including damage eyes retinopathy which can lead blindness damage nerves neuropathy
Medications
Instructed in new medication Allopuriniol and in S/E such as drowsiness, fever, headache, paresthesia, peripheral neuropathy, neuritis, hypersensitivity vasculitis, necrotizing angiitis, epistaxis, nausea, vomiting, diarrhea, abdominal pain, gastritis, taste loss (or perversion, dyspepsia), renal failure, uremia, agranulocytosis, anemia, aplastic anemia, thrombocytopenia, leukopenia, leukocytosis, eosinophilia, hepatitis, hepatic necrosis, hepatomegaly, cholestatic jaundice, arthralgia, myopathy, rash, exfoliative, urticarial, and purpuric lesions, erythema multiforme, severe furunculosis of nose, ichthyosis, alopecia, toxic epidermal necrolysis, ecchymoses, chills.
Instructed in new medication Amitriptyline to manage depression. In additon, warned of possible S/E such as coma, seizures, hallucinations, delusions, disorientation, ataxia, tremor, peripheral neuropathy, anxiety, insomnia, restlessness, drowsiness, dizziness, weakness, fatigue, headache, extrapyramidal reactions, MI, stroke, arrhythmias, heart block, orthostatic hypotension, tachycardia, ECG changes, hypertension, edema, blurred vision, tinnitus, mydriasis, increased intraocular pressure, dry mouth, nausea, vomiting, anorexia, epigastric distress, diarrhea, constipation, paralytic ileum, urine retention, agranulocytosis, thrombocytopenia, leukopenia, eosinophilia, hypoglycemia, hyperglycemia, rash, urticaria, photosensitivity, diaphoresis and hypersensitivity reaction. Instructed to take full dose at bedtime but warned patient of possible morning orthostatic hypotension. Avoid alcohol during drug therapy. Consult MD before taking other medications. Avoid activities that require alertness and good psychomotor coordination until CNS effects of drug are known. Drowsiness and dizziness usually subside after a few weeks. Dry mouth may be relieved with sugarless hard candy or gum. Saliva substitutes may be needed. Instructed to use a sun block, wear protective clothing and avoid prolonged exposure to strong sunlight. To prevent photosensitivity reactions. Do not stop drug therapy abruptly.
SN instructed patient / caregiver about Bethanechol. Sometimes given orally or subcutaneously to treat urinary retention resulting from general anesthetic, diabetic neuropathy of the bladder, or a side effect of antidepressants or to treat gastrointestinal atony (lack of muscular tone). Adverse reaction are rare following oral administration of Bethanechol, but are more common following subcutaneous injection. Adverse reactions are more likely to occur when dosage is increased. Adverse reactions that have been observed: Body as a Whole: malaise; Digestive: abdominal cramps or discomfort, colicky pain, nausea and belching, diarrhea, borborygmi, salivation; Renal: urinary urgency; Nervous System: headache; Cardiovascular: a fall in blood pressure with reflux tachycardia, vasomotor response; Skin: flushing producing a feeling of warmth, sensation of heat about the face, sweating; Respiratory: bronchial constriction, asthmatic attacks; Special Senses: lacrimation, miosis.
SN instructed patient that Zocor( Simvastatin) may infrequently cause muscle problems , whichcan rarely lead to very serious conditions called rhabdomyolysis and autoimmune myopathy. Daily use of alcohol may increase your risk for liver problems, especially when combined with simvastatin.
Sn instructed patient that venelex ointment contains balsam peru 87.0mg and castor oil usp 788.0mg in an ointment base of glyceryl monostearate and trypsin. It promotes debridement of eschar and other necrotic tissue. Balsam peru is a effective capillary bed stimulant used to increase circulation in the wound site area. Also, balsam peru has a mildly bactericidal action. Castor oil improves epithelialization by reducing premature epithelial desiccation and cornification. Also, it can act as a protective covering and aids in the reduction of pain. Venelex ointment is used to promote wound healing and the treatment of decubitus ulcers, varicose ulcers and dehiscent wounds. Venelex™ ointment is easy to apply and quickly reduces odors frequently accompanying a decubitus ulcer. The wound may be left open or appropriate dressing applied. Please note that wounds generally heal poorly in the presence of hemoglobin or zinc deficiency. Venelex™ ointment can relieve pain and promote healing. Venelex ointment is for external use only. Do not apply to fresh arterial clots. Avoid contact with eyes. Keep this and all other medications out of reach of children. Keep tightly closed. Use only as directed by a physician. When applied to a sensitive area, a temporary stinging may occur. Apply a thin film of venelex™ ointment topically a minimum of twice daily or as often as necessary. Wound may be left unbandaged or appropriate dressing can be applied. To remove, wash gently with an appropriate wound cleanser.
