This content does not have an English version. Oral fluids can be given to alert patients; otherwise, intravenous saline (ideally warmed to 104 to 107.6F [40 to 42C]) should be administered to maintain urine output. Four degrees of frostbite are classically described. Only in the Nursing Diagnosis Manual will you find for each diagnosis subjectively and objectively sample clinical applications, prioritized action/interventions with rationales a documentation section, and much more! This procedure is done to prevent further tissue damage, to allow normal blood circulation and to permit movements or motion in the joints. The article references the current version of this guideline. Hypothermia is often caused by exposure to cold weather or immersion in a cold body of water. To minimize further tissue damage, skin should air dry or be gently blotted dry (not rubbed). These measures raise the core temperature and improve circulation. 16. opioid agent for pain management during the rewarming phase. This involves the use of a sterile procedure field, sterile gloves, sterile supplies and dressing, sterile instruments (Kent et al., 2018). endstream endobj 281 0 obj <>/Metadata 19 0 R/Outlines 49 0 R/Pages 278 0 R/StructTreeRoot 54 0 R/Type/Catalog>> endobj 282 0 obj <>/MediaBox[0 0 612 792]/Parent 278 0 R/Resources<>/Font<>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI]>>/Rotate 0/StructParents 0/Tabs/S/Type/Page>> endobj 283 0 obj <>stream Symptoms include cold skin and a prickling feeling, followed by numbness and inflamed or discolored skin. -Describe measures to protect and heal the tissue, including frostbite care. Kent, D. J., Scardillo, J. N., Dale, B., & Pike, C. (2018). A warm bath or whirlpool for 20 to 45 minutes will help rewarm your limbs. 10. Recommended nursing diagnosis and nursing care plan books and resources. 7. ears. Treatment of frostbite requires rewarming of the affected part using warm water that ranges from 98.6 to 102.2 degrees F, or 37 to 39 degrees C. Additionally, clients should take nonsteroidal anti-inflammatory drugs to relieve pain; and thrombolytics to reduce the risk of thrombosis and reperfusion injury. The prostacyclin analog iloprost (Ventavis) inhibits platelet aggregation, dilates blood vessels, downregulates lymphocyte adhesion to endothelial cells, and may have fibrinolytic activity. Risks of thrombolysis include systemic and catheter site bleeding, compartment syndrome, and failure to salvage tissue. Nursing Care Plans Nursing Diagnosis & Intervention (10th Edition)Includes over two hundred care plans that reflect the most recent evidence-based guidelines. HV]kP}7?.XJ`MA({Ge~$] IJ 8s yftDmx;1| Zs8Sj0983l $ }i/|$n@Oeq12i*a",m!^EQ The following are the therapeutic nursing interventions for Impaired Tissue Integritynursing diagnosis: 1. The aftermath of frostbite reflects the severity of the original injury and may include changes in skin color and nail structure, hyperhidrosis, stiffness, sensory loss, pain, and neuropathy.1 Patients may need to be referred for psychosocial support or counseling as well as rehabilitation and pain management. An alternative classification system categorizes first- and second-degree frostbite as superficial, and third- and fourth-degree frostbite as deep.3 Laypersons as well as healthcare personnel working in remote or austere settings may find this simplified classification easier to use for assessment and reporting purposes. Assessment is required in order to distinguish possible problems that may have lead to Hypothermia. In a normal setting, these defenses are adequate to defend the body from any threats. obesity dyslipidemia smoking Pathologic phases of frostbite include cellular hydration. Wilderness & Environmental Medicine. Make your tax-deductible gift and be a part of the cutting-edge research and care that's changing medicine. Accessed June 30, 2014. Yes, Recommendations based on patient-oriented outcomes? 6. NANDA International Nursing Diagnoses: Definitions & Classification, 2021-2023The definitive guide to nursing diagnoses is reviewed and approved by NANDA International. Pay special attention to all high-risk areas such as bony prominences, skin folds, sacrum, and heels. Nursing outcomes for the diagnosis impaired tissue integrity (00044) in adults with pressure ulcer, Evaluation of surgical wound healing in orthopedic patients with impaired tissue integrity according to nursing outcomes classification. McIntosh SE, Opacic M, Freer L, et al. A total of 46 new nursing diagnoses and 67 amended nursing diagnostics are presented. B6Si,.90p However, some factors may cause impairment or a break in this line of defense, causing impairment of tissue integrity. Hypothermia occurs as the body temperature falls lower than normal; usually below 35 C (95 F). 