Perilite Exposure

and Hot Sitz Bath

2E Group 5
 Course Learning Outcomes
CLO#1: Define the term related to perilite exposure and hot sitz
bath

CLO#2: State the importance of Hot sitz bath and Perilite exposure

CLO#3: Discuss the process of heat transfer and analyze the

physiologic response to heat
 Course Learning Outcomes
CLO#4: Explain the variables that influence the effectiveness of
heat

CLO#5: Examine the therapeutic effects of administering Hot sitz

bath and Perilite exposure

CLO#6: Identify the advantages and disadvantages of moist heat

and dry heat application
 Course Learning Outcomes
CLO#7: Distinguish the indications and contraindication of hot sitz
bath and perilite exposure

CLO#8: Explain theories, principles, and standards as applicable to

hot sitz bath and perilite exposure

CLO#9: Examine evidence-based nursing responsibilities and

guidelines in performing hot sitz bath and perilite exposure
 Course Learning Outcomes
CLO#10: Enumerate the nursing responsibilities in Hot sitz bath and
Perlite exposure

CLO#11: Demonstrate beginning skills in Hot sitz bath and Perilite

exposure

CLO#12: Document client response before, during, and after Hot

sitz bath and Perilite exposure
CLO#1: DEFINE THE
TERMS RELATED TO
PERILITE EXPOSURE
AND HOT SITZ BATH
Sitz Bath - A warm, comforting
soak for the perineal area, which
includes the area between your
legs and includes the anus, vagina,
and scrotums.
Perilite Exposure - Is the term for
the practice of applying dry heat to
the perineal region for comfort.
Heat Application - The application
of heat to the skin and underlying
tissues with the intention of
reducing pain, inflammation, or
muscle spasms..
Heat Tolerance - The capacity to
adapt physiologically to heat stress
exposure.
Heat Transfer - In general, heat Conduction - A method through
transfer describes the flow of heat which heat or electricity is directly
(thermal energy) due to transported through a substance
temperature differences and the without the material moving when
subsequent temperature there is a temperature difference
distribution and changes. or an electrical potential difference
between adjacent regions.
Convection - The movement within Evaporation - Evaporation is the
a fluid is induced by the tendency process that changes liquid water
of colder, denser material to sink to gaseous water (water vapor).
under the influence of gravity and
hotter, less dense material to rise,
which ultimately leads to the
transfer of heat.
Radiation - A type of energy that Episiotomy - Is a cut in the tissue
originates from a source and that occurs during childbirth
moves at the speed of light through between the vaginal opening and
space. the anus.
Episiorraphy - Surgical repair of Perineorraphy - Perineorrhaphy
injury to the vulva by suturing. means suturing of the perineum,
and is sometimes used
synonymously with perineoplasty,
which means surgical repair of the
perineum.
Moist heat application - Is a type of
physical therapy intended to
reduce pain, quicken recovery,
calm muscles, and increase range
of motion.
 CLO#2: STATE THE
IMPORTANCE OF HOT SITZ
BATH AND PERILITE EXPOSURE
 IMPORTANCE OF HOT SITZ BATH AND
PERILITE EXPOSURE

IMPORTANCE OF HOT SITZ BATH IMPORTANCE OF PERILITE EXPOSURE

1. RELIEVES PAIN 1. EASES DISCOMFORT BY RELAXING

2. INCREASE ANOGENITAL BLOOD FLOW THE MUSCLES AND CAPILLARIES
3. HELP EASE PAIN AND ITCHING FROM 2. SPEEDS UP WOUND HEALING AFTER
HEMORRHOIDS. AN EPISIOTOMY REPAIR
4. HELP EASE PAIN FROM AN ANAL 3. INCREASES BLOOD FLOW
FISSURE. 4. INCREASES THE AMOUNT OF OXYGEN
5. BATHE AND SOOTHE THE PERINEUM AND NUTRIENTS AVAILABLE TO THE
AFTER CHILDBIRTH. WOUND
6. CLEAN AND SOOTHE THE ANAL AREA
OR PERINEUM AFTER SURGERY.
7. EASE PROSTATE PAIN DURING
PROSTATITIS OR AFTER A PROCEDURE.
8. HELP EASE PERIOD CRAMPS
 CLO#3: Discuss the process of heat
transfer and analyze the physiologic
response to heat
 PROCESS OF HEAT TRANSFER
CONDUCTION
the transfer of heat from a warm
object to a cooler object or vice versa
by contact
is the transfer of thermal energy from
a region of higher temperature to a
region of lower temperature through
direct molecular communication
within a medium or between mediums
in direct physical contact without a
flow of the material medium.
Example:
Applying an ice pack or bathing a
patient with a cool cloth increases
conductive heat loss. The body
gains heat by conduction when it
makes contact with materials
warmer than skin temperature
(e.g., application of an
aquathermia pad).
 PROCESS OF HEAT TRANSFER

