including damage eyes retinopathy which can lead blindness damage nerves neuropathy
General
Instructed patient that PCP only receives one snapshot of vitals signs including BP, and stressed importance of maintaining BP log so that PCP may adjust as needed.
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.
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 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.
SN instructed on intermittent claudication which is a condition caused by narrowing of the arteries that supply the legs with blood. Intermittent claudication causes pain in your calves when walking, Patients with intermittent claudication develop pain when they walk because not enough oxygen-containing blood reaches the active leg muscles. There are two main ways to treat claudication: medication and a surgical treatment, called revascularization. Medication therapies are often used initially as they are non-invasive. Compression therapy can also be used as a noninvasive way to treat symptoms of claudication. Intermittent calf compression has been shown in studies to improve symptoms-free walking distance.
Instructed patient in lifestyle and home remedies that may help decrease edema and keep it from coming back. Before trying any self-care techniques, talk to your doctor about which ones are right for you. Moving and using the muscles in the part of your body affected by edema, especially your legs, may help pump the excess fluid back toward your heart. Ask your doctor about exercises you can do that may reduce swelling. Patient verbalized understanding.
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.
Instructed patient Eat a heart-healthy diet Eating a healthy diet can reduce your risk of heart disease. A diet rich in fruits,
vegetables and whole grains can help protect your heart. Beans, other low-fat sources of protein and certain types of fish
also can reduce your risk of heart disease. Stop your activity if you feel short of breath, dizzy, or have any pain in your chest. Do not do any activity
or exercise that causes pulling or pain across your chest, (such as using a rowing machine, twisting, or lifting weights.
SN instructed that Swelling occurs whenever the organs, skin, or other parts of your body enlarge. It is typically the result of inflammation or a buildup of fluid. Swelling can occur internally (within the body) or it can affect your outer skin and muscles. A range of conditions can cause swelling.
SN instructed patient and caregiver on strategies that can significantly help decrease the risk of a fall such as: skid-proof mats or strips in the shower and bathtub, removal of furniture that can slip away if grabbed accidentally for support, supportive non-slip footwear and not walking in stocking feet. SN also instructed on side effects of most medications taking that could possibly cause dizziness and to report it so that it can be addressed by physician. Patient and caregiver voiced understanding of all instructions given.