The nurse instructs the older client to have a sitz bath twice daily at home after discharge. Which does the nurse include in client teaching?
1. Warm the sitz bath solution to slightly hot.
2. Replace sitz bath with a warm moist towel.
3. Ask for help before getting up after sitz bath.
4. Limit the duration of the sitz bath to 5 minutes.
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3. The nurse instructs the older client to ask for help before getting up from the sitz bath because vasodilation from the warm water can cause hypotension and dizziness; this is especially true for older clients on medications such as antihypertensive agents, vasodilators, antianginal agents, and central nervous system depressants. Older clients are prone to orthostatic hypotension without vasodilation or medication because baroreceptors can become less responsive as clients age.
1. Older clients are more likely to have impaired circulation; diminished subcutaneous fat; thin, fragile skin, and altered sensation in the extremities; therefore, the nurse instructs the client to use warm water for the sitz bath and cautions the client about using hot water to prevent scalding injuries. Ideally, the client determines the tem-perature of the sitz bath water with a thermometer; however, most clients do not have a thermometer and test the water using the hand or foot. The nurse cautions the client to avoid this practice if the client has peripheral vascular disease, diabetes mellitus, impaired skin integrity, or impaired sensation to the extremity.
2. A warm moist towel cannot replace a sitz bath because the sitz bath envelopes the regional tissue, providing deeper heat penetration than offered by applying moist heat.
4. The nurse instructs the client to soak in the sitz bath for 15-20 minutes.
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