CONVECTION
heat transfer by means of
Example:
movement of liquid or gas Sitz Bath or for newborns they
is a combination of conduction and lose a lot of heat by convection
the transfer of thermal energy by
when exposed to cold air or
fluid circulation or movement of the
draughts.
hot particles in bulk to cooler areas
in a material medium.
this transfer occurs in the sitz bath.
 PROCESS OF HEAT TRANSFER
RADIATION
is the transfer of heat through
electromagnetic radiation. For
anybody, the reflectivity depends
on the wavelength distribution of
incoming electromagnetic radiation
and therefore the temperature of
the source of the radiation.
Example:
Radiation Therapy - The goal
of radiation therapy is to kill
cancer cells using the least
amount of radiation possible,
with treatments spread over
an appropriate period. Usually,
healthy cells in the radiation
treatment field are able to
recover.
 PROCESS OF HEAT TRANSFER

Example:
Evaporation of moisture from a
EVAPORATION wet body dissipates heat along
is the transfer of heat that occurs
with the moisture. Keeping the
when a liquid is converted to a
vapor. newborn dry by drying the wet
newborn at birth prevents
hypothermia via evaporation.
 PHYSIOLOGICAL RESPONSES TO HEAT

Vasodilation or increase in capillary surfaces

Heat causes vasodilation and increases blood flow to the affected

area bringing oxygen nutrients, antibodies, and leukocytes.

Increase in capillary permeability

heat increases capillary permeability which allows extracellular
fluid and substances such as plasma proteins to pass through the
capillary walls and may result in edema or an increase in pre-
existing edema.
 PHYSIOLOGICAL RESPONSES TO HEAT

Increase blood flow

heat increases blood flow by expanding blood vessels. Increased
blood flow can help relax a tight muscles, restore movement, and
reduce pain.

Increase cell metabolism

as temperature increases, the rate of metabolism increases and
then rapidly declines at higher temperatures - a response that
can be described using a thermal performance curve (TPC).
 PHYSIOLOGICAL RESPONSES TO HEAT

Increase supply of nutrients

it improves digestion and increases the absorption of many
nutrients

Relaxation of muscles
when heat is applied to a sore area of the body, blood vessels
widen and blood flow increases to transport excess lactic acid
and other toxins away from tired muscles. These muscles are also
made more elastic by the heat, and nerve endings are stimulated
to block pain signals.
 CLO#4: Explain the
variables that influence
the effectiveness of heat
VARIABLES INFLUENCING THE EFFECTIVENESS
OF HEAT:

Individual Tolerance - General Condition of

Tolerance is influenced to Patient - Shock or
some degree by age, the metabolic disorders such
condition of the skin, and as diabetes increase the
the condition of the hazard of tissue
nervous and circulatory damage.
system.
VARIABLES INFLUENCING THE EFFECTIVENESS
OF HEAT:

Moisture - When the Size of area to be

humidity in the air is high,
the warm moisture stays
on our skin longer, making
us feel even hotter. This is
known as “heat index”.
treated - The greater
the body area to be
treated, the lower the
temperature should be.
VARIABLES INFLUENCING THE EFFECTIVENESS
OF HEAT:

Intactness of Skin - Injured Length of Exposure -

skin areas are more
sensitive to temperature
vibrations whether the
heat is moist or dry.
People feel hot
applications most while
the temperature is
changing. After a period
of time, tolerance
increases.
VARIABLES INFLUENCING THE EFFECTIVENESS
OF HEAT:

Location of the area - Duration of Treatment -

Individual tolerance to Refers to how long
heat depends on the (days, weeks, months,
number of heat receptors years) a patient should
in body parts. be treated with manual
methods for any given
problem.
VARIABLES INFLUENCING THE EFFECTIVENESS
OF HEAT:

Environment Temperature Age of Patient - Adults

- Whether in a warm or in a
humid environment, heat
can’t be dissipated through
evaporation to some
degree that it can dry or
cool circumstances.
over the age of 60 are
generally regarded as
being especially
vulnerable to heat.
CLO#5: Examine the
therapeutic effects
of administering Hot
sitz bath and Perilite
exposure
Therapeutic 1. Can provide relief from pain or
effects of Hot itching in the genital area.

