high blood pressure
SN reviewed patients medication with primary caregiver and instruct on medication compliance to better control the patients disease process. SN refilled patient’s medication box for daily routine implementation during visit. SN informed M.D. of patients elevated blood pressure and no new orders received, SN was advised to continue with patients current regimen.
Skilled nurse monitored blood pressure on patient and assess medication Instructed patient diet: early after a cardiac event, while you are still in the hospital. This phase usually includes light supervised exercise such as walking the halls and stair climbing.
Instructed patient about Midline activities to avoid do not lift heavy items or do very hard
exercise, such as shoveling. Do not use sharp objects near the catheter to avoid cutting or damaging it. Remind caregivers
not to check your blood pressure or give needles in the arm where the catheter is placed.
Instructed patient training for patients and their caregivers who
will be using the device at home should include how to: Recognize signs and symptoms of complications, such as redness,
warmth, and pain associated with possible infection Contact appropriate healthcare providers, especially in emergency
situations, respond to emergency situations; for instance, if bright red blood is seen in the tubing or canister, to immediately stop NPWT, apply direct manual pressure to the dressing, and activate emergency medical services.
SN instructed that the metoprolol lowers blood pressure by decreasing workload of heart. Watch for dizziness, lightheadedness when getting up, headache, stomach upset, loss of taste, fatigue and insomnia.
SN instructed patient / caregiver about Bethanechol. Sometimes given orally or subcutaneously to treat urinary retention resulting from general anesthetic, diabetic neuropathy of the bladder, or a side effect of antidepressants or to treat gastrointestinal atony (lack of muscular tone). Adverse reaction are rare following oral administration of Bethanechol, but are more common following subcutaneous injection. Adverse reactions are more likely to occur when dosage is increased. Adverse reactions that have been observed: Body as a Whole: malaise; Digestive: abdominal cramps or discomfort, colicky pain, nausea and belching, diarrhea, borborygmi, salivation; Renal: urinary urgency; Nervous System: headache; Cardiovascular: a fall in blood pressure with reflux tachycardia, vasomotor response; Skin: flushing producing a feeling of warmth, sensation of heat about the face, sweating; Respiratory: bronchial constriction, asthmatic attacks; Special Senses: lacrimation, miosis.
SN instructed patient and caregiver on hypertensive urgency which is a situation where the blood pressure is severely elevated and that experiencing hypertensive urgency may or may not experience one or more of these symptoms: severe headache, shortness of breath, nosebleeds, and severe anxiety, chest or back pain, numbness or severe weakness, change in vision or difficulty speaking. Patient and caregiver were advised to seek immediately medical assistance and/or call 9-1-1 if any of these signs or symptoms appear. Patient and caregiver verbalized understanding. Family is independent with hypertension process.
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.
SN instructed patient / caregiver on medication Hydrochlorothiazide. SN explained to patient that Hydrochlorothiazide ( HCTZ ) is a medication indicated for edema and hypertension. SN explained to patient / caregiver that it is a diuretic that reduces fluid volume overload which, in turn, lowers blood pressure. Explained that side effects of this medication includes dizziness, dehydration, weakness, pancreatitis, anemia and nausea. SN instructed patient / caregiver to notify physician ( MD ) if experiencing persistence or worsening of side effects.
SN instructed patient / caregiver about the medication Isosorbide. SN explained that Isosorbide is a medication given to reduce the blood pressure and that it also reduces the heart rate. SN explained that the side effects of this medication includes fatigue, anxiety, weakness, dizziness, tachycardia, pulmonary edema, constipation and dry mouth. SN instructed patient / caregiver to notify physician ( MD ) if experiencing persistence of side effects or if experiencing blurred vision, difficulty breathing, wheezing, dizziness, light - headedness, confusion, depression or dry mouth.