Hot Sitz Bath (Hip Bath)

OBJECTIVES:
a.    To relieve muscle spasm
b.    To soften exudates
c.    To hasten the suppuration process
d.    To hasten healing
e.    To reduce congestion and provide comfort in the perineal area

INDICATIONS: Hemorrhoids

NURSING ALERT:
a.    Warm water should not be used if considerable congestion is already present.
b.    The patient should be observed closely for signs of weakness and faintness.
c.    After the patient is in the tub or the chair, check to see whether or not there is pressure against the patient’s thighs or legs.
d.    Support patient’s back in the lumbar region.

CHARTING:

a.    Type of solution
b.    Length of time of application
c.    Type of heat application
d.    Condition and appearance of wound
e.    Comfort of patient

EQUIPMENT: Available bathroom with appropriate size tub for patient.
a.    Towels and bathmat
b.    Bath blanket
c.    Inflatable ring
d.    Patient’s clean clothes

ACTION
1. Check physician’s order for sitz bath patient.
Rationale:   To know if it is indicated for the patient.

2. Prepare the materials needed:
a.    Take linen to bathroom.
b.    Fill clean tub about one-third full with warm
water.
c.    Check with your hand to determine that temperature
Of water is between 105°F and 110°F (40.5°C to 43.3°C).
d.    Place towel or inflatable ring, if appropriate, on tub
bottom and bathmat on floor beside tub.
Rationale: To save time and effort

3. Explain purpose and procedure to patient.
Rationale: For the patient to be aware on the purpose and procedure.

4. Instruct patient top undress.
Rationale: Undress everytime you take a bath (especially the hip is exposed)

5. Test the water in a sitz with a thermometer before the patient enters the tub. If the purpose of the sitz bath is to
apply heat, water at a temperature of 43°C to 46°C for 15 minutes will produce relaxation of the parts involved after a short contraction. Warm water should not be used if considerable congestion is already present. If the purpose of the sitz bath is to produce relaxation or to help promote healing in a wound by cleaning it of discharge and debris, then water at a temperature of 34°C to 37°C is used.

6. Assist the patient into the tub and position him properly. Check to see whether there is pressure against the patient’s thighs or legs. If the patient’s feet do not touch the floor, and the weight of the legs is resting on the edge of the tub, a stool should be used to support the feet and to relieve the pressure on the back of the legs. It may also be necessary to place a towel in the water to support the patient’s back in the lumbar region. The bath can seem very long if one’s body is not in good alignment and comfortable.

7. Wrap a bath blanket around the patient’s shoulders, and drape the ends over the tub. This protects the patient’s from feeling chilly and form exposure.

8. Observe the patient closely for signs of weakness and fatigue. A cold compress may be placed at the back of the neck or forehead, to help prevent the patient from feeling weak. Discontinue the bath if the patient’s condition warrants. Typical signs of faintness include skin pallor, a rapid pulse rate, and nausea.

9. Test the water in the tub several times, and keep it at the desired temperature. Additional hot water may be added by pouring it slowly form a pitcher or by opening a hot-water fauce a little bit. The water should be agitated by stirring it as hot water and added to prevent burning the patient.

10. Do not leave the patient alone unless it is absolutely certain that it is safe to do so.

11. Help the patient out of the tub when the bath is completed. Normally, a hot sitz bath should be continued for 15 to 30 minutes. Help the patient dry, and cover the patient adequately.

12. Assist the patient to his bed, where it is best for him to lie down, and out of drafts until normal circulation returns.


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