Sitz Bath: 2. Cleanses the perineum, which is

the space between the rectum and
the vulva or scrotum.
3. Promote healing of an anal fissure.
4. By soaking the rectal area in a tub
of warm water -- two or three
times a day for 10 to 15 minutes --
you can clean the anus, improve
blood flow, and relax the anal
sphincter.
Therapeutic 1. Relief of pain and muscular
effects of spasm.
Perilite 2. Increases blood circulation.
Exposure: 3. Hastens wound healing
following an episiotomy
repair.
4. Reduces edema and
soreness.
 CLO#6: IDENTIFY THE
ADVANTAGES AND
DISADVANTAGES OF MOIST
HEAT AND DRY HEAT
APPLICATION
 DRY HEAT

ADVANTAGES: DISADVANTAGES:

1. Less risks of burns to skin 1. Increases body fluid

than moist application
2. Retains temperature
longer since not
influenced by evaporation
3. Doesn’t cause maceration
loss through sweating
2. Doesn’t penetrate
deep into tissues
3. Increase drying of the
skin
 MOIST HEAT

ADVANTAGES:
1. Moist application reduces drying of skin and
softens wound exudates
2. Warm moist doesn’t promote sweating and
insensible fluid loss
3. Moist heat penetrates deeply into tissue
layers. Moist compresses comfort well to area
of body being treated
 MOIST HEAT

DISADVANTAGES:
1. Moist heat creates a greater risk for burns to
skin since moisture conducts heat
2. Prolonged exposure can cause maceration of
skin
3. Moist heat will cool rapidly because of moist
evaporation
 CLO#7: DISTINGUISH
THE INDICATIONS AND
CONTRAINDICATION
OF HOT SITZ BATH
AND PERILITE
EXPOSURE
 HOT SITZ BATH
INDICATIONS: CONTRAINDICATIONS:

Patients with: 1. Menstruating or

1. Hemorrhoids pregnant women
2. Anal
Fissures/Surgery
3. Episiotomy
4. Uterine Cramps
 PERILITE
EXPOSURE
INDICATIONS: CONTRAINDICATIONS:

1. Patients who have 1. Patients with

undergone rectal or cardiovascular condition
perineal surgery 2. Presence of cyst or
2. Post-partum patients malignancy in the area
with episiotomy wounds 3. Patients with open
3. Patients having vaginal wounds with hemorrhage
inflammation or bladder
spasm
 CLO#8: EXPLAIN THEORIES,
PRINCIPLES, AND STANDARDS
AS APPLICABLE TO HOT SITZ
BATH AND PERILITE
EXPOSURE
 FOR HOT SITZ BATH:

1. ANATOMY & PHYSIOLOGY 2. PSYCHOLOGY 3. CHEMISTRY

CLIENTS WHO HAVE AN NURSE SHOULD EXPLAIN THE APPLICATION OF HEAT MAY
EPISIOTOMY HAVE PAINFUL PROCEDURE TO THE PATIENT CAUSE VASODILATION
HEMORRHOIDS OR VAGINAL FIRST TO GAIN COOPERATION.
INFLAMMATION MAY BENEFIT A NURSE SHOULD KNOW IF A THE LOCAL RESPONSE TO
FROM IMMERSING THE PELVIC PATIENT IS SENSITIVE TO HOT APPLICATIONS
AREA IN WARM WATER. SITZ WARMNESS. DEPENDS ON THE LENGTH
BATH REQUIRES SPECIAL OF TIME
ATTENTION TO BODY POSTURE

AND LIMB POSITION TO AVOID

CRAMPING AND CONSTRICTION

OF CIRCULATION FROM
AGAINST THE EDGE OF THE
TUB.
 FOR HOT SITZ BATH:

5. SOCIOLOGY
4. PHYSICS

HEAT IS MOST VALUABLE AND MOST THE PATIENT NEEDS TO

VERSATILE PHYSICAL FOR TREATMENT
WATER HAS ALSO GREAT CAPACITY, IT
UNDERGOES CHANGE MORE SLOWLY THAN
OTHER SUBSTANCES. IT ALSO GIVES OFF
MORE HEAT.
COOPERATE WITH NURSE IN
ORDER FOR TREATMENT TO
BE EFFECTIVE TO BE ABLE
TO PROMOTE THE PATIENTS
EARLY RECOVERY.

