Skilled nurse developed patient plan of care with patient/caregiver involvement to be countersigned by physician. SN to perform complete physical assessment each visit with emphasis on disease process. SN to assess other co-morbidities including list diseases and other conditions that present themselves during this episode of care. SN to recognize and intervene to minimize complications; notify physician immediately of any potential problems that impede completion of patient recovery and desired goals.
SN completed patient cardiovascular and pulmonary assessment. Medication reviewed and administered. Educated staff on monitoring patient for mood changes, aggressive episodes, anxiety, and agitation related to medication SEs. Staff instructed to monitor environmental hazards to prevent falls and injuries. Staff was also encourages to encourage patient to rise slowly to prevent syncope and dizziness.
SN completed patient cardiovascular and pulmonary assessment. Educated staff on monitoring patient for dizziness, syncope, cardiovascular status, anxiety, and agitation related to medication SEs. Staff to encourage patient to rise slowly to prevent syncope and dizziness. Staff instructed to monitor environmental hazards to prevent falls and injuries in addition to monitoring skin for breakdown due to episodes of bowel and bladder incontinence.
SN instructed the patient about care of incision site. Patient was instructed to check the incision daily for signs and symptoms of infection like increased drainage or bleeding from the incision site, redness in or around it, foul odor or pus coming from the incision, increased swelling around the area and fever above 101.0°F or shaking chills.
SN instructed patient/ CG about thickened liquids. SN explained that thickened liquids are used to treat patients with Dysphagia. Thick liquids decrease aspiration. Thick liquids may give the patient more time to perform additional swallows or other swallowing strategies. Thickened liquids slow down the bolus flow to compensate for a delayed swallow and reduced airway closure.
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.
Instruct patient and caregiver regarding self-management of total knee replacement. Instructed patient about how is life different after a knee replacement it’s also normal to have temporary swelling, pressure and/or bruising in your ankles and feet, and these may last for a few months. Here are a couple things you can do to help: ice your knee (always cover ice packs in a towel to avoid frostbite, wear compression stockings, elevate your leg with a pillow, ankle exercises verbalized.
Instructed patient how prevent a decrease in physical activity. Encourage activity including cooperation with neighboring evacuees, incorporate rehabilitative activity into daily life. Explain the benefits of activities such as walking/ exercise on health, and promote them. Sn leave patient calmly watching TV.
Patient was given teaching on good body mechanics to avoid injury such as: keep your back straight as you walk and also when lifting making sure to never bend at the waist. If sitting put a pillow or rolled towel to support your lower back.
SN instructed patient on importance of hand washing before and after eating, after using the bathroom , after blowing your nose, coughing, or sneezing, after being outside , in order to prevent spread of germs.