Instructed patient to check your skin and the back of your skin barrier each time you change your pouching system. You can use a mirror to check your skin under the stoma. Look for any places where stool or urine may have leaked under the skin barrier and onto your skin. When you apply your next pouching system these areas may need some extra reinforcement with skin barrier strips, rings or paste.
Instructed patient Clean technique includes: Hand washing, Using gloves is optional. Re-using a trach tube and/or inner cannula that has been properly cleaned, Using prepared sterile water and normal saline. Re-using the same trach ties if they are properly cleaned. Re-using suction catheters if they are properly cleaned(up to 8 hrs or 3/per day)
Instructed caregiver when should I call healthcare provider? Contact your healthcare provider or physician immediately:.If you have difficulty breathing and it is not relieved by your usual method of clearing secretions. When secretions become thick, if crusting occurs or mucus plugs are present, Your physician may recommend increasing your fluids or using cool mist humidification,If you have any other problems or concerns.
Instructed patient when skin redness where the tape or dressing was the nurse may need to change the dressing size or the type of tape or dressing used. Call home care nurse.
Eat smaller, more frequent meals. This may ensure a better mix with available bile. Include small amounts of lean protein, such as poultry, fish and nonfat dairy, at every meal, along with vegetables, fruit and whole grains.
Instructed patient gradually increase the fiber in your diet. This can help normalize bowel movements by reducing incidents of diarrhea or constipation. However, it can also make gas and cramping worse. The best approach is to slowly increase the amount of fiber in your diet over a period of weeks.
Patient with bilateral mastectomy with strips with moderate serosanguineous drainage, and two Jackson-pratt skilled nurse performed JP Drain Care , the JP drain removes fluids by creating suction in the tube. JP#1 drain 30 ml and JP#2 drain 25 Ml serosanguineous drainage .The bulb is squeezed flat and connected to the tube that sticks out of your body. The bulb expands as it fills with fluid.
Instructed patient sterile technique includes: Hand washing, Wearing sterile gloves. Using a new trach tube, inner cannula, and trach tie. Using sterile water (new bottle or bag every 24 hours). Discarding suction catheters after each use.
Instructed patient what to do if a person has trouble breathing The most common reason for breathing problems, other than an illness, is If you have trouble passing the catheter into the trach and it feels tight, put a few drops of saline into the tube and try to suction again. Do not force the catheter; it may push the plug in further. If you are unable to remove the mucus plug, change the trach tube and try to suction again.
Instructed patient If you do put tape around the skin barrier edges do not remove the tape after water activities. Removing the tape may cause the skin barrier to loosen. It is helpful to hold your skin smooth as you put your pouching system on to avoid wrinkles that may lead to leakage.