HEAT MAYBE TRANSFERRED FROM 1 PLACE

TO ANOTHER BY CONDUCTION,
CONVECTION AND RADIATION

APPLICATION OF HEAT & COLD EMPLOYS

PHYSICAL AGENTS; HEAT, LIGHT &
ELECTRICITY

 FOR PERILITE EXPOSURE:

1. ANATOMY & PHYSIOLOGY 2. BODY MECHANICS 3. PHYSICS

THROUGHOUT BLOOD VESSELS POSITION OF THE MOTHER IS APPLICATION OF HEAT

AND NERVES, SKIN AND DORSAL RECUMBENT WITH EMPLOYS PHYSICAL AGENTS:
CONNECTIONS THEY MAKE LEGS AND KNEES FLEXED TO HEAT, WATER AND LIGHT. HEAT
WITH NERVES AND BLOOD ALLOW PROPER EXPOSURE OF MAY BE TRANSFERRED FROM
VESSELS OF THE BODY, AREA TO BE TREATED. ONE PLACE TO ANOTHER BY
PRACTICALLY ALL PARTS OF RADIATION (PERILITE
THE BODY MAY BE INFLUENCED EXPOSURE AND CONVECTION).
BY APPLICATION OF HEAT TO
SKIN.
FOR PERILITE EXPOSURE:

4. PSYCHOLOGY 5. SOCIOLOGY

NURSE EXPLAINS PURPOSE OF PATIENT NEEDS TO COOPERATE

TREATMENT IN ORDER TO GAIN WITH NURSE IN ORDER FOR
COOPERATION. TREATMENT TO BE EFFECTIVE
AND TO ADD PATIENTS EARLY
RECOVERY.
CLO#9: Examine
evidence-based
nursing
responsibilities
and guidelines in
performing hot
sitz bath and
perilite exposure
GUIDELINES IN PERFORMING
HOT SITZ BATH:

Check the physician's order.

Check the temperature of the water for hotness and coldness.
Monitor the patient's vital signs before and after the procedure
Observe the patient closely for 15-20 minutes throughout the
procedure .
GUIDELINES IN PERFORMING
HOT SITZ BATH:
Nurses should explain the procedure to the patient.
Nurses should observe and provide privacy and safety of the patient.
Nurses should drape the patient accordingly and properly.
Nurses should make sure that the perineum is immersed in the bath.
Nurses should maintain with the warmth and promote comfort in the
patient.
GUIDELINES IN PERFORMING
PERILITE EXPOSURE:
Explain the procedure to the patient.
Instruct the patient to carefully wash their genital and rectal before
proceeding the procedure
Check the equipment for any defects as to avoid unwanted accidents.
Handle the equipment with dry hands especially plugging the
equipment as to avoid short circuiting the equipment.
GUIDELINES IN PERFORMING
PERILITE EXPOSURE:
Nurses should provide privacy as well as observe safety during the
procedure.
The lamp should be placed away 20-50 cm away from the perineum.
Instruct the patient to not touch the the lamp's surface.
The heat lamp should be left for 15 minutes and then removed from
the patient's perineum.
Parts of the lamp that are washable should be placed with antiseptic
solutions before it is put back in place.
 CLO#10: ENUMERATE THE
NURSING RESPONSIBILITIES IN
HOT SITZ BATH AND PERLITE
EXPOSURE
NURSING RESPONSIBILITIES BEFORE ,
DURING, AND AFTER HOT SITZ BATH
Before Hot Sitz Bath:

Check the physician’s order for a Hot Sitz Bath.

