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Instructed in new medication Amitriptyline to manage depression. In additon, warned of possible S/E such as coma, seizures, hallucinations, delusions, disorientation, ataxia, tremor, peripheral neuropathy, anxiety, insomnia, restlessness, drowsiness, dizziness, weakness, fatigue, headache, extrapyramidal reactions, MI, stroke, arrhythmias, heart block, orthostatic hypotension, tachycardia, ECG changes, hypertension, edema, blurred vision, tinnitus, mydriasis, increased intraocular pressure, dry mouth, nausea, vomiting, anorexia, epigastric distress, diarrhea, constipation, paralytic ileum, urine retention, agranulocytosis, thrombocytopenia, leukopenia, eosinophilia, hypoglycemia, hyperglycemia, rash, urticaria, photosensitivity, diaphoresis and hypersensitivity reaction. Instructed to take full dose at bedtime but warned patient of possible morning orthostatic hypotension. Avoid alcohol during drug therapy. Consult MD before taking other medications. Avoid activities that require alertness and good psychomotor coordination until CNS effects of drug are known. Drowsiness and dizziness usually subside after a few weeks. Dry mouth may be relieved with sugarless hard candy or gum. Saliva substitutes may be needed. Instructed to use a sun block, wear protective clothing and avoid prolonged exposure to strong sunlight. To prevent photosensitivity reactions. Do not stop drug therapy abruptly.
Instructed that insulin/oral diabetic agents, are used to relieve the symptoms and not to cure the disease.
Patient was instructed on hypertension. Very high blood pressure can cause headache, vision problems, nausea and vomiting. It is called hypertensive crisis, which is blood pressure that rises very fast.
Patient was instructed on how to manage pressure that is necessary to avoid future complications. Provide appropriate support surface, repositioning every two hours in bed, off-load heel using pillows or positioning boot, use pillow between legs for side lying.
Instructed on the importance of using adjunctive equipment (e.g., cane) as a measure aimed to reducing the risk of falls/injuries.
Taught that the lungs are two sac-like organs located in the chest cavity.
Taught that the systolic reading (the top number) represents the pressure exerted on the blood vessel wall when the heart is contracting.
Instructed patient / caregiver blood pressure readings in the arm cannulated with the PICC should be avoided.
SN instructed that symptoms of low blood sugar (hypoglycemia) include sudden sweating, shaking, fast heartbeat, hunger, blurred vision, dizziness, or tingling hands/feet. It is a good habit to carry glucose tablets or gel to treat low blood sugar. If you don't have these reliable forms of glucose, rapidly raise your blood sugar by eating a quick source of sugar such as table sugar, honey, or candy, or drink fruit juice or non-diet soda. Tell your doctor about the reaction immediately. Low blood sugar is more likely if you drink large amounts of alcohol, do unusually heavy exercise or do not consume enough calories from food. To help prevent low blood sugar, eat meals on a regular schedule, and do not skip meals. Check with your doctor or pharmacist to find out what you should do if you miss a meal.
SN instructed patient on liver failure. The early symptoms of liver failure are similar to symptoms of many other conditions. Because of this, liver failure may initially difficult to diagnose. Some of the most common initial symptoms of liver failure are: Nausea, Loss of appetite, fatigue, diarrhea. As liver failure progresses, the symptoms become more serious. The most common symptoms of advanced liver failure include: Skin itchiness, jaundice, bleeding easily, bruising easily, swollen abdomen, mental disorientation or confusion, sweet or foul smelling breath, sleepiness, coma. Educated patient that the liver filters the Ammonia out the blood and that liver failure causes Ammonia levels to increase, which cause change of mental status, confusion, and sleepiness or fatigue.