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Heat Stroke, References: Ignatavicius, D., Workman, L., Rebar, C., &…
Heat Stroke
Interventions
do not give food or liquids by mouth because of vomiting and aspiration risk
rapid cooling
monitor and support the patients airway
midazolam or propofol - if shivering happens during cooling process
moved to critical care unit
at the scene:
remove the patients clothing, spray cold water on body and scalp, fan patient, put ice bags if available on scalp, groin, neck, armpits, and immersion in cool water (if possible)
in the hospital:
oxygen by mask, administer fluids, use a cooling blanket, don't administer aspirin or antipyretics, monitor rectal temp, do ABGs, monitor intake and output and stop cooling when body temp reaches 102F
Patient Education
educate the patient on conditions to avoid
educate on when to go inside
educate on what temps could be possibly dangerous
encourage plenty of fluids if you are going to be out in the heat, and make sure there is somewhere to get more (if you can buy them or if they have a cooler)
what to do if you are feeling overheated
what clothing to wear
educate patients on what resources are available in the case of having no AC in the summer or where to go if they don't have anywhere cool
Pathophysiology
medical emergency where body temp exceeds 104 degrees F
this has a very high mortality rate if not treated quickly
the patients thermoregulation fails and cannot adjust to an elevation in body temp
exertional heat stroke - sudden onset, result of strenuous physical activity in hot humid conditions
occurs over a period of time as a result to chronic exposure to hot humid environment (living in a home without AC in summer)
Assessment
s/s
elevated body temp (above 104 F)
hot and dry skin
sweating
mental status change as a result of thermal injury to the brain
vital sign changes (hypotension, tachycardia, tachypnea)
electrolyte imbalances, decreased renal function, pulmonary edema, coagulopathy
labs
cardiac troponin 1 elevated
References:
Ignatavicius, D., Workman, L., Rebar, C., & Heimgartner, N. (2021). Medical-surgical nursing: Patient-centered collaborative care.
Evolve
, (10th ed.). ISBN: 978-0-323-61242-5
Holman, H. C., Williams, D., Johnson, J., Ball, B. S., Wheless, L., Leehy, P., & Lemon, T. (2019). RN Adult medical surgical nursing: Review module. Assessment Technologies Institute