pressure ulcer prevention
General
Instructed patient abour the V.A.C. therapy System is an Advanced Wound Therapy System consisting of a V.A.C. Therapy unit that delivers negative pressure and a sterile plastic tubing with SensaT.R.A.C, pressure sensing lumens that connect the therapy unit to the dressing Special foam dressings. KCI recommends the V.A.C. Dressings be changed every 48 to 72 hours, but no less than 3 times per week. Patient has the ability to move around depending on the condition, the wound location and type of therapy unit prescribed. The V.A.C. Therapy System may be disconnected so you can take a shower. Therapy may not be off any longer than two hours per day.
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 that High blood pressure makes your heart work harder than it needed to before. Over the space of many years, this extra effort can lead to the heart muscle becoming thicker and less effective at pushing the blood round. This allows fluid to build up in your lower legs and ankles, which causes them to swell up.
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 / caregiver on proper incontinence care as to check every 2-3 hours if needed. Educated on pressure reduction measures as to change patient's position in bed/chair every 2-3 hours, avoid positioning on affected areas and use pressure reduction mattress or chair cushion.
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 taught patient rise slowly and pause prior to ambulation to ensure proper blood pressure adjustment. Pump ankle 5-10x to reduce risk of blood pressure drop after rising from seating position. Make sure you feel your seat on the back of your legs prior to sitting. Use appropriate assistive device to ambulate. Take extra precaution while turning, around rugs/mats and avoid walking backwards.
SN instructed that at the first sign of a migraine, retreat from your usual activities if possible. Instructed on ways to help treat migraine headaches such as, turn off the lights. Migraines often increase sensitivity to light and sound. Relax in a dark, quiet room. Sleep if you can.Try temperature therapy. Apply hot or cold compresses to your head or neck. Ice packs have a numbing effect, which may dull the sensation of pain. Hot packs and heating pads can relax tense muscles; warm showers or baths may have a similar effect. Suggested him to massage painful areas. Apply gentle pressure to your scalp or temples. Alleviate muscle tension with a shoulder or neck massage.
SN instructed that self-care measures can help ease the pain of a migraine headache. Such as, muscle relaxation exercises. Relaxation may help ease the pain of a migraine headache. SN instructed that relaxation techniques may include progressive muscle relaxation, meditation or yoga. SN also instructed that it is best to get enough sleep, but don't oversleep. Get an adequate amount of sleep each night. It's best to go to bed and wake up at regular times, as well. SN instructed on the importance of being able to rest and relax. If possible, rest in a dark, quiet room when you feel a headache coming on. Place an ice pack wrapped in a cloth on the back of your neck and apply gentle pressure to painful areas on your scalp.
SN instructed that symptoms of a lower urinary tract infection or bladder infection may include: Frequent need to urinate, burning sensation while urinating pressure in the lower abdomen, pain in the lower back blood in urine. Symptoms of an upper urinary tract infection or a kidney infection may include: Fever, chills, nausea and / or vomiting, Pain higher in the back ( around the upper sides and waist ). In women, the symptoms of a urinary tract infection are similar to those caused by some vaginal infections.