CITY OF MANILA

UNIVERSIDAD DE MANILA
One Mehan Gardens
Manila, Philippines 1000

COLLEGE OF HEALTH SCIENCES

DEPATMENT OF NURSING

RELATED LEARNING EXPERIENCE

Hot and Cold Application

Name: _____________________________ Grade: _______

Section: _____________ Date: ________

RATING QUANTITATIVE DESCRIPTION

1 Poor Failure to perform the procedure
2 Needs Improvement Performs the procedure with some incompetence
3 Satisfactory Performs procedure with average level of competence
Performs procedure with moderate level of
4 Very Satisfactory
competence
5 Outstanding Performs procedure with high level of competence

HOT APPLICATION
5 4 3 2 1
I. ASSESSMENT
1. Check for doctor’s order for type of compress, location and duration of
application.
Rationale: it ensures safe and correct application. Also, for
legal purposes.
2. Assess the general condition of the client taking note of the age,
diagnosis, level of consciousness, circulatory status and the vital signs
Rationale: this information will establish a baseline data for
comparison
3. Review medical record of patient to check for any condition that may
contraindicate the application.
Rationale: heat can cause vasodilation which can lead to
hemorrhage
II. PLANNING
4. Expected outcomes…
a. client will feel comfortable & relaxed : heat reduces muscle
stiffness
b. client will be relieved from pain : heat application can
reduce pain perception
c. client’s skin is pink & warm to touch : vasodilation from
 heat exposure will increase the blood flow to the
affected part
5. Wash hands
Rationale: for infection control
6. Obtain materials needed
Rationale: can prevent unnecessary delays, saves time,
effort and energy
III. IMPLEMENTATION
7. Greet and identify the client
It ensures safe and correct application
8. Introduce yourself and state your purpose. Explain the procedure to
the client giving emphasis on the precautions to prevent injury
Rationale: reduces anxiety and gain cooperation of the
client during the procedure
9. Close door and bedside curtains and expose only the affected area
Rationale: provide privacy for client, decreases drafts,
therefore reduces the chance to transmit microorganisms
10. Place client on a comfortable position
Rationale: the procedure is to be done within several
minutes and limited mobility in uncomfortable position can
cause muscular stress
11. Test the temperature of the water using bath thermometer or elbow
Rationale: testing the temperature will prevent burn or
injury to the client. Elbow is used because it is one of the
sensitive part of the body
12. With the hot water bag on a flat surface, pour water from the pitcher
into the hot water bag, filling it with 1/2 to 2/3 full
Rationale: filling the bag ½-1/3 fill will prevent discomfort
from the pressure due to the weight of the water
13. Expel air by laying the bag against a flat surface until the water
reaches the neck of hot water bag.
Rationale: expelling the air from the bag can prevent
bulking to the bag and can be easier to apply because it will
conform to the shape of the area to be applied
14. Tightly screw in the stopper and check for any leakage by turning the
bag slowly upside down.
Rationale: to test for leaks and prevent risk of burning the
skin skin of the patient
15. Wrap hot water bag with clean cover
Rationale: direct contact of hot water bag can cause injury
to the patient’s skin
16. Gradually place the hot water bag to the affected area as ordered by
the doctor noting the client’s immediate reaction.
Rationale: apply the bag slowly can give the patient time to
test the temperature of the bag
 17. Checks hot water bag from time to time (10-15 minutes).
Rationale: to check for therapeutic or adverse effects and be
sure that the heating devices is placed properly
18. Refill the hot water bag as necessary
Rationale: refilling the bag is necessary to maintain the
desired temperature
19. Removes the hot water bag at the end of the ordered time or at a
maximum of 20- 30 minutes if no length of time was specified
Rationale: to prevent rebound phenomenon and avoid
injury to the client
20. Replaces any linen or clothing removed earlier
Rationale: to provide privacy to the client
21. Leaves the client comfortable
Rationale: ensures the client’s sense of well being
22. After care of the materials used
Rationale: to ensure the cleanliness of the materials
23. Hand washing
Rationale: for infection control
IV. EVALUATION
24. Inspect the condition of the affected area
Rationale: evaluates the response of the body to heat
therapy
25. Note if client is free from pain
Rationale: evaluate client’s response to the procedure
V. DOCUMENTATION
26. Records as to time, date duration and effects
Rationale: for legal purposes and it will serve as a
communication tool for other health care professionals

