pressure ulcer prevention
General
SN instructed patient on spontaneous coronary artery dissection ( SCAD ) and stent placement. A stent is a small rod made out of metal or fabric. It is inserted into a coronary artery when there is a blockage or when the artery is narrow. A coronary artery is a blood vessel that carries oxygen to the heart muscle. You received a stent due to coronary artery disease ( also called SCAD). That is caused by a thickening of the inside walls of the coronary arteries. This thickening is called atherosclerosis. A fatty substance called plaque builds up inside the thickened walls of the arteries, blocking or slowing the flow of blood. If your heart muscle doesn't get enough blood to work properly, you may have angina ( chest pain ) or a heart attack. The stent will help hold the artery open so blood can flow and help keep the artery from narrowing again. You will need to take medicine that keeps the stent open and blood flowing. It is very important to take the medicine exactly how your doctor tells you to take it. In addition to taking medicine, the best way to keep your heart healthy is to maintain a healthy lifestyle. Quit smoking. Make sure you keep your blood pressure and cholesterol at healthy levels. Exercise as recommended by your doctor. Eat a heart - healthy diet. Patient verbalized understanding well.
SN instructed that urinary tract infection generally develops when bacteria enter the urinary tract and begin multiplying. The most common urinary tract infections are cystitis, which affects the bladder, and urethritis, which affects the urethra. Urinary tract infections are the second most common type of infection that develop in the body. Symptoms of the infection include burning or pain during urination, an urge to urinate often, pressure in the lower belly, foul-smelling urine, back pain below the ribs, tiredness or shakiness, fever and urine that looks reddish or cloudy. A urinary tract infection is more likely to occur in women than men, and it affects people of all ages.
SN instructed patient on ways of reducing nausea such as, get some fresh air, open a window and take a walk outside. Apply a cool compress to the forehead or back of the neck. Sit up for about an hour after eating to relieve any pressure on the stomach. Try alternative therapies like meditation and acupuncture. Eat smaller meals. Patient nods head in understanding.
SN instructed patient that the incentive spirometer is used to improve the function of their lungs, and for patient to breathe in from the device as slowly and as deeply as possible, then holds their breath for 2 – 6 seconds, which provides back pressure that pops open alveoli. Patient should do this ten times and repeat 2 to 3 times a day.
Sn instructed on monitoring vital signs blood pressure, temperature, oxygen and weight instructed on what equipment is needed and SN will instruct on equipment logging and reporting of vital signs. Sn instructed on importance in logging vital signs and monitoring if medication is working or change of condition. Sn will instruct patient after vitals are done on what to report to physician / nurse ( MD / SN ). Patient verbalized understanding.
Sn Instructed patient / caregiver on the importance in logging blood pressure, blood sugar, oxygen and temperature daily to ensure medication treatment is working. Sn instructed on parameters and what to report to Physician / nurse ( MD / SN ). Instructed that it is important to know parameters and when to contact physician. Instructed this is a good practice to manage medical condition. Patient / caregiver verbalized understanding.
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.
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 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.
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.