Instructed caregiver although the formula has water in it, patient may need extra water to keep from getting dehydrated. Patient may need more water when sweating, such as during hot weather or if you have a fever. Patient may also need more water if you have diarrhea or if you are vomiting.
Skilled nurse teach caregiver A bolus feeding is an amount of formula given over a short period of time. Feeding syringe: Connect the feeding syringe to the end of the PEG tube. Pour the correct amount of formula into the syringe. Hold the syringe up high. Formula will flow into the PEG tube. The syringe plunger may be used to gently push the last of the formula through the PEG tube. Caregiver always need to flush your PEG tube before and after each use with 100 ML H2OD
SN instructed patient to perform daily meticulous foot care, to be sure to dry feet completely after a bath, checking for any sores, cuts or scrapes and to report any wounds as soon as they appear to SN or MD. Also have a podiatrist cut toenails regularly to prevent ingrown toenails and other complications.
Caregiver instructed about feeding and tube care to prevent a clogged feeding tube, flush your tube with water each time after giving a feeding or medication. If your feeding tube becomes clogged, you can use these methods: Place the syringe into your feeding tube, and pull back on the plunger. Flush your tube with warm tap water.
Skilled nurse teaching how patient performed colostomy care , washed the stoma itself and the skin around the stoma with soft paper towels, mild soap and water. Measured the stoma, cut out the opening, removed the paper back and set it aside. Finally hold the punch with the sticky side toward your body. Center the opening on the stoma , then press firmly abdomen for 30 seconds.
Skilled nurse remove PICC,line per doctor order, the catheter tip should also be examined and there is no breakage at the end, no S/S of infections noted. Skilled nurse applied at the insertion site with sterile gauze to prevent bleeding which and when the bleeding stops, the gauze is removed and a sterile dressing is applied. Instructed patient the dressing should remain for approximately 24 hours. After this time, the site should be assessed and a new dressing applied if needed. Patient understand the instructions given.
Patient is unable to perform wound care due to complexity of wound, location, size of wound, poor manual dexterity, forgetful (dementia), and knowledge deficit. No skilled/willing caregiver to perform wound care.
SN instructed patient on the importance of daily monitoring of the blood pressure; along with reporting an elevated BP of 160/90 and above to MD/SN stat.
SN instructed patient that water helps flush your urinary tract, make sure you drink plenty of plain water daily. Don't hold it when you need to urinate. Holding it when you need to go can help any bacteria that may be present develop into a urinary tract infection. Wipe from front to back after a bowl movement. This is especially important to help prevent bacteria from the anus from entering the vagina or urethra.
Medication profile reviewed and reconciled. SN reviewed and instructed patient on medication regimen of spirivia. Instructed patient that medication is used for maintenance treatment of bronchospasm associated with chronic obstructive pulmonary disease (COPD). Spiriva HandiHaler is indicated to reduce exacerbations in COPD patients. Instructed patient that, with administration of Spiriva HandiHaler, a Spiriva capsule is placed into the center chamber of the HandiHaler device. The capsule is pierced by pressing and releasing the green piercing button on the side of the HandiHaler device. The tiotropium formulation is dispersed into the air stream when its inhaled through the mouthpiece. Instructed to inhale once or twice to get al medication inhaled. Instructed patient that dry mouth or constipation may occur. Instructed to notify MD/SN right away if any serious side effects, including: vision changes (such as blurred vision, seeing halos), eye pain, difficult/painful urination, fast heartbeat.