bedbound-patient
General
SN instructed the reason it is important to help or use proper turning techniques to prevent friction and shearing of skin. Friction usually, but not always, accompanies shear. Friction is the force of rubbing two surfaces against one another. Shear is the result of gravity pushing down on the patient's body and the resistance between the patient and the chair or bed. When combined with gravity/force (pressure), friction causes shear, and the outcome can be more devastating than pressure alone.
SN instructed patient and caregiver on strategies that can significantly help decrease the risk of a fall such as: skid-proof mats or strips in the shower and bathtub, removal of furniture that can slip away if grabbed accidentally for support, supportive non-slip footwear and not walking in stocking feet. SN also instructed on side effects of most medications taking that could possibly cause dizziness and to report it so that it can be addressed by physician. Patient and caregiver voiced understanding of all instructions given.
SN instructed patient on non pharmacological pain management like massage, a lot of people find relief from gentle massage. Several studies have found that massage is effective in relieving pain and other symptoms for people with serious illness. Relaxation techniques like guided imagery, breathing techniques, and gentle movement like rom exercises. Relaxation techniques are often very effective, particularly when a patient / caregiver is feeling anxious. Physical therapy if a person has been active before and is now confined to bed, even just moving the hands and feet a little bit can help. Pet therapy if you have bouts of pain that last 5, 10, or 15 minutes, trying to find something pleasant like petting an animal soft fur to distract and relax yourself can be helpful. Gel packs, these are simple packs that can be warmed or chilled and used to ease localized pain.
Sn teaching patient to take pain medication before pain becomes severe to achieve better pain control and decreases the amount of pain medication that is required. SN instructed patient on pain relief measures, including relaxation techniques, massage, stretching, positioning, and / or hot / cold packs.
Patient / caregiver were instructed on important measures during transfers to wheelchair: Stand as close to the user as possible. Be sure footing is as stable as possible. Proper shoes is also recommended as sandals or flats do not provide support for a safe wheelchair transfer . Patient / caregiver verbalized understanding of instruction given.
SN instructed patient on hallucinations, you must use diversion tactics when hallucinations start, try telling yourself they are not real especially when they are scary, use music or television for distraction when auditory hallucinations start, continue to take medication as ordered, call a friend or family member for support when needed. Patient verbalized understanding.
SN instructed patient on spontaneous coronary artery dissection ( SCAD ) and stent placement. A stent is a small rod made out of metal or fabric. It is inserted into a coronary artery when there is a blockage or when the artery is narrow. A coronary artery is a blood vessel that carries oxygen to the heart muscle. You received a stent due to coronary artery disease ( also called SCAD). That is caused by a thickening of the inside walls of the coronary arteries. This thickening is called atherosclerosis. A fatty substance called plaque builds up inside the thickened walls of the arteries, blocking or slowing the flow of blood. If your heart muscle doesn't get enough blood to work properly, you may have angina ( chest pain ) or a heart attack. The stent will help hold the artery open so blood can flow and help keep the artery from narrowing again. You will need to take medicine that keeps the stent open and blood flowing. It is very important to take the medicine exactly how your doctor tells you to take it. In addition to taking medicine, the best way to keep your heart healthy is to maintain a healthy lifestyle. Quit smoking. Make sure you keep your blood pressure and cholesterol at healthy levels. Exercise as recommended by your doctor. Eat a heart - healthy diet. Patient verbalized understanding well.
Sn instructed patient in walker safety. When you stand wait one minute before attempting to walk. Do not take a step until all 4 legs of the walker are level on the ground. Do not place the walker too far ahead of you. Keep the walker’s back legs even with your toes. Always look forward at your path, don’t look down at your feet. To get up from a seat, do not pull up on your walker. Push up from your seat. Do not lean forward over your walker. Work at keeping good posture. Be careful when you walk from a tile or hardwood floor to a carpeted floor. Do not use your walker on stairs or on an escalator. Check the rubber tips on the legs of your walker often. Replace the tips when they become worn. Patient verbalized understanding of teaching.
SN instructed patient on ways of reducing nausea such as, get some fresh air, open a window and take a walk outside. Apply a cool compress to the forehead or back of the neck. Sit up for about an hour after eating to relieve any pressure on the stomach. Try alternative therapies like meditation and acupuncture. Eat smaller meals. Patient nods head in understanding.
SN instructed patient / caregiver what should be done in the event of seizure. Place a pillow or something soft under her head to protect it. Remove and hard objects or furniture that may get in the way and cause injury. Turn her on her side to help avoid aspiration of secretions into the lungs. Never place anything in her mouth or try to restrain her in any way. Notify physician ( MD ) of any seizure activity as well as duration of the seizure. When the seizure has subsided, she may feel disoriented or tired so it’s okay to allow her to rest and sleep. Patient and caregiver verbalized understanding of all teaching.