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Instructed in measures important in foot care of the diabetic: wear shoes that support and fit properly, wear socks that are clean and fit properly, avoid going barefooted, etc.
Patient was instructed on how to avoid hypoglycemia. Choose high fiber, low sugar bedtime snacks such as two graham crackers with 1/2 cup skim milk. Avoid eating excessive amounts of high sugar foods, which will make the blood sugar spike then plummets. When the blood sugar falls after a sugar high it tends to drop dramatically low.
Taught that resting frequently during an activity to allow the heart to recover is a measure aimed to increasing tolerance in response to increased physical activity.
Instructed on some signs/symptoms of Diabetes Mellitus (DM), such as: itching, changes in vision and weight loss.
SN stressed importance of daily foot care such as wearing shoes or slippers at all time to prevent foot injury.
SN completed assessment done on all body systems and noted patient with elevated blood pressure during visit. SN completed treatment during visit and noted no drainage on old tx, wound callused and new area found to left medial top of foot remains intact with no drainage noted. SN noted patient complaint of pain to bilateral lower extremities with +2 edema noted. SN educated primary caregiver on the importance of elevation of bilateral lower extremities as well as pain management for patient.
Instructed caregiver reducing additional risk factors, such as , high cholesterol, and elevated blood glucose, are important in prevention and treatment of a diabetic foot ulcer. Wearing the appropriate shoes and socks will go a long way in reducing risks. the patient podiatrist can provide guidance in selecting the proper shoes.
Instructed patient when should I call my clinician when on V.A.C. Therapy: immediately report to your clinician if you have any of these symptoms: fever over 102°, diarrhea, headache, sore throat, confusion, sick to your stomach or throwing up, dizziness or feel faint when you stand up, redness around the wound, skin itches or rash present, wound is sore, red or swollen, pus or bad smell from the wound, area in or around wound feels very warm.
SN instructed patient that bleeding is frequently associated with any non-tunneled catheter insertion. More frequent dressing changes and/or a mild pressure dressing may be required. Excessive bleeding or bleeding that persists for more than 24 hours is not normal. Excessive bleeding may be caused by coagulation disorders, vigorous physical activity, or a traumatic insertion procedure.
RN instructed patient about medication Famotidine that is used to treat gastroesophageal reflux disease, a condition in which backward flow of acid from the stomach causes heartburn and injury of the esophagus. RN instructed patient to swallow the tablets and capsules with a full glass of water. RN also explained about side effects of treatment such as: hives, skin rash, itching, swelling of the face, throat, tongue, lips, eyes, hands, feet, ankles, or lower legs. RN instructed to call Physician immediately if any of these signs or symptoms appear. Patient and caregiver voiced understanding of all instructions given.