The back of the hand and foot are not very temperature sensitive. In contrast the inner aspect of the
wrist and forearm, the neck, and the perineal area are temperature sensitive.
Therapeutic uses of heat
1. SEDATIVE EFFECT
- Heat is generally considered to produce a relaxation effect and increase the contractility of muscles.
2. RELIEVES PAIN
- Heat relieves pain by promoting muscle relaxation, increasing circulation, and promoting psychological
relaxation and a feeling of comfort.
Dry Heat
ADVANTAGES
DISADVANTAGES:
1. Moist heat creates a greater risk for burns to skin since moisture conducts heat
2. Prolonged exposure can cause maceration of skin
3. Moist heat will cool rapidly because of moist evaporation
INDICATIONS:
• Patients who have undergone rectal or perineal surgery
• Post-partum patients with episiotomy wounds
• Patients having vaginal inflammation or bladder spasm
• Patients with painful or local irritation from hemorrhoids
CONTRAINDICATIONS:
• Patients with cardiovascular condition
• Presence of cyst or malignancy in the area
• Patients with open wounds with hemorrhage
• Patients with burns or fracture at the lower limbs
• Heat lamps are contraindicated in pressure ulcer care
• BODY MECHANICS
• position of mother is dorsal recumbent with legs and knees flexed to allow proper exposure of area to
be treated
• PHYSICS
• application of heat employs physical agents: heat, water and light. Heat maybe transferred from one
place to another by radiation (perilite exposure) and convection (hot sitz) bath.
• PSYCHOLOGY
• nurse explains purpose of treatment in order to gain cooperation.
• SOCIOLOGY
• the patient needs to cooperate with nurse in order for treatment to be effective and to add patients
early recovery.
BEFORE:
• Check the client’s condition before applying the procedure.
• Check all electrical equipment for defects or try to switch it on and off.
• Always handle equipment with dry hands
• Check physicians order for each area to be treated and duration of therapy
• Do perineal flushing
DURING:
• Position client comfortably with only area where heat is to be applied
• Position lamp at a safe distance from where it is to be applied
• Inspect skin and see to it that its clean and dry before applying heat
• Place bed cover over lamp but not allowing bed sheet to touch the light bulb
• Check skin every 5 minutes interval throughout duration of procedure
• Monitor any untoward response
• Perilite exposure should be given 24 hours after delivery
• Place bed cover after pulling lamp and provide privacy
• Position lamp at 18-24 inches away from the body part to be exposed.
AFTER:
• Assist the client
• Do after care
• Monitor clients response
• Do recording; record on patients chart
- time when it started
- patients reaction
- condition of perineum
- inspect sutures and episiotomy after procedure
• Inspect condition of part being treated
• Explain procedure
• Instruct patient to do perineal flushing before perilite exposure
• Check the equipment for any defects
• Handle equipment with dry hands especially when you’re about to plug it.
• Provide privacy during procedure
• During exposure, keep lamp 20-50 cm away from perineum.
• Heat lamp should be left in place for 15 minutes then removed
• Perilite exposure process should be repeated 3-4 times a day
• Washable parts of lamp should be wiped with antiseptic solutions before it is returned to storage area
or used with another patient
INDICATIONS:
• Post partum mother with episiotomy wound
• With rectal or vaginal surgery
CONTRAINDICATIONS:
• Patients with hemorrhage
• Mother who had undergone CS delivery
• PSYCHOLOGY
• nurse should explain first the procedure to patient to gain cooperation
• nurse should know if patient is sensitive to warmness.
• CHEMISTRY
• heat generally is the speed of chemical reaction since metabolism is largely caused by chemical
reactions, the application of heat speeds metabolism either locally or generally
• the solvent action of water maybe increased by adding other substances like soap.
• Magnesium Sulfate is used for preterm labor or commonly used for treatment of preeclampsia to slow
uterine contractions.
• PHYSICS
• heat is most valuable and most versatile physical for treatment.
• water has also great capacity, it undergoes change more slowly than other substances. It also gives off
more heat.
• heat maybe transferred from 1 place to another by conduction, convection and radiation.
• application of heat & cold employs physical agents; heat, light & electricity
• BODY MECHANICS
• position of mother is dorsal recumbent with legs and knees flexed to allow proper exposure of area to
be treated
• PHYSICS
• application of heat employs physical agents: heat, water and light. Heat maybe transferred from one
place to another by radiation (perilite exposure) and convection (hot sitz) bath.
• PSYCHOLOGY
• nurse explains purpose of treatment in order to gain cooperation.
• SOCIOLOGY
• the patient needs to cooperate with nurse in order for treatment to be effective and to add patients
early recovery.
BEFORE:
• Check doctors order for desired solution and body part to be soaked at a desired temperature.
• Assess the condition of skin of the body to be immersed
• Explain procedure to the patient.
• Nurse must have adequate knowledge about the procedure.
DURING:
• Check the temperature of water in a sitz bath before the patient enters into the tub (40.5-43.5 degrees
Celsius)
• Assist the patient into the tub and position her properly
• Wrap a blanket around patients shoulder
• Don’t leave the patient alone unless certain that its safe to do so
AFTER:
• Assist the patient in going out of the tub after the procedure is complete
• Assist patient to her bed, its best for her to be down, avoid draft until normal condition and circulation
returns
• Monitor patients general response to therapy and properly document significant data
• Do after care