Domain 11. Safety-protection
Class 6. Thermoregulation
Diagnostic Code: 00254
Nanda label: Risk for perioperative hypothermia
Diagnostic focus: Perioperative hypothermia
Nursing Diagnosis: Risk for Perioperative Hypothermia
Introduction
Perioperative hypothermia is a condition in which the patient’s body temperature drops below the normal range during an operative procedure. It may occur due to excessive blood loss, anesthesia, or cold temperatures in the patient’s environment. It can lead to serious complications including cardiac arrest, arrhythmia, poor wound healing and death. To prevent such complications, it is important that nurses recognize and address potential risk factors for perioperative hypothermia in a timely manner.
NANDA Nursing Diagnosis Definition
The National Association of Nurses (NANDA) defines perioperative hypothermia as “ a state in which body temperature falls below normal physiological limits”. It is classified as a high-risk diagnosis meaning it should be monitored closely by healthcare providers.
Risk factors
Perioperative hypothermia is more likely to occur in cases where certain risk factors are present. These can include:
• Surgery time: Long operative procedures increase the risk for hypothermia due to increased exposure to room temperature and anesthesia.
• Anesthesia: Certain anesthetic agents can cause a decrease in the patient’s body temperature.
• Age: Infants and elderly patients are at increased risk due to their lower levels of fat and muscle tissue, which act as insulation to retain body heat.
• Cold environmental conditions: Operating rooms and other hospital settings should be kept at a comfortable temperature to reduce the risk of hypothermia.
• Low blood volume: Agents used to control bleeding during surgery can cause a decrease in circulating blood volume, thus reducing body temperature.
• Peripheral vasoconstriction: This occurs when the body directs blood supply away from the extremities in order to conserve heat.
At-risk populations
Certain groups of people are more likely to experience adverse effects from perioperative hypothermia, including:
• Elderly: Elderly patients have greater sensitivity to changes in body temperature due to decreased circulation, decreased fat stores, and slowed metabolism.
• Obese patients: Obese patients are at greater risk of developing hypothermia due to the heat retaining ability of their fat tissue.
• Malnourished patients: Malnourished patients may lack enough fat stores to help regulate body temperature, putting them at a higher risk for cold-related injuries.
• Smokers: Nicotine and other chemicals found in cigarettes can inhibit circulation, causing hypothermia.
• Patients with chronic medical issues: Patients with diabetes, heart disease and other chronic illnesses may be at an increased risk of perioperative hypothermia due to difficulty maintaining a regular body temperature.
Associated conditions
Patients who experience perioperative hypothermia are at risk for various other health issues, some of which can be serious or life-threatening. These may include:
• Increased risk of infection: The body’s immune system is inhibited when body temperature drops below normal. This can increase the risk of infection from bacteria and viruses.
• Cardiac and respiratory failure: Hypothermia can impact the function of the heart and lungs, leading to cardiac arrest, arrhythmias and respiratory distress.
• Poor wound healing: Cold can slow down the process of healing and affect the patient’s ability to recover from surgery.
• Nausea, headache and dizziness: These symptoms may occur as a result of a sudden drop in temperature.
Suggestions of Use
To prevent perioperative hypothermia, nurses should monitor the patient’s temperature, watch for signs and symptoms of hypothermia, and take necessary measures to keep the patient warm, such as providing warm blankets and garments. In addition, the OR temperature should be regularly checked and monitored, with blankets or heating lamps used as needed. It is also important to keep track of the patient’s hydration status, as dehydration can encourage hypothermia.
Suggested Alternative NANDA Nursing Diagnosis
Alternative NANDA Nursing Diagnoses to consider when assessing a patient for perioperative hypothermia include, but are not limited to:
• Risk for Complications of Surgery
• Impaired skin integrity
• Readiness for enhanced thermoregulation
Usage Tips
When performing nursing assessments and interventions related to perioperative hypothermia, nurses should always remember to:
• Take care to record the patient’s temperature every few hours during surgery to ensure it remains within a normal range.
• Monitor for any signs or symptoms of hypothermia, such as pale or cool skin, shallow breathing, and shivering.
• Provide warming blankets, dressings, and heating lamps if necessary and continually check the patient’s temperature.
NOC Outcomes
When running a nursing care plan for a patient at risk for perioperative hypothermia, some NOC outcomes to consider include:
• Temperature Control: The patient’s body temperature remains within the normal range.
• Comfort Level: The patient is comfortable and reports no discomfort or pain due to cold temperatures.
• Respiratory Status: The patient has a well-oxygenated environment and reports no respiratory distress.
Evaluation Objectives and Criteria
Following a nursing care plan for perioperative hypothermia, the nurse should evaluate their interventions based on the objectives and criteria set forth:
• Temperature Control: The patient’s body temperature should remain between 97 and 99 degrees Fahrenheit throughout surgery and recovery.
• Comfort Level: The patient should report feeling comfortable and no signs of distress due to cold temperatures.
• Respiratory Status: The patient’s oxygen levels should remain steady and the patient should have no respiratory distress.
