diverticulosis-and-diverticulitis
Instructed in new medication Vioxx to manage osteoarthritis. In addition, warned of possible S/E such as headache, asthenia, fatigue, dizziness, aseptic meningitis, hypertension, lower-extremity edema, sinusitis, diarrhea, dyspepsia, epigastric discomfort, heartburn, nausea, abdominal pain, GI bleeding, urinary tract infection, hyponatremia, back pain, bronchitis, upper respiratory tract infection, pulmonary edema and flu-like syndrome. Patient may experience signs and symptoms of GI bleeding, including bloody vomitus, blood in urine and stool and black, tarry stools. Advised to call MD if he experiences these signs or symptoms. Report rash, unexplained weight gain or edema. Avoid aspirin and products containing aspirin unless prescriber has instructed otherwise. Avoid OTC anti-inflammatories such as ibuprofen (Advil) unless prescriber has instructed it. All NSAIDs including Rofecoxib may adversely affect the liver. Signs and symptoms of liver toxicity include nausea, fatigue, lethargy, itching, jaundice, right upper quadrant tenderness and flu-like syndrome. Instructed to stop therapy and call MD immediately if patient experiences these signs or symptoms. Women must inform MD if they become pregnant, or they are planning on becoming pregnant while taking drugs. This drug may be taken without regard to food although taking it with food may decrease GI distress. The most common adverse effects of this drug are dyspepsia, epigastric discomfort, heartburn and nausea. Taking drug with food may help minimize these effects.
Patient/CG were instructed on: Treatment for cervicalgia ( neck pain ) are usually conservative and include methods of relieving inflammation . Applying ice to the area is a good way of relieving pain and swelling and is often advised where a muscle tear is suspected. Heat is contraindicated in such a situation as this is likely to make the problem worse by increasing blood flow to the area. If the cervicalgia is due to muscle tension rather than an injury then thermotherapy can be effective in aiding relaxation of the muscle and relieving neck pain. Adequate rest and the temporary use of a supportive neck collar is also helpful in some cases of cervicalgia ( neck pain ) although it is inadvisable to use a collar long-term as this may itself lead to muscle weakness in the neck. Many patients also make use of anti-inflammatory medications, including prescribed drugs, and natural supplements to lower inflammation and pain. Physical therapy, including neck stretches and strengthening exercises, is a good idea for anyone who suffers from chronic neck pain, and intractable cases may require more invasive surgical intervention to address some causes of cervicalgia
SN instructed patient / caregiver on service authorization, advance directives, rights and responsibilities, rights of the elderly and obtained necessary signatures. Instructed patient / caregiver on 24 hour nurse availability and provided / posted the agency telephone number. Also instructed that after hours, weekends and holidays an answering service will reach the nurse and he / she will return the patient / caregiver call and answer any questions or make a visit if needed. Patient and caregiver stated understanding. Patient and caregiver educated on diabetic diet, diabetic foot care, symptoms / signs ( s / s ) of depression, managing pain with medications, healthy skin, and pressure ulcer prevention. Leaflets left in home.
SN instructed patient on nutrients required for wound healing. To promote wound healing with good nutrition, plan healthy, balanced meals and snacks that include the right amount of foods from 5 food groups: protein, fruits, vegetables, dairy and grains. Fats and oils should be used sparingly. Choose vegetables and fruits rich in vitamin c, such as strawberries or spinach. For adequate zinc, choose whole grains and consume protein, such as eggs, meat, dairy or seafood. Some wounds may require a higher intake of certain vitamins and minerals to support healing. Include adequate protein throughout the day. Include a source of protein at each meal or snack. Stay well-hydrated with water or other unsweetened beverages. For people with diabetes, monitor, and control blood sugar levels to help prevent new wounds from developing and to support healing and recovery. Patient verbalized understanding.
SN instructed patient and caregiver about Lymphedema disease, also known as lymphatic obstruction. Is a condition of localized fluid retention and tissue swelling caused by a compromised lymphatic system, which normally returns interstitial fluid to the thoracic duct and then the bloodstream. The condition can be inherited or can be caused by a birth defect, though it is frequently caused by cancer treatments, and by parasitic infections. Though incurable and progressive, a number of treatments can ameliorate symptoms. Tissues with lymphedema are at high risk of infection. Symptoms may include a feeling of heaviness or fullness, edema and ( occasionally ) aching pain in the affected area. In advanced lymphedema, there may be the presence of skin changes such as discoloration, verrucous ( wart-like ) hyperplasia, hyperkeratosis, and papillomatosis; and eventually deformity ( elephantiasis ). Patient verbalized understanding the teaching.
