A sponge bath with tepid water reduces fever by dilating superficial blood vessels, thus releasing heat and lowering body temperature. A tepid-water sponge bath may lower systemic temperature when routine fever treatments fail, particularly for infants and children, whose temperatures tend to rise very high, very quickly.
Basin of tepid water, about 80° to 93°F (26.7° to 33.9°C) ▪ bath (utility) thermometer ▪ bath blanket ▪ linen-saver pad ▪ washcloths ▪ patient thermometer ▪ hot-water bottle and cover ▪ ice bag and cover ▪ towel ▪ clean patient gown ▪ gloves, if the patient has open lesions or has been incontinent ▪ antipyretics as ordered.
Preparation of Equipment
Prepare a hot-water bottle and an ice bag. Then place the bath thermometer in a basin, and run water over it until the temperature reaches the high end of the tepid range (93° F) because the water will cool during the bath. Immerse the washcloths in the tepid solution until saturated.
Confirm the patient’s identity using at least two patient identifiers according to your facility’s policy.1
Check the medication record for recent administration of an antipyretic because this type of drug can affect the patient’s response to the bath.
Assessing Neurovascular Status
When assessing an injured extremity, include these steps and compare your findings bilaterally.
Inspect the color of fingers or toes.
To detect edema, note the size of the digits.
Simultaneously touch the digits of the affected and unaffected extremities and compare temperature.
Check capillary refill by pressing on the distal tip of one digit until it’s white. Then release the pressure and note how soon the normal color returns. It should return quickly in both the affected and unaffected extremities.
Check sensation by touching the fingers or toes and asking the patient how they feel. Note reports of any numbness or tingling.
To check proprioception, tell the patient to close his eyes; then move one digit and ask him which position it’s in.
To test movement, tell the patient to wiggle his toes or move his fingers.
Palpate the distal pulses to assess vascular patency.
Record your findings for the affected and the unaffected extremities, using standard terminology to avoid ambiguity. Warmth, free movement, rapid capillary refill, and normal color, sensation, and proprioception indicate sound neurovascular status.
Explain the procedure to the patient, provide privacy, and make sure the room is warm and free from drafts.
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