TEPID SPONGING PROCEDURE
DEFINITION : this is a method of reducing body temperature
that exceeds 39degree Celsius.
This is a means by which a reduction of body temperature
occurs by evaporation. It is a clean procedure.
Assessment
Check the purpose for the cool application e.g injury , fever
Asssess baseline vital signs
Observe fluid and electrolytes status, especially in clients
with elevated temperature
Assess the skin before and after application to determine if
alteration occurs
Nursing diagnosis
Nursing diagnosis Related factors
hyperthermia Diseases condition,
reduced fluid
intake, poor
circulation to the
skin, change in
environmental
Impaired body Elevated body
comfort temperature and
pain
OBJECTIVES:
1. To reduce the body temperature of a patient with hyper
pyrexia
2. To prevent mental confusion
3. To make patient comfortable
Client will temperature will be reduced by 1-2c within
30mins of nursing intervention
Client will verbalize less pain
REQUIREMENT
TROLLEY
TOP SHELF:
A. Wash basin with water at 30degree Celsius
B. Bath thermometer
C. Face flannels
D. Bath towels
BOTTOM SHELF:
A. Vital signs tray
B. Cleans gowns
C. Extra linens
PROCEDURE
1. Explain the procedure to the patient
2. Wash hand and wear gloves
3. Screen the patient
4. Take the patient temperature and record ( for baseline data
for comparison and to assess the effectiveness of the
treatment).
5. Fan-fold the top cover down to the patient fore head.
6. Remove patients gown
7. Place a cold flannel on the patient forehead
8. Place cold flannels on the axial, groin and renew as needed.
9. Place a cold flannel on the patient chest
10. Sponge the arms, legs with long , slow strokes. Changing the
flannel when it becomes warm. Do not dry the patient
(vaporization of the water remove the heat from the skin
surface).
11. Turn the patient on his/her side.
12. Protect the bed with bath towel and sponge the back.
13. Start again with the fore head, axilla, groins , chest ,arms
and legs. Repeating the process for at least 20minutes. If the
fan is available , allow it to blow on the patient ; air movement
augment heat loss.
14. Take temperature , if the temperature is 38.3 degree
celcisus or less, you may discontinue sponging otherwise
continue until this temperature is reach
15. Dry patient
16. Record the temperature
17. Put on clean gown and leave patient comfortable
18. Clear away the equipment
19. Remove gloves and wash
20. Check the temperature 30minutes later and record
POINTS TO NOTE
1. Carefully observe the patients condition throughout
2. If patient has a chill, becomes cyanosed or has a weak pulse
stop sponging and report at once.
3. An infant or toddler may be put into bath of tepid water to
reduce the temperature
4. It may take 45minutes to 1hour of continuous sponging
before the temperature will come down.
Documentation
Every temperature checked must be duly charted and signed.
DATE TIME OBSERVATION SIGNATURE
26/04/2023 10:00AM Patient observed
to have high fever
with temp of
38.80c
10:10am A drop in temp to
38.5oc
10:40am Temp at 37.0oc
Evaluation
Patient verbalized a feeling of comfort after 40mins of nursing
intervention
Patient temp reduced from 38.8 to 37.0
TRINITY NURSING DEPARTMENT PRATICAL EXAMINATION
CHECKLIST FOR TEPID SPONGING
EXAM NO…………………. DATE: ………………
PROCEDURE 0 1/4 1/2
1 Explain procedure to patient1/2
2 Identify the equipment1/4
3. Provide privacy for patient1/4
4 Wash hands and wear gloves ¼
5 Take patient temperature and record1/2
6 Fanfold the top covers to the foot of the bed1/2
7 Remove the patient’s gown1/4
8 Place a cold flannel on the fore head ½
9 Place a cold flannel in the axilla and groin and renew as needed
¼
10 Place a cold flannel on the chest and abdomen ¼
11 Sponge the arm, legs with long , slow strokes, changing the
flannel when it becomes warm1/2
12 Turn the patient on his/her side1/4
13 Protect the bed with bath towel and sponge the back1/2
14 Repeat the process with forehead, axilla, groins, chest,
abdomen, arms, legs and back for at least 20minutes.1/2
15 Put on the fan if available or open nearby window to promote
heat loss1/4
16 Take patients temperature, if the temperature is 38.3c or less,
you may discontinue sponging otherwise continue until this
temperature is reached ½
17 Dry patient ¼
18 Record the temperature ¼
19 Put on the clean gown and leave patient comfortable1/4
20 Check the temperature 30minutes later and record ¼
Total ……7marks………. Marks obtained …………………………………
Remarks …………………………………………… signature …………………………………………………
