Hypothermia is a condition in which the body’s core temperature drops below the normal range. This can occur due to exposure to cold temperatures, immersion in cold water, or a variety of other factors. In this blog post, we will discuss the NANDA nursing diagnosis for hypothermia, as well as the defining characteristics, related factors, risk population, and associated problems. We will also provide suggestions for use, alternative NANDA diagnoses, usage tips, lists of NOC and NIC interventions, and conclude with a summary of the importance of understanding and addressing hypothermia.
NANDA Nursing Diagnosis Definition
According to NANDA International, the nursing diagnosis for hypothermia is defined as “abnormally low body temperature.” This diagnosis can be made when a patient’s core body temperature drops below the normal range of 36-37 degrees Celsius (96.8-98.6 degrees Fahrenheit).
Defining Characteristics
Subjective
- Patient reports feeling cold
- Patient reports shivering
- Patient reports decreased mental status or confusion
Objective
- Core body temperature less than 36 degrees Celsius (96.8 degrees Fahrenheit)
- Shivering
- Pale, cool, or cyanotic skin
- Decreased pulse rate or blood pressure
- Decreased mental status or confusion
Related Factors
- Exposure to cold temperatures
- Immersion in cold water
- Insufficient clothing or shelter
- Chronic illness or disease
- Medications that affect thermoregulation
- Alcohol or drug use
Risk Population
Individuals at risk for hypothermia include those who are exposed to cold temperatures, such as outdoor workers or hikers, as well as those who are immersed in cold water, such as swimmers or boaters. Additionally, individuals with chronic illnesses or diseases, those taking medications that affect thermoregulation, and those who use alcohol or drugs are at risk.
Associated Problems
Hypothermia can lead to a variety of health problems, including:
- Cardiac arrhythmias
- Respiratory failure
- Coagulopathies
- Neurological damage
- Death
Suggestions for Use
- Assess the patient’s body temperature and other vital signs
- Identify any factors that may be contributing to the patient’s hypothermia, such as exposure to cold temperatures or chronic illness
- Implement interventions to raise the patient’s core body temperature and prevent further heat loss
- Monitor the patient’s response to interventions and adjust as needed
- Provide education and resources to the patient and their family about preventing hypothermia and recognizing the signs and symptoms
Suggested Alternative NANDA Diagnoses
- Hypothermia, accidental
- Hypothermia, intentional
- Hypothermia, risk for
- Impaired thermoregulation
- Impaired temperature regulation
Usage Tips
- Be aware of the patient’s risk factors and environment, such as cold temperatures or immersion in cold water
- Monitor the patient’s vital signs, including body temperature, to detect hypothermia early
- Use warming blankets and/or warm fluids to raise the patient’s core body temperature
- Consider the use of rewarming methods, such as a warm bath or extracorporeal rewarming, in severe cases of hypothermia
NOC Results
- Thermoregulation: The patient’s temperature will be monitored and interventions will be implemented to maintain a normal body temperature.
- Cardiac output: The patient’s cardiac output will be monitored to ensure that it is not compromised due to hypothermia.
- Respiratory status: The patient’s respiratory status will be monitored to ensure that it is not compromised due to hypothermia.
- Coagulation: The patient’s coagulation status will be monitored to ensure that it is not compromised due to hypothermia.
- Neurological status: The patient’s neurological status will be monitored to ensure that it is not compromised due to hypothermia.
NIC Interventions
- Warming therapy: The patient will receive warming therapy, such as warming blankets or warm fluids, to raise their core body temperature.
- Rewarming methods: The patient will receive rewarming methods, such as a warm bath or extracorporeal rewarming, if necessary.
- Monitoring and assessment: The patient’s vital signs and response to interventions will be closely monitored and assessed.
- Education and resources: The patient and their family will be provided with education and resources regarding preventing hypothermia and recognizing the signs and symptoms.
Conclusion
Hypothermia is a serious condition that can lead to a variety of health problems and even death. It is important for healthcare professionals to understand the diagnosis, related factors, and interventions in order to provide effective care for patients. Assessing the patient’s body temperature, identifying contributing factors, and implementing interventions to raise the patient’s core body temperature and preventing further heat loss can help to improve patient outcomes and prevent complications. It is also important to provide education and resources to the patient and their family about preventing hypothermia and recognizing the signs and symptoms. With proper understanding and management, healthcare professionals can effectively address and prevent hypothermia.