2023 Nurseslabs | Ut in Omnibus Glorificetur Deus! Monitor patients continence status and minimize exposure of skin impairment site and other areas to moisture from incontinence, perspiration, or wound drainage.Prevents exposure to chemicals in urine and stool that can strip or erode the skin causing further impaired tissue integrity. Hawkins SC, Simon RB, Beissinger JP, Simon D. Cold injuries. Includes step-by-step instructions showing how to implement care and evaluate outcomes, and help you build skills in diagnostic reasoning and critical thinking. 4(LH;]-nhV In-Depth Products and services By Mayo Clinic Staff Hypothermia occurs when your body loses heat faster than it can produce heat and your body temperature falls below 95 F (35 C). Other causes can be related to thermal factors (e.g., burns, frostbites), or chemical injury (e.g., adverse reactions to drugs), infection, nutritional imbalances, fluid imbalances, and altered circulation (e.g., pressure ulcers). 8j)>2`u"6hd l"'5}G#b@W H]K0BlOoavA^u:/o:^MzKIWfx;x Note: Always travel with more than half a tank of gasoline in the wintertime. The patients cognitive function and vital signs will improve, including heart rate. "[Those most at risk are] certain patients with diabetes, patients who have previous history of frostbite are prone to it, the elderly or your very young children, and also, for example, if you're dehydrated," he says. hbbd```b``"@$&,. Backer HD, Bowman WD, Paton BC, et al. Tissue plasminogen activator improves outcomes for deep frostbite extending to proximal interphalangeal joints if given within 24 hours. 12. Although there is no evidence that adding antiseptic solution produces better outcomes, it is not likely to be harmful and may reduce infection risk. The definitive treatment for frostbite is rapid rewarming in a water bath, but a frostbitten area that's been thawed and then freezes again is at risk for a much poorer outcome during the healing process.2,6 If the patient faces a risk for refreezing, then the frostbitten body part shouldn't be actively rewarmed.2,3,6 Whether to employ rapid rewarming of the body part depends on the patient's risk for refreezing due to delays in evacuation from a cold environment. Depending on the patient's clinical status, treatment options include hyperbaric oxygen therapy, hydrotherapy, sympathectomy, fasciotomy, and amputation.1, Evaluating for the presence of microvascular thrombosis in the early stages of care can help to determine possible reperfusion strategies. If possible, a frozen extremity should not be used for walking, climbing, or other activity until care has been obtained. Your message has been successfully sent to your colleague. Frostbite should be treated only after the person's core body temperature is greater than 35 C (95 F). The following descriptions provide an overview of frostbite injury progression. In: Triage Protocols for Aging Adults. Besides providing a measure of pain relief, ibuprofen may support tissue viability by decreasing the production of thromboxane and other inflammatory mediators.3 Aspirin may also provide beneficial antiprostaglandin and analgesic effects for patients with frostbite.7,10 Severe pain is most effectively treated with parenteral opioid analgesics. Give extra covering (passive warming), such as clothing and blankets; cover postoperative patients with heat-retaining blankets.Warm blankets provide a passive method for rewarming. In this new version of a pioneering text, all introductory chapters have been rewritten to provide nurses with the essential information they need to comprehend assessment, its relationship to diagnosis and clinical reasoning, and the purpose and application of taxonomic organization at the bedside. The patients skin will look pale and cool to the touch with a delayed capillary refill. What skin care routines do you recommend while the frostbite heals? T The extremity can be rewarmed using controlled and rapid rewarming. IUGd+&I5GcoPZm} FJ p1{e\^cN!l/.n w\5ltmOK[4m+$M,f17b,f*'TIFi! aQz:&{6|Q&8)#1Glk A pilot study of the diagnosis and treatment of impaired skin integrity: dry skin in older persons. In: 9. Frostbite is not an inherently infection-prone injury, so antibiotic prophylaxis is unnecessary. This material may not otherwise be downloaded, copied, printed, stored, transmitted or reproduced in any medium, whether now known or later invented, except as authorized in writing by the AAFP. Nursing Interventions: -The nurse will assess every hour patient's temperature and report any temperature less than 95 degrees to the doctor for further orders.