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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 patient on measures to control hypertension, such as, control stress, decrease cholesterol and sodium in the diet, take medication exactly as prescribed, etc.
Instructed patient on possible adverse reactions to insulin, which include hypoglycemia, hyperglycemia, and skin rash and local reaction at injection site.
Patient was instructed on how to remove bubble from the syringe. Draw up the insulin slowly and steadily. When bubbles are forming in the syringe means that the drawing has been done too fast, so push the insulin back into the bottle and re-draw. Patient was told to do this many times as needed until the bubbles are gone.
Patient was instructed on hypoglycemia. Hypoglycemia may result from a variety of causes that include: Other causes. Hypoglycemia also may occur, though rarely with prolonged fasting or missed meals, severe malnutrition, or prolonged strenuous exercise.
Instructed on the importance of having her nails clipped straight across and gently filed with an emery board.
Taught that the systolic reading (the top number) represents the pressure exerted on the blood vessel wall when the heart is contracting.
The patient was instructed in carotid endarterectomy about daily care of the surgical incision and dressing changes. The patient was advised the atherosclerotic process and explain the importance of risk factor modification to reduce the chance of future plaque buildup in the carotid and other arteries. The patient was encouraged to avoid bending from the waist or lifting and straining.
The patient was instructed in iron deficiency anemia that stools will appear dark or black as the effect of iron additional treatment. The patient was advised the importance of checking for blood loss in the stool if has gastrointestinal bleeding predispositions. The patient was taught the correct use of guaiac exams. The patient was reviewed to take iron with meals to make best use of absorption. The patient was recommended the need to increase vitamin C consumption.
The patient was instructed in liver biopsy providing him/her pain controlling. The patient was encouraged to use minor painkillers. The patient was advised to evade taking no steroidal anti-inflammatory medications and hepatotoxic medications.