SN instructed about the Plaquenil. Some people taking this medication over long periods of time or at high doses have developed irreversible damage to the retina of the eye. Stop taking hydroxychloroquine and call your doctor at once if you have trouble focusing, if you see light streaks or flashes in your vision, or if you notice any swelling or color changes in your eyes.
Skilled nurse instructed patient about medication Famotidine is used to treat ulcers (sores on the lining of the stomach or small intestine); gastroesophageal reflux disease (GERD, a condition in which backward flow of acid from the stomach causes heartburn and injury of the esophagus [tube that connects the mouth and stomach. Shake the liquid well for 5 to 10 seconds before each use to mix the medicine evenly. Swallow the tablets and capsules with a full glass of water.The following symptoms are common, but if you experience any of them call your doctor immediately: hives, skin rash, itching, swelling of the face, throat, tongue, lips, eyes, hands, feet, ankles, or lower legs.
SN instructed patient / caregiver regarding Metoprolol Tartrate, which is in a group of drugs called beta - blockers. That is affect the heart and circulation ( blood flow through arteries and veins ). Metoprolol is used to treat angina ( chest pain ) and hypertension ( high blood pressure ). It is also used to treat or prevent heart attack. Call your doctor at once if you have any of these serious side effects: chest pain, pounding heartbeats or fluttering in your chest, feeling light - headed, fainting; feeling short of breath, even with mild exertion, swelling of your hands or feet, nausea, upper stomach pain, itching, loss of appetite, dark urine, clay - colored stools, jaundice ( yellowing of the skin or eyes ), easy bruising, unusual bleeding ( nose, mouth, vagina, or rectum ), purple or red pinpoint spots under your skin, wheezing, trouble breathing. Less serious side effects may include: dry mouth, constipation, heartburn, vomiting, diarrhea, headache, drowsiness, tired feeling, sleep problems ( insomnia ), or anxiety, nervousness. Do not suddenly stop taking metoprolol tartrate. Sharp chest pain, irregular heartbeat, and sometimes heart attack may occur if you suddenly stop metoprolol tartrate. The risk may be greater if you have certain types of heart disease. Tell your doctor or dentist that you take metoprolol tartrate before you receive any medical or dental care, emergency care or surgery.
SN instructed patient / caregiver on the medication Oxybutynin. This medication is used to treat overactive bladder a condition in which the bladder muscles contract uncontrollably ( spasms ) and cause frequent urination, an urgent need to urinate, and / or the inability to control urination. Oxybutynin is in a class of medications called anticholinergics. It works by relaxing the bladder muscles. Possible side effects included: Dry mouth or eyes ( less common - dry nose or skin ), dizziness and / or drowsiness, mild constipation, upset stomach, heartburn, nausea, blurred vision or ( eye ) sensitivity to light. Patient / caregiver verbalized understanding.
SN instructed patient on medication Sofosbuvir. Is used with other antiviral medications ( such as ribavirin, peginterferon, daclatasvir ) to treat chronic ( long-lasting ) hepatitis C, a viral infection of the liver. It works by reducing the amount of hepatitis C virus in your body, which may help your liver recover. Chronic hepatitis C infection can cause serious liver problems such as scarring ( cirrhosis ), or liver cancer.Sofosbuvir in combination with other antiviral medications reduces the amount of hepatitis C virus in the body and helps the body's immune system fight the infection. It is not known if this treatment can prevent you from passing the virus to others. Do not share needles, and practice "safer sex" ( including the use of latex condoms ) to lower the risk of passing the virus to others.Fairly understood the teaching.