-The nurse will assess HR and BP every 15 minutes. {f7m]VId39ol^le endstream endobj startxref Acute compartment syndrome of the extremities. Call your doctor if you suspect you have frostbite or hypothermia. The late ischemic phase involves progressive tissue ischemia and infarction from a cascade of events: inflammation, intermittent vasoconstriction, reperfusion injury, emboli in microvessels, and thrombus formation in larger vessels. Includes step-by-step instructions showing how to implement care and evaluate outcomes, and help you build skills in diagnostic reasoning and critical thinking. The sixteenth edition includes the most recent nursing diagnoses and interventions from NANDA-I 2021-2023 and an alphabetized listing of nursing diagnoses covering more than 400 disorders. After tissues have thawed, the more viable body parts can have erythema, edema, and blisters.1 If the affected areas remain dark and dusky, fail to form blisters, and develop a hard, black eschar, then tissue necrosis, gangrene, or mummification may ultimately result, requiring eventual amputation.1 An accurate prognosis about tissue viability may not be possible for several weeks or months while the freezing injury fully evolves.1, In all degrees of frostbite, pain may be extreme during and after thawing, and it can last days to months depending on the amount of tissue lost.1 Pressure from clothing or shoes as well as activity can worsen the pain; manifestations such as tingling and sensations of electric shock and burning have also been reported.2 Various intensities of sensory loss occur in the affected part for all degrees of frostbite and generally persist from 4 years to indefinitely.1, Because virtually all frostbitten body parts look similar while they're still frozen, the extent of damage can't be reliably determined until the body part thaws and the wounds evolve over time to reveal the line of demarcation between viable and necrotic tissue.1,4 This period can extend from 45 days to 3 months after the cold injury.1,3. Yes, Published source:Wilderness & Environmental Medicine. Monitor fluid intake and urine output (and/or central venous pressure).Decreased output may indicate dehydration or poor renal perfusion. Rewarming a frostbitten body part is extremely painful. calf muscles. To avoid further mechanical injury, the affected part should be handled gently. Rapid rewarming in the field should be performed only if definitive care is more than two hours away and refreezing can be prevented. If a thermometer isn't available, use water that's the temperature of a hot tub; to test it, you as the nurse should be able to hold your hand in it for at least 30 seconds without feeling uncomfortable before immersing the patient's body part.3 If hot water must be added to maintain the target temperature, remove the patient's body part from the water until the water temperature is retested to ensure it isn't too hot before reimmersion.2 Prevent the patient's injured extremity from resting on the bottom or touching the sides of the water bath vessel to avoid inadvertent tissue trauma from pressure while the extremity is numb.2,8, Frostbite of the ears and nose can be managed by continually applying warm, moist compresses to the affected areas until thawing occurs.9. The prefreeze phase consists of tissue cooling, which leads to vasoconstriction and ischemia without ice crystal formation. B Be sure to conduct a physical assessment to observe for concomitant injury such as: I In dressing frostbite injuries, it is essential to use strict aseptic technique. Alarmed, he asks the clerk to call an ambulance. The worst cases, the tissue can die, and you may need surgery to remove it. Patient reports any altered sensation or pain at site of tissue impairment. It helps guide nurses throughout their shift in caring for the patient. Seek emergency medical care. Take all medications antibiotics or pain medicine as prescribed by your doctor. Ensure proper nutrition and stay hydrated. 18. If possible, an ibuprofen regimen should be initiated in the field setting. Its availability is limited in the United States, but it can be administered in the field if available once it has been warmed. (See Tips for preventing frostbite.). Update your knowledge of prehospital and hospital management of patients with frostbite and use the prevention strategies discussed here in patient teaching. Mayo Clinic does not endorse companies or products. Interprofessional patient problems focus familiarizes you with how to speak to patients. Bergeron MF, et al. Nurses can play a fundamental role in teaching both patients and members of the general community how to stay safe in the cold. HVmk0nN;Ahnln1>.eNv^@lKG]FGioy63N>hg6: y7*|GyDw=OS>)Yx&"]#l}1K %4O#X'>Y),M? For more information, check out our privacy policy. 11. During the early stage of frostbite, when the skin has thawed out, the affected area becomes red and is very painful. Tell the patient to avoid rubbing and scratching. It has consistently shown favorable effects when given up to 72 hours after freezing injury. Regulate the environment temperature or relocate the patient to a warmer setting. 332 0 obj <>stream Copyright 2020 by the American Academy of Family Physicians. vasodilation. 