Explain the purpose and procedure to the patient as to what the outcomes
and expected results of the procedure.
Kindly advise and encourage the patient to empty their bladder before the
procedure begins.
Proceed with medical handwashing and prepare the materials for the
procedure.
Finally, check the vital signs of the patient before proceeding with the
procedure.
During Hot Sitz Bath:
Determine the temperature of the water by submerging a part of the elbow
in the water. (Ideal Temperature: 100°F - 105°F or 38°C - 41°C)
Fill the sitz bath chair with ⅓ of warm water.
Place the inflatable ring on the top of the chair and bathmat beside the tub.
Assist the patient to undress as well as into going the sitz bath chair and
position the patient properly. Supply warmth to the patient by putting a
towel or bath towel onto their shoulders.
Stay by the patient’s side during the whole procedure or for about 20
minutes maximum and assess the patient closely for any signs of weakness
or fatigue, if so immediately stop the procedure.
After Hot Sitz Bath:
Once the procedure is complete, assist the patient with after care
such as drying and dressing.
Assist the patient to his bed and position the patient comfortably.
Properly discard soiled linens and thoroughly clean the sitz bath chair.
Once the procedure is complete, proceed with the recording on the
patient’s chart.
NURSING RESPONSIBILITIES BEFORE ,
DURING, AND AFTER PERILITE EXPOSURE
Before Perilite Exposure:
Check the physician’ order for Perilite Exposure.
Carefully prepare the equipment and check for any damages.
Explain the purpose of the procedure as to what are the expected
outcomes and results of the procedure to the patient.
Proceed with medical handwashing and prepare and bring the
materials to the patient’s room.
During Perilite Exposure:
Assist the patient to thoroughly do perineal flushing or if the patient is
able to do perineal flushing on their own, encourage them to do self
perineal care.
Place the patient in a comfortable position and assist them in a dorsal
recumbent position while covering them with a blanket.
Place the heat lamp under the blanket for about 18-24 inches away from
the perineum as to avoid burning the patient.
Carefully check the patient for any discomfort or any other unwanted
reactions.
Kindly instruct the patient not to change position nor touch the lamp
during the entire procedure.
After Perilite Exposure:
Remove the lamp after 15 minutes or as ordered by the physician and
carefully check the perineal area of the patient for any unwanted results and
reactions.
Assist the patient in a comfortable position and kindly proceed with after care
as well as returning the equipment to their proper storage area.
Finally, proceed with the recording of proper documentation including client
reaction and response as well as condition and appearance of the wound.
 CLO#11: DEMONSTRATE
BEGINNING SKILLS IN HOT
SITZ BATH AND PERILITE
EXPOSURE
 PERILITE EXPOSURE
Review physician’s order. Prepare
equipment and check for safety
factors i.e., frayed cords, bulb in
place.
Explain the procedure to the patient
and its purpose.
Do medical handwashing
Bring the materials to the patient’s
room.
Render perineal flushing. Dry the
perineum thoroughly and remove
bedpan. (If patient is ambulatory,
encourage self-perineal care).
Place the patient in a dorsal recumbent
position. Cover with blanket.
Place the heat lamp under the blanket
about 18-24 inches from the perineum
to avoid burning the patient.
Check for any discomfort, burning
reaction or other untoward reaction.
Instruct patient not to change position
nor touch lamp during the entire
procedure.
Remove lamp after 15 minutes or as
ordered by the physician. Check the
perineal area for untoward reactions.
PERILITE EXPOSURE
Assist the patient in position of
comfort.
Do after care. Return equipment to
proper storage area.
Do proper documentation including
the patient’s reaction, length of
procedure, condition and
appearance of wound, medications
applied (if indicated).
 HOT SITZ BATH
Check the physician’s Bring the materials to
order for hot sitz bath. the bathroom. 26
Explain purpose and Check patient’s vital
procedure to the signs.
patient. Check with your elbow
Encourage the patient to determine that
to void or use the temperature of water
bathroom before is between 100°F to
starting the 105°F or 38°C to 41°C.
procedure. Fill sitz bath chair
Do medical about 1/3 full of warm
handwashing water
Place inflatable ring
on the chair and
bathmat on the floor.
Assist the patient to
undress.
Assist the patient into
the sitz bath chair.
Support the back with
rolled towels. Put
towel or bath blanket
around the shoulders
for warmth.
 HOT SITZ BATH
Remain with patient When sitz bath is Record procedure on
during sitz bath or completed, assist patient’s chart.
check frequently. patient with drying Charting should
Procedure takes 20 and dressing. include medication/
minutes. Discard soiled linen; solution used, length
Assess patient for any clean the sitz bath of time applied, type
untoward reactions. If chair. of heat application,
patient feels dizzy, condition and
faint or weak, stop the appearance of wound
procedure and comfort of the
immediately. patient.
CLO#12: Document
client response and
outcomes before,
during, and after
Hot sitz bath and
Perilite exposure
Documentation of
Responses and Outcomes
Before, During, and After
Hot Sitz Bath:
Before:
Date and Time of the Procedure
Checking of the Patient's Vital Signs
Making rapport and trust with the
patient with the nurse After:
Patient's relief after reducing perineal
During:
pain and healing of the perineal area.
Amount of water that was filled in the
Cleansing of the patient's perineum and
Sitz Bath Chair
to relieve pain and itching
Temperature of the water that was
utilized for the procedure
Recordings of any complications
during the procedurre
Documentation of
Responses and Outcomes
Before, During, and After
PERILITE EXPOSURE:
Before:
Physician's approval for perilite exposure.
Safety of the equipment that would be used for the procedure.
Making rapport and trust with the patient with the nurse.

During:
Amount of heat that was used for
perilite exposure.
Distance between the perilite lamp
from the patient's perineum.
Amount of time that the perilite lamp
was used for procedure.
Checking any unwanted reaction or
adverse reactions from the patient.
After:
Condition of the patient's perineum after
the procedure.
Recording of in-detail information and
proper documentation of the procedure
such as the length of the procedure and
the results of the procedure.
THANK YOU!