pressure ulcer
General
SN instructed patient about on gastric ulcer. Gastric ulcers occur on the inside of the stomach. Pain is the most common symptom. The pain is caused by the ulcer and is aggravated by stomach acid coming in contact with the ulcerated area. The pain typically may: Be felt anywhere from your navel up to your breastbone. Be worse when your stomach is empty. Flare at night. Often be temporarily relieved by eating certain foods that buffer stomach acid or by taking an acid-reducing medication. Disappear and then return for a few days or weeks. See your doctor: If vomiting of blood — which may appear red or black. Dark blood in stools or stools that are black or tarry. Nausea or vomiting. Unexplained weight loss. Appetite changes.
SN teaching patient / caregiver on measures to prevent pressure ulcers, such as: Clean skin at times of soiling, avoid irritating cleaning agents, use moisturizers on dry skin, do not message bony prominences, keep skin clean and dry, and comply with proper lifting and positioning techniques.
Instructed caregiver reducing additional risk factors, such as , high cholesterol, and elevated blood glucose, are important in prevention and treatment of a diabetic foot ulcer. Wearing the appropriate shoes and socks will go a long way in reducing risks. the patient podiatrist can provide guidance in selecting the proper shoes.
Sn Instructed on importance in logging blood pressure daily to ensure medication treatment is working and to manage medical condition. Instruction to log at about the same time daily. Instructions on parameters and when to call physician / nurse. Instruction given to take log to physician's apt to show physician ( MD ) his blood pressure readings. Patient / caregiver verbalized understanding
Instructed caregiver how to prevent Pressure Ulcers for Bed bound patients: Protect the Skin
patient from injury - Avoid massaging the skin on bony parts of the patient body. Limit pressure
on bony areas by changing positions frequently. If the patient in a bed, preferably every 2 hours.
Instructed patient abour the V.A.C. therapy System is an Advanced Wound Therapy System consisting of a V.A.C. Therapy unit that delivers negative pressure and a sterile plastic tubing with SensaT.R.A.C, pressure sensing lumens that connect the therapy unit to the dressing Special foam dressings. KCI recommends the V.A.C. Dressings be changed every 48 to 72 hours, but no less than 3 times per week. Patient has the ability to move around depending on the condition, the wound location and type of therapy unit prescribed. The V.A.C. Therapy System may be disconnected so you can take a shower. Therapy may not be off any longer than two hours per day.
SN instructed the reason it is important to help or use proper turning techniques to prevent friction and shearing of skin. Friction usually, but not always, accompanies shear. Friction is the force of rubbing two surfaces against one another. Shear is the result of gravity pushing down on the patient's body and the resistance between the patient and the chair or bed. When combined with gravity/force (pressure), friction causes shear, and the outcome can be more devastating than pressure alone.
SN instructed patient that High blood pressure makes your heart work harder than it needed to before. Over the space of many years, this extra effort can lead to the heart muscle becoming thicker and less effective at pushing the blood round. This allows fluid to build up in your lower legs and ankles, which causes them to swell up.
SN educated patient on the importance of daily vital sign monitoring. Due to patients disease processes it is important to monitor blood pressure, weight, pulse and oxygen daily if equipment is available. SN instructed patient to weigh correctly they need to wake up, pee and than weigh daily at the same time if possible, same amount of clothing, same area. Patient is to weigh prior to eating/drinking in the morning. Notify home health or PCP if -/+ 3 lbs in a day or +/-5 lbs in a week is seen. SN educated patient to monitor blood pressure and pulse, and instructed to check before medications and if elevated/low recheck in 1-2 hours. SN educated patient to always log vitals so patients MD has a larger snap shot on what is going on.Patient/CG verbalized understanding
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.