Chapter 18 Applying Heat and Cold

Chapter 18  Applying Heat and Cold

Complete Chapter Questions And Answers
 

Sample Questions

Multiple Choice
Identify the choice that best completes the statement or answers the question.

____ 1. A patient has orders for a heating pad to be placed on the lower back. The nurse teaches the patient that to prevent rebound phenomenon the heating pad is to be removed after
A.
The swelling has decreased.
B.
25 to 30 minutes.
C.
The discomfort has resolved.
D.
2 to 3 hours.

____ 2. Following the nurse’s explanation of why a warm pack should be applied to an infected hang nail, the patient demonstrates understanding by stating,
A.
“Heat to the area causes vasoconstriction, resulting in increased white blood cells to fight infection.”
B.
“If I apply moist heat to the area it will decrease the metabolism required for pathogens to multiply.”
C.
“Applying heat will decrease the blood flow and as a result will increase my body’s ability to fight infection.”
D.
“My body’s ability to fight off infection will be enhanced by allowing more white blood cells to get to the wound.”

____ 3. Prior to applying a warm pack to reduce a patient’s discomfort from back spasms the nurse will
A.
Warm the towel in the microwave.
B.
Check peripheral pulses for a baseline.
C.
Assess the skin for edema and color.
D.
Prepare the warm pack using sterile technique.

____ 4. The nurse explains to the patient with a sprained wrist that cold therapy will be more beneficial in relieving pain than heat by stating,
A.
“Cold therapy decreases swelling and pressure on nearby nerves, which helps decrease pain.”
B.
“Heat therapy decreases swelling by constricting vessels and nerves, which can increase discomfort.”
C.
“Heat therapy decreases pain by increasing oxygen and nutrients to the injured area.”
D.
“Cold therapy increases the inflammatory process, which speeds healing and decreases discomfort.”

____ 5. The nurse applies a hypothermia blanket to a patient with a temperature of 105.4°F. The nurse understands that the therapeutic effectiveness is indicated when
A.
The patient begins to shiver.
B.
The blood pressure and pulse increase.
C.
The temperature slowly falls to 100°F.
D.
The level of consciousness decreases.

Chapter 18. Applying Heat and Cold
Answer Section

MULTIPLE CHOICE

1. ANS: B

Feedback
A
Rebound phenomenon occurs whether swelling has decreased or not.
B
To prevent rebound phenomenon, heat therapy is applied no more than 30 minutes every 2 to 3 hours. Chapter Objective: Contrast the physiological effects of local heat and cold applications.
C
Less discomfort is a desired result but does not prevent rebound phenomenon.
D
Heat should never be applied longer than 30 minutes once every 2 to 3 hours or the patient could experience rebound phenomenon.

PTS: 1 REF: Chapter: 18 | Page: 380 OBJ: Chapter Objective: 18-2
KEY: Content Area: Reduction of Risk Potential | Integrated Process: Teaching and Learning | Client Need: Physiological Integrity/Reduction of Risk Potential/Potential for Complications of Treatment | Cognitive Level: Application

2. ANS: D

Feedback
A
Heat to an area results in vasodilation, which increases white blood cells’ access to the wound.
B
Applying moist heat increases metabolism.
C
Applying heat increases blood flow.
D
Applying heat enhances infection fighting properties by increasing blood flow and delivering white blood cells. Chapter Objective: Explain how application of heat can support healing.

PTS: 1 REF: Chapter: 18 | Page: 378 OBJ: Chapter Objective: 18-4
KEY: Content Area: Basic Care and Comfort | Integrated Process: Teaching and Learning | Client Need: Physiological Integrity/Basic Care and Comfort/Non-Pharmacological Comfort Interventions | Cognitive Level: Application

3. ANS: C

Feedback
A
Warm packs should never be prepared in the microwave due to a potential for causing burns.
B
Applying a warm pack will not affect peripheral pulses.
C
Prior to applying a warm pack the skin of the affected area should be assessed for temperature, color, edema, sensation, and integrity. Chapter Objective: Detail the nursing assessments to make prior to, during, and after application of heat therapy.
D
Unless the area the warm pack is to be applied to is open there is no need for sterile technique.

PTS: 1 REF: Chapter: 18 | Page: 382 OBJ: Chapter Objective: 18-5
KEY: Content Area: Basic Care and Comfort | Integrated Process: Nursing Process/Implementation | Client Need: Physiological Integrity/Basic Care and Comfort/Non-Pharmacological Comfort Interventions | Cognitive Level: Comprehension

4. ANS: A

Feedback
A
By decreasing swelling at the site of injury, pressure on nerves is also decreased, resulting in less discomfort. Chapter Objective: Contrast the physiological effects of local heat and cold applications.
B
Heat therapy results in vasodilation, which in turn increases swelling around nerves, resulting in increased discomfort.
C
Although heat increases oxygen and nutrients to the area it does this by vasodilation of vessels and increasing edema and discomfort.
D
Cold therapy decreases the inflammatory response; inflammatory response, though necessary, temporarily increases discomfort.

PTS: 1 REF: Chapter: 18 | Page: 383 OBJ: Chapter Objective: 18-2
KEY: Content Area: Basic Care and Comfort | Integrated Process: Teaching and Learning | Client Need: Physiological Integrity/Basic Care and Comfort/Non-Pharmacological Comfort Interventions | Cognitive Level: Application

5. ANS: C

Feedback
A
Shivering indicates temperature was lowered too quickly and the temperature will increase as a result.
B
Elevated blood pressure and pulse are symptoms of an elevated temperature.
C
If used correctly the patient’s temperature should slowly decrease; a temperature of 100°F will not require continued treatment with the hypothermia blanket. Chapter Objective: Compare the methods of heat and cold application.
D
A falling level of consciousness indicates either a very high or low temperature.

PTS: 1 REF: Chapter: 18 | Page: 380 OBJ: Chapter Objective: 18-7
KEY: Content Area: Physiological Adaptation | Integrated Process: Nursing Process/Evaluation | Client Need: Physiological Integrity/Physiological Adaptation/Alterations in Body Systems | Cognitive Level: Comprehension