NIC Interventions
To reduce the risk of perioperative hypothermia, nurses can implement the following interventions:
• Thermoneutral Environment: The temperature of the operating room and other relevant areas should be monitored and kept at a comfortable temperature.
• Passive Re-warming: Warm blankets and garments should be used to help maintain the patient’s core body temperature.
• Active Re-warming: If necessary, nurses can use devices such as heating lamps or forced hot water blankets to safely and effectively raise the patient’s body temperature.
• Forced Heating Systems: Specialized forced-air warming systems can be used to regulate core body temperature.
• Internal Monitoring: Electrocardiogram, pulse oximeter and other vital monitoring equipment should be used to closely track the patient’s heart rate, respiratory rate and other key indicators.
Nursing Activities
The nursing activities for prevention and treatment of perioperative hypothermia can include:
• Assessing patient: A complete physical examination should be performed before and after the procedure, with particular attention paid to the patient’s temperature.
• Educating the patient: The nurse should explain the risks and signs of hypothermia, as well as preventive strategies, to both the patient and family members.
• Monitoring patient: The nurse should closely monitor the patient’s vital signs, temperature, level of consciousness, and general condition throughout the procedure.
• Modifying the environment: The nurse should modify the operating room temperature as needed and provide adequate warmth and protection against cold-related injury.
• Administering medications: Medications may be necessary to reduce the risk of hypothermia, such as anticoagulants or IV fluids.
Conclusion
Perioperative hypothermia is a potentially life-threatening condition that can occur during surgery. By recognizing the risk factors, at-risk populations and associated conditions, nurses can take appropriate measures to minimize the risk of hypothermia and its serious complications. Through patient education, assessment, monitoring, and interventions, nurses can help ensure their patients are safe and comfortable throughout their surgical procedure.
5 FAQs
Q1. What is perioperative hypothermia?
A1. Perioperative hypothermia is a condition in which the patient’s body temperature drops below the normal range during an operative procedure. It may occur due to excessive blood loss, anesthesia, or cold temperatures in the patient’s environment.
Q2. What puts a patient at risk of perioperative hypothermia?
A2. Risk factors for perioperative hypothermia can include surgery time, anesthesia, age, cold environmental conditions, low blood volume and peripheral vasoconstriction.
Q3. Who is more susceptible to hypothermia?
A3. Elderly patients, obese patients, malnourished patients, smokers, and those with chronic medical conditions are more likely to experience adverse effects from perioperative hypothermia.
Q4. What are some associated conditions of hypothermia?
A4. Patients who experience perioperative hypothermia are at risk for various other health issues, including an increased risk of infection, cardiac and respiratory failure, poor wound healing, nausea, headaches and dizziness.
Q5. How can perioperative hypothermia be prevented?
A5. To prevent perioperative hypothermia, nurses should monitor the patient’s temperature, watch for signs and symptoms of hypothermia, and take necessary measures to keep the patient warm, such as providing warm blankets and garments. In addition, the OR temperature should be regularly checked and monitored, with blankets or heating lamps used as needed.
{
“@context”: “https://schema.org”,
“@type”: “FAQPage”,
“mainEntity”: [{
“@type”: “Question”,
“name”: “What is perioperative hypothermia?”,
“acceptedAnswer”: {
“@type”: “Answer”,
“text”: “Perioperative hypothermia is a condition in which the patient’s body temperature drops below the normal range during an operative procedure. It may occur due to excessive blood loss, anesthesia, or cold temperatures in the patient’s environment.”
}
}, {
“@type”: “Question”,
“name”: “What puts a patient at risk of perioperative hypothermia?”,
“acceptedAnswer”: {
“@type”: “Answer”,
“text”: “Risk factors for perioperative hypothermia can include surgery time, anesthesia, age, cold environmental conditions, low blood volume and peripheral vasoconstriction.”
}
}, {
“@type”: “Question”,
“name”: “Who is more susceptible to hypothermia?”,
“acceptedAnswer”: {
“@type”: “Answer”,
“text”: “Elderly patients, obese patients, malnourished patients, smokers, and those with chronic medical conditions are more likely to experience adverse effects from perioperative hypothermia.”
}
}, {
“@type”: “Question”,
“name”: “What are some associated conditions of hypothermia?”,
“acceptedAnswer”: {
“@type”: “Answer”,
“text”: “Patients who experience perioperative hypothermia are at risk for various other health issues, including an increased risk of infection, cardiac and respiratory failure, poor wound healing, nausea, headaches and dizziness.”
}
}, {
“@type”: “Question”,
“name”: “How can perioperative hypothermia be prevented?”,
“acceptedAnswer”: {
“@type”: “Answer”,
“text”: “To prevent perioperative hypothermia, nurses should monitor the patient’s temperature, watch for signs and symptoms of hypothermia, and take necessary measures to keep the patient warm, such as providing warm blankets and garments. In addition, the OR temperature should be regularly checked and monitored, with blankets or heating lamps used as needed.”
}
}]
}