SN explained that the problems with the veins in the legs may lead to chronic venous insufficiency ( CVI ). CVI means that there is a long-term problem with the veins not being able to pump blood back to your heart. When this happens, blood stays in the legs and causes swelling and aching. Two problems that may lead to chronic venous insufficiency are: Damaged valves. Valves keep blood flowing from the legs through the blood vessels and back to the heart. When the valves are damaged, blood does not flow as well. Deep vein thrombosis ( DVT ). Blood clots may form in the deep veins of the legs. This may cause pain, redness, and swelling in the legs. It may also block the flow of blood back to the heart. Seek immediate medical care if you have these symptoms. A blood clot in the leg can also break off and travel to the lungs. This is called pulmonary embolism ( PE ). In the lungs, the clot can cut off the flow of blood. This may cause chest pain, trouble breathing, sweating, a fast heartbeat, coughing (may cough up blood), and fainting. It is a medical emergency and may cause death. Call 911 if you have these symptoms. Healthcare providers call the two conditions,Deep vein thrombosis ( DVT ) and pulmonary embolism ( PE ), venous thromboembolism ( VTE ).
Skilled Nursing visited PT, PT alert and oriented x 3 PERRL. SN assessed PT head to toe , Vital signs taken and recorded using universal precaution standard . Lungs Bilateral even , unlabored respiration, abdomen soft non distended, skin warm and dry to touch , no distress and complications noted at this time. Osteoarthritis can occur in any joint. It occurs most often in the hands, knees, hips, and spine. Warning signs are: Stiffness in a joint after getting out of bed or sitting for a long time. Swelling or tenderness in one or more joints. A crunching feeling or the sound of bone rubbing on bone. Taught that eating well-balanced meals and avoiding.Taught that avoiding excess sugar intake and avoiding excess salt intake are measures aimed to preventing/controlling Osteoarthritis.Taught that using assistive and/or protective devices, as needed, is a measure aimed to preventing/controlling Osteoarthritis.
Instructed caregiver persons with mental retardation are living longer and integrating into their communities. Primary medical care of persons with mental retardation should involve continuity of care, maintenance of comprehensive treatment documentation, routine periodic health screening, and an understanding of the unique medical and behavioral disorders common to this population. Office visits can be successful if physicians familiarize patients with the office and staff, plan for difficult behaviors, and administer mild sedation when appropriate. Some syndromes that cause mental retardation have specific medical and behavioral features. Health issues in these patients include respiratory problems, gastrointestinal disorders, challenging behaviors, and neurologic conditions. Some commonly overlooked health concerns are sexuality, sexually transmitted diseases, and end-of-life decisions.
SN educated patient and caregiver on medication Empagliflozin (jardiance). It is used along with diet and exercise, and sometimes with other medications, to lower blood sugar levels in people with type 2 diabetes. Empagliflozin is also used to reduce the risk of stroke, heart attack, or death in people who have type 2 diabetes along with heart and blood vessel disease.Taking medication(s), making lifestyle changes (e.g., diet, exercise, quitting smoking), and regularly checking your blood sugar may help to manage your diabetes and improve your health.This medication may cause changes in your blood sugar. You should know the symptoms of low and high blood sugar and what to do if you have these symptoms. Empagliflozin may cause side effects like urinating a lot, including at night, increased thirst. Tell your doctor if any of these symptoms are severe or do not go away:
Instructed in new medication Pred Forte to manage inflammation of palpebral and bulbar conjunctiva, cornea and anterior segment of globe. In addition, warned of possible S/E, such as, increased intraocular pressure, thinning of cornea, interference with corneal wound healing, increased susceptibility to viral or fungal corneal infections, corneal ulceration, discharge, discomfort, foreign body sensation, glaucoma exacerbation, cataracts, visual acuity and visual field defects, optic nerve damage with excessive or long-term use, systemic effects, and adrenal suppression with excessive or long-term use. Instructed to wash hands before and after installation and warned not to touch tip of dropper to eye or surrounding area. Apply light finger pressure on lacrimal sac for 1 minute after installation. On long-term therapy, have frequent tests of intraocular pressure. Instructed not to share drug, washcloths, or towels with family members, and notify MD if anyone develops same signs or symptoms. Stress importance of compliance with recommended therapy. Notify MD if improvement does not occur within several days or if pain, itching, or swelling of eye occurs. Instructed not to use leftover drug for new eye inflammation because serious problems may occur.