Rabu, 06 Juni 2012

Nursing Care Plan for Hypothermia - Diagnosis and Interventions


Definition of Hypothermia:

Circumstances where an individual experiencing or at risk of decreased body temperature constantly below 35, 5 º C per-rectal because of the increased vulnerability to external factors.

Related factors:

Situational (personal, environmental)
  • related to the heat, rain, wind
  • related to clothes that do not fit with the climate
  • related to decreased circulation: extreme weight loss
  • related to alcohol consumption
  • related to dehydration
  • related to inactivity
Mayor data:
  • Temperatures below 35.5 º C per-rectal
  • Cold skin
  • Pallor (medium)
  • Chills (mild)
Minor data :
  • Mental disorder / sleepy / restless
  • Decrease in pulse and respiration
  • Cachexia / malnutrition
Expected outcomes are:

Individuals will:
  • Identifying risk factors for hypothermia.
  • Connecting method of maintaining the warmth / heat loss prevention.
  • Maintain body temperature within normal limits.

Nursing Interventions - Nursing Care Plan for Hypothermia :
  1. Teach clients to reduce exposure to the cold environment of the old.
  2. Explain to family members that neonates, infants and the elderly are more susceptible to heat loss.
  3. Teach early signs of hypothermia: skin cold, pale, shivering.
  4. Explain the need to drink 8-10 glasses of water each day
  5. Explain the need to avoid alcohol in very cold weather.
  6. Teach for extra wear.
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