COLD APPLICATION
5 4 3 2 1
I. ASSESSMENT
1. Check for doctor’s order for type of compress, location and duration of
application.
Rationale: ensures safe and correct application and for legal
purposes
2. Assess the general condition of the client taking note of the age,
diagnosis, level of consciousness, circulatory status and the vital signs
Rationale: will establish a baseline data for comparison
3. Consider time in which the injury occurred
Rationale: to prevent edema
4. Review medical record of patient to check for any condition that may
contraindicate the application.
Rationale: cold can cause vasoconstriction, leading to
decrease of circulation that may cause tissue damage
II. PLANNING
5. Expected outcomes…
a. affected area is cool to touch: cooling results to
vasconstriction
b. edema is reduced : cold reduces the blood flow to
affected part
c. client is relieved from pain : cold creates local anesthetic
effect
6. Wash hands
Rationale: for infection control
7. Obtain materials needed
Rationale: prevents unnecessary delays, save time, effort
and enery
III. IMPLEMENTATION
8. Greet and identify the client
Rationale: ensures safe and correct application
9. Introduce yourself and state your purpose. Explain the procedure to
the client giving emphasis on the precautions to prevent injury
Rationale: reduces the anxiety and gain cooperation of the
patient during the procedure
10. Close door and bedside curtains and expose only the affected area
Rationale: provides privacy and decreases drafts. Hence,
reducing the chance of transferring microorganisms
11. Place client on a comfortable position
Rationale: the procedure is to be done within several
minutes and limited mobility in uncomfortable position
causes muscular stress.
12. Tests the bag for leaks by filling it with cold water, then empties the
bag and fills it with cracked ice 1/3 to 1/2 full.
Rationale: prevent leakage from soiling the bed linens and
clothing of the patient. Crushed ice makes the bag easier to
apply because it will conform to the patients affected area
13. Squeezes the bag to expel air by resting bag on a flat surface until only
ice is left
Rationale: Air is a poor conductor of heat and will interfere
with the removal of heat from the body surface.
14. Fastens the cap and wipes the bag dry
Rationale: to prevent condensation on the surface of the bag
15. Cover the ice bag with a wash cloth
Rationale: to provide comfort and wash cloth will absorb all
the water that forms on the surface
16. Places the ice bag on the affected area as ordered by the doctor
Rationale: placing the bag only to the affected area can
prevent more injury to the surrounding tissues
17. Checks hot water bag from time to time (10-15 minutes)
 Rationale: to check for therapeutic or adverse effect and
ensure to check that the bag is placed properly. Cold can
cause vasoconstriction which lead to circulatory
impairment
18. Checks hot water bag from time to time (10-15 minutes).
Rationale: to check for therapeutic or adverse effect and
ensure to check that the bag is placed properly. Cold can
cause vasoconstriction which lead to circulatory
impairment
19. Refill as soon as ice melted
Rationale: no longer effective is ice has been melted
20. Removes the ice bag & dry off any moisture. Replaces the linen or
clothing
Rationale: drying can prevent maceration of skin and
replacing linens can provide privacy
21. Leaves the patient comfortable
Rationale: ensures patient’s well-being
22. Hand washing
Rationale: for infection control
IV. EVALUATION
23. Inspect affected area for changes in condition of skin
Rationale: determine the patient’s reaction to the procedure
24. Notes client’s level of comfort
Rationale: determine if pain has been relieved
V. DOCUMENTATION
25. Records as to time, date duration and effects
Rationale: for legal purposes and it will serve as a
communication tool for other health care professionals

TOTAL POINTS: 255 Points

REMARKS:
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Conforme:

_______________________ ______________________
Student Clinical Instructor