7. What changes in my skin should I look for? Determine etiology (e.g., acute or chronic wound, burn, dermatological lesion, pressure ulcer, leg ulcer).Prior assessment of wound etiology is critical for the proper identification of nursing interventions that will guide nursing care. Discuss the relationship between adequate nutrition consisting of fluids, protein, vitamins B and C, iron, and calories.Nutrition plays a vital role in maintaining intact skin and in promoting wound healing. In the earliest stage of frostbite, known as frostnip, there is no permanent damage to skin. B/ $hL(GN,3uB&@6 dtx mp$OHR1# cQRX*0%3(Fe!a2 Skin wounds may be covered with wet or dry dressings, topical creams or lubricants, hydrocolloid dressings (e.g., DuoDerm), or vapor-permeable membrane dressings such as Tegaderm. Management of moderate-to-severe hypothermia takes priority over management of frostbite. First-degree frostbite causes numbness, erythema, and often edema. If the windchill drops below negative 15 degrees Fahrenheit, not unheard of in the northern half of the U.S., frostbite can set in within half an hour. In more severe cases, when the tissue has started to freeze, the skin may appear white and numb. What increases the risk of frostbite? We may earn a small commission from your purchase. Which is the most beneficial nursing intervention for this client? Patient demonstrates understanding of plan to heal tissue and prevent injury. If ordered, turn and position the patient at least every two (2) hours and carefully transfer the patient.This is to avoid the adverse effects of external mechanical forces (pressure, friction, and shear). F - For injuries in the lower extremities, do not allow the patient to walk. Other recommended site resources for this nursing care plan: document.getElementById( "ak_js_1" ).setAttribute( "value", ( new Date() ).getTime() ); Gil Wayne ignites the minds of future nurses through his work as a part-time nurse instructor, writer, and contributor for Nurseslabs, striving to inspire the next generation to reach their full potential and elevate the nursing profession. Explain all procedures and treatments to the patient and SO.Repeated explanations are needed to avoid confusion. The primary cause of frostbite is exposure to freezing temperatures. The cells eventually burst and die. 17. They used angiography to identify perfusion deficits with subsequent catheter-directed infusion of intra-arterial fibrinolytic agents in 66 patients found to have arterial thrombosis.11 Outcome data from 62 patients included in the analysis revealed a complete digit salvage rate of 68.6%. These include extracellular and intracellular ice crystal formation, cellular dehydration and shrinkage, derangement of intracellular electrolyte concentrations, endothelial damage, vasoconstriction, thrombosis, ischemia-reperfusion injury, and ultimately tissue necrosis.1,3 Multiple mediators, including thromboxane A2, arachidonic acid, bradykinin, histamine, and prostaglandins, contribute to the inflammatory response at the tissue level.3. Miller T. Preparing for cold weather exercise. Regulate the environment temperature or relocate the patient to a warmer setting. The effect of hydration on frostbite outcomes has not been studied, but appropriate hydration is important for recovery. Remove rings or other tight items. T Tetanus prophylaxis can be given if there is associated trauma. In addition to frostbite, the article includes discussions of hypothermia and nonfreezing injuries such as frostnip, pernio, and immersion foot, which are not discussed in this guideline. In the vascular stasis phase, vessels fluctuate between dilation and constriction. Frostbite prevention is a major component of military and wilderness planning. Substantial edema should be anticipated. Encourage the use of pillows, foam wedges, and pressure-reducing devices.These measures help redistribute and relieve pressure and prevent pressure injury. Patients with who experience vomiting can easily become dehydrated and experience abdominal pain. Understanding factors that predispose people to cold injuries is essential to mitigate these risks. Nurses Pocket Guide: Diagnoses, Prioritized Interventions, and Rationales Quick-reference tool includes all you need to identify the correct diagnoses for efficient patient care planning. The result would be a vascular damage. The depth of tissue freezing determines the degree of frostbite injury and associated signs and symptoms. Does the use of clean or sterile dressing technique affect the incidence of wound infection? Other recommended site resources for this nursing care plan: Recommended resources for the nursing diagnosis impaired tissue integrity and care plan: document.getElementById( "ak_js_1" ).setAttribute( "value", ( new Date() ).getTime() ); Gil Wayne ignites the minds of future nurses through his work as a part-time nurse instructor, writer, and contributor for Nurseslabs, striving to inspire the next generation to reach their full potential and elevate the nursing profession. If a body part is frozen in the field, it should be protected from further damage. Normal body temperature is around 37 C (98.6 F). New to this edition are ICNP diagnoses, care plans on LGBTQ health issues, and on electrolytes and acid-base balance. Berman, A., Snyder, S. J., Kozier, B., Erb, G. L., Levett-Jones, T., Dwyer, T., & Parker, B. Move the person to a warmer place and shelter him or her from cold. Menna Barreto, L. N., Swanson, E. A., & de Abreu Almeida, M. (2016). This article reviews the pathophysiology of frostbite, prehospital and hospital management of a patient with frostbite, and prevention strategies for personal preparedness and patient education. Frostbite. This care plan handbook uses an easy, three-step system to guide you through client assessment, nursing diagnosis, and care planning. When tissues freeze, frostbite occurs. Numbness. Laskowski-Jones, Linda MS, APRN, ACNS-BC, CEN, FAWM, FAAN; Jones, Lawrence J. BA, NREMT, FAWM. Moisture promotes evaporative heat loss. Recommended nursing diagnosis and nursing care plan books and resources. Frostbite on fingertip Frostbite is an injury caused by freezing of the skin and underlying tissues. Gangrene is a condition that involves the destruction of body tissue caused by a major bacterial infection or a lack of blood supply. These methods provide for a more gradual warming of the body. For milder cases of frostbite, a nonprescription pain reliever can help reduce pain and inflammation. 8. Check out these best-sellers and special offers on books and newsletters from Mayo Clinic Press. A person viewing it online may make one printout of the material and may use that printout only for his or her personal, non-commercial reference. 15 November, 2005. Educate the patient on the need to notify the physician or nurse.This is to prevent further impaired tissue integrity complications. Check for electrolytes, arterial blood gases, and oxygen saturation by pulse oximetry.Acidosis may emerge from hypoventilation and hypoxia. Early rewarming of the tissue appears to decrease injury or damage. Yes, Guideline developed by participants without relevant financial ties to industry? 299 0 obj <>/Filter/FlateDecode/ID[<8077CADA29399A4E9C452830676D15DB>]/Index[280 53]/Info 279 0 R/Length 101/Prev 466515/Root 281 0 R/Size 333/Type/XRef/W[1 3 1]>>stream 1. Areas most frequently affected by frostbite include the posterior thorax. It can also happen in the muscles and internal organs . Monitor the patients HR, heart rhythm, and BP.HR and BP drop as hypothermia progresses. 'Nm3wsRS4D3;^1;;7 Ackley and Ladwigs Nursing Diagnosis Handbook: An Evidence-Based Guide to Planning CareWe love this book because of its evidence-based approach to nursing interventions. (2019). For more information, please refer to our Privacy Policy. The scenario described in the beginning of this article is one example of the risk inherent in cold weather. Assess the patients level of pain.Pain is part of the normal inflammatory process. Long-term functional outcomes of tPA use to salvage digits are not known. Patient describes measures to protect and heal the tissue, including wound care. Ackley and Ladwigs Nursing Diagnosis Handbook: An Evidence-Based Guide to Planning CareWe love this book because of its evidence-based approach to nursing interventions. Tetanus prophylaxis is warranted because tetanus is a reported complication of frostbite.5, Blister debridement isn't typically performed or recommended in the prehospital setting unless it appears the blister will rupture.2 Clear fluid may be drained, but blisters with hemorrhagic fluid should be protected with padding and kept intact until they can be managed definitively in the hospital setting.3 Prompt initiation of parenteral antibiotics is indicated for evidence of infection.5, In the postrewarming phase of care, diagnostic imaging and advanced interventions in the hospital setting are employed to both evaluate and treat the tissue damage associated with frostbite. To help control swelling, elevate the affected extremity or body part. Editor's Note: An article on hypothermia and cold weather injuries was published in the December 1, 2019, issue of American Family Physician (https://www.aafp.org/afp/2019/1201/p680.html). Blisters act like a bandage. Perhaps the most important strategy for addressing frostbite is effective education, including hypothermia prevention. New York, N.Y.: The McGraw-Hill Companies; 2012. https://accessmedicine.mhmedical.com. Provide warmed fluids such as tea or soup for alert patients.Warm fluids produce a heat source. If a thermometer is unavailable, an uninjured extremity should be placed in the water for 30 seconds to confirm that the temperature is tolerable. This series is coordinated by Michael J. Arnold, MD, contributing editor. What constitutes our bodys protection against external threats? When frostbitten areas have been thawed in the field or prehospital setting, don't let the patient bear weight or otherwise use the involved body part to minimize the chance of further injury.2 Monitor for the development of compartment syndrome in rewarmed extremities and anticipate the need for urgent surgical evaluation and fasciotomy if compartment pressures are elevated.1 (See Signs and symptoms of acute compartment syndrome.) Your doctor may order X-rays, a bone scan or an MRI to help determine the severity of the frostbite and check for bone or muscle damage. 