bedbound-patient
General
SN instructed patient and caregiver to monitor circulation r/t Unna boots. Report if dressing is tight and constricting esp. in back of leg. Check color of feet and report if bluish or purple in color. Report any c/o numbness or tingling. Dressing should be removed immediately if any s/s occur. and notify physician or nurse.
Instructed patient to seek immediate medical care if any of the following situations occur besides vomiting: blood present in the vomit, severe headache, severe abdominal pain, fever over 101 degrees Fahrenheit, diarrhea or rapid breathing or pulse.
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.
Instructed caregiver about certain foods and beverages might irritate the patient's bladder, including: coffee, tea and carbonated drinks, even without caffeine. Caregiver verbalized.
Instructed caregiver you can take these steps to reduce the patient's risk of urinary tract infections: drink plenty of liquids, especially water. Drinking water helps dilute your urine and ensures that you'll urinate more frequently allowing bacteria to be flushed from your urinary tract before an infection can begin.
SN instructed that infrequent passage of hard, dry stool, low back pain, abdominal fullness and/or abdominal discomfort, decreased appetite, nausea and/or vomiting, and rectal pressure may constitute as signs/symptoms of constipation. Patient verbalized understanding.
SN instructed patient and caregiver on measures to prevent constipation: increasing fluids (prefer approx. 8 glasses of water daily) eating a diet high in fiber, and avoiding foods with sugars (pasta, pastries, cheese, rice, etc.), exercise regularly at a slow, steady pace, as directed by md if you are able. Both parties verbalized understanding.
SN instructed patient and caregiver on some measures aimed to controlling/managing constipation, such as: establish regular times for evacuations usually after a meal and drink a warm liquid one-half hour before breakfast to stimulate bowel movement, avoid laxative and enema abuse. Instructed on some potential complications of constipation, such as: stool impaction bowel blockage, liquid bowel movement may ooze around hard stool in the colon, pain, valsalva maneuver may be caused by straining, causing a slowed pulse, decreased blood return and increased venous pressure, rectal bleeding and rectal pain.
Instructed caregiver keep the patient's skin around her PEG tube dry. This will help prevent skin irritation and infection. Caregiver verbalized understanding.
Instructed patient Exercise Although resting for short periods can alleviate pain, too much rest may actually increase pain and put you at greater risk of injury when you again attempt movement. Research has shown that regular exercise can diminish pain in the long term by improving muscle tone, strength, and flexibility. Exercise may also cause a release of endorphins, the body's natural painkillers. Some exercises are easier for certain chronic pain sufferers to perform than others.