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Heat and Cold

used for centuries as a treatment of pain.

Why nurse should advocate for a

trial of heat or cold? - It works well for some patients - it works quickly - Adverse effects are virtually non-existent - It can provide some patients/families within important sense of control over the relief of pain.

Rationale: applying heat to the skin will increase blood flow and reduce neurotransmitters, which sensitize pain nerve fibers. Heat may compete for nerve transmission with pain and therefore, in the brain there is a perception of heat and a reduced perception of pain.

Avoid use of heat in the following situations: - any are that is bleeding - any area with decreased feeling -any injury within the first 24 hours - if the person is using any mentholcontaining products(vicks,ben gay etc) - within the site of radiation therapy while receiving radiation-may use this area five days after completing treatment, provided that the skin is not flaky, red or tender.

Avoid use of cold in the following situations:

-any area with poor circulation. - within a site of radiation therapy while receiving radiation- may use this area five days after completing treatment, provided that the skin is not flaky, red or tender. - on a wound in the healing phase.

Relaxation and Imagery: appropriate for almost any type of pain with a goal of reducing muscle tension and anxiety. Patient may benefit from simple relaxation centered on slow ,deep breathing. Progressive muscle relaxation in which patient uses isometric exercise to systematically relax muscles from head to foot may also be helpful.

Caution should be used in in using relaxation and imagery techniques in patients who are either: - confused - drowsy - have a poor grasp of the language of the relaxation therapist. - Have a previous history of significant psychiatric history, such as having hallucinations.

Distraction the idea is to divert the attention by actively involving the patient in the performance of a distracting task that is interesting and more pleasant than the painful procedure.

Other Therapies recognize that the complementary therapies such as therapeutic touch, massage, reflexology, Reiki and aromatherapy, including acupuncture acupressure may be useful nonpharmacological adjuncts to pain management.

These modalities can be administered by individuals with training in their application.

Combine pharmacological methods with nonpharmacological methods to achieve effective pain management. Non-pharmacological methods of treatment should not be used to substitute for adequate pharmacological management. The selection of non-pharmacological methods of treatment should be based on individual preference and the goal of treatment. Any potential contraindications to nonpharmacological methods should be considered prior to application.

Thank you very much!