7 In recent years, the majority of frostbite cases have occurred in urban settings, where social disadvantage . Thompson DA. Copyright 2023 American Academy of Family Physicians. .3yQeYFpBLyTj.HTt/G'&Q}Xi)K{@C+u\bnX`*!]qU lyC Identify a plan for debridement when necrotic tissue (eschar or slough) is present and if compatible with overall patient management goalsHealing does not transpire in the appearance of necrotic tissue. In: Adult Telephone Protocols: Office Version. Philadelphia, Pa.: Elsevier; 2018. https://www.clinicalkey.com. Keep a sterile dressing technique during wound care.A sterile technique reduces the risk of infection in impaired tissue integrity. to maintaining your privacy and will not share your personal information without Supplemental oxygen, if available, is also recommended, especially if the patient is hypoxic or at high altitude.3. Fitzpatrick's Dermatology in General Medicine. Moderate to severe hypothermia increases the risk for ventricular fibrillation, along with other dysrhythmias. This nursing care plan for vomiting includes a diagnosis and care plan for nurses with nursing interventions and outcomes for the following conditions: Risk for Fluid Volume Deficient & Acute Pain. Other well-known contributing factors include wind chill, exposed skin, wetness, peripheral vascular disease or other causes of circulatory impairment, fatigue, substance misuse or abuse, altered consciousness or judgment, inadequate clothing or shelter, dehydration, smoking or nicotine use, immobility, and prior frostbite injury.1. 8. Damages from frostbite make the patient susceptible to infection. Don't thaw or warm the affected area if it might refreeze. Get out of the cold and wind. Diagnosing frostbite is based on your signs and symptoms, skin appearance, and a review of recent activities in which you were exposed to cold. And it can be a very serious injury.". Although virtually any body part can be affected, the areas most often involved are the hands, feet, nose, and ears.1, Frostbite can develop in areas covered by clothing that offers inadequate protection from environmental conditions or is so tight it impairs circulation. As hypothermia advances, vasodilation transpires, furthering heat loss. Outline nursing interventions for patients with frostbite. Keep the patient and linens dry.These methods provide for a more gradual warming of the body. Mild hypothermia can be treated concurrently with frostbite. The patients skin becomes warm and less pale. Warming can be uncomfortable, but after warming, the condition completely resolves. This surgical emergency can be caused by reperfusion of ischemic tissue. For more information about pain, please visit: Acute Pain Nursing Diagnosis & Care Plan. Rapid warming can induce ventricular fibrillation. GPP]p$tMN\; = ^:z MBishJS#%usPX'pAiEwQvO[ablsvYex4P4)_a--Xrj HHb2|?\[p9%GgW/Kq6k0z=zv|?ef7L xxa,IwK0ycc!4_[c *~(AXBrM6uk r]Lp+h^XF[m:4H~H 4-$$Ep{@@Q;8tZ#}[C:pQ9RZ\SozNnOn" mQ: Frostbite is a trauma where exposure to freezing temperatures and actual freezing of the tissue fluids in the cell and intercellular spaces takes place. (2014). Here are the common goals and expected outcomes forHypothermianursing diagnosis. If hands and feet begin to get cold, exercise can help promote peripheral circulation. Coverage of guidelines from other organizations does not imply endorsement by AFP or the AAFP. 2nd ed. Control the heat source according to the patients physical response.Body temperature should be raised no more than a few degrees per hour. Assess the patients peripheral perfusion at frequent intervals.Hypothermia initially precipitates peripheral vascular constriction as a compensatory mechanism to minimize heat loss from extremities. 2. 3. The patient may start to remove clothing and bed covers. The patient will not experience complications of hypothermia such as cardiac arrest, respiratory failure, and organ damage. Preventing and managing hypothermia and frostbite injury. Note and monitor the patients temperature.For alert patients, the oral temperature is regarded as more reliable than tympanic or axillary. What kind of follow-up, if any, should I expect? This content does not have an Arabic version. Assess patients nutritional status; refer for a nutritional consultation or institute dietary supplements.Inadequate nutritional intake places the patient at risk for skin breakdown and compromises healing, causing impaired tissue integrity. Evidence on outcomes is lacking, but hydrotherapy has few negative sequelae and may benefit recovery.
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