bedbound-patient
General
Instructed caregiver how to prevent Pressure Ulcers for Bed bound patients: Protect the Skin patient from injury - Avoid massaging the skin on bony parts of the patient body. Limit pressure on bony areas by changing positions frequently. If the patient in a bed, preferably every 2 hours.
SN educated patient on the importance of daily vital sign monitoring. Due to patients disease processes it is important to monitor blood pressure, weight, pulse and oxygen daily if equipment is available. SN instructed patient to weigh correctly they need to wake up, pee and than weigh daily at the same time if possible, same amount of clothing, same area. Patient is to weigh prior to eating/drinking in the morning. Notify home health or PCP if -/+ 3 lbs in a day or +/-5 lbs in a week is seen. SN educated patient to monitor blood pressure and pulse, and instructed to check before medications and if elevated/low recheck in 1-2 hours. SN educated patient to always log vitals so patients MD has a larger snap shot on what is going on.Patient/CG verbalized understanding
SN instructed patient on nonpharmacologic pain relief measures, including relaxation techniques, massage, stretching, positioning, and hot/cold packs. SN instructed patient to report to physician if patient experiences pain level greater than 6, pain medications not effective, patient unable to tolerate pain medications, pain affecting ability to perform patient’s normal activities.
SN to educate patient on CPAP machine as follows: CPAP stands for continuous positive airway pressure. The machines help people with sleep apnea breathe more easily and regularly every night while they are sleeping. A CPAP machine increases the air pressure in your throat to prevent your airway from collapsing when you inhale. Patient admits that most nights he goes to bed with Cpap, but finds mask on floor after waking in AM. SN to advise patient of importance of wearing Cpap as follows: The CPAP breathing machine is used by people with chronic obstructive sleep apnea, a disorder which causes airways to close up during sleep. People with obstructive sleep apnea stop breathing while sleeping. When breathing stops the individual is suddenly jolted awake, gasping for air. Patient to deny any sleep issues lately. People with sleep apnea often do not remember these episodes, but instead experience chronic fatigue that they have no explanation for. Over time, sleep apnea can increase the risk of hypertension, heart failure, heart attack, and stroke. Patient verbalized understanding of teaching today. SN to continue to monitor.
SN educated patient on some ways to cope with stress and anxiety. explained to the patient that anxiety can be a normal part of life when faced with stressors such as changes in relationships, presenting in front of a crowd, or making decisions. There is no one right answer to eliminate anxiety. It is important to find healthy coping skills that will work for you. Consult with your primary care physician when anxiety becomes persistent or unmanageable. SN Instructed patient about some coping skills to consider when struggling with anxiety include: Reaching out to support system (i.e. family/friends, counselors, psychiatrists, or support groups). Deep breathing Meditation, Yoga, Avoiding caffeinated beverages, Healthy diet, and Calming music. Patient Verbalized fair understanding of anxiety teaching.
SN assessed patient for COVID 19 symptoms . Patient questions if they have had a fever, cough, SOB loss of taste of smell or generalized pain. patient denied any symptoms. Patient instructed on COVID 19 symptoms, transition and prevention.
Patient educated that there is good and bad bacteria in our body’s and the ABT will kill both which result in the yeast infection. Yeast infection is identify by area is likely an area that is moist it is red and has raised pumps. Patient instructed on possible yeast infections related to long term use of ABT, in areas that include but is not limited to between legs, under breast, and in between groin. Patient instructed to report any symptoms to MD or SN during visit.
SN instructed patient that the incentive spirometer is used to improve the function of their lungs, and for patient to breathe in from the device as slowly and as deeply as possible, then holds their breath for 2 – 6 seconds, which provides back pressure that pops open alveoli. Patient should do this ten times and repeat 2 to 3 times a day.
SN instructed that the joint that is damaged by injury or disease can be removed and replaced with a new one. There are times when only a part of the joint needs to be replaced or repaired. Your healthcare provider may try other treatments before joint replacement surgery, such as steroid injections or medicines. Pain relief and increased function are the goals of joint replacement. Knee, hip, and shoulder joints are the most common joints replaced. Joints in your elbows, fingers, and ankles can also be repaired or replaced. Your risk of infection, bleeding, and blood clots increase with surgery. You may be allergic to the material used in your new joint. Nerves, muscles, tendons, and blood vessels near your joint may become damaged during surgery. The new joint may loosen or come out of the socket. Sn instructed patient on symptoms / signs ( S/S ) of infection such as fever, drainage, swelling, redness. Patient recalls back partial teaching of redness. Patient instructed to report any symptoms should they occur to physician / nurse ( MD / SN ).
Sn instructed patient on ways to prevent Urinary tract infection ( UTI ). If the patient is elderly be careful with cleaning, be sure that the perineal area is being cleansed properly. Women should always wipe themselves from the front to the back. If you are tending to perineal care, take steps to ensure that you always wipe your starting in front of the urethra and wiping towards the anus. Before wiping the area again, fold the rag to a clean section. The idea is that residue from the anus should never be dragged toward or against the urethra. Patients that wear adult diapers, or briefs, should be changed on a regular basis. They should be checked every two hours or so and they should never be allowed to sit in dirty briefs for prolonged periods. You should also wiped and cleansed after every brief change and bowel movement. Douches should never be used. The right drinks - what you drink can make a difference. Caffeinated drinks and alcohol can irritate the bladder and should be avoided as much as possible. Patient and caregiver verbalized understanding.