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SN instructed patient / caregiver on service authorization, advance directives, rights and responsibilities, rights of the elderly and obtained necessary signatures. Instructed patient / caregiver on 24 hour nurse availability and provided / posted the agency telephone number. Also instructed that after hours, weekends and holidays an answering service will reach the nurse and he / she will return the patient / caregiver call and answer any questions or make a visit if needed. Patient and caregiver stated understanding. Patient and caregiver educated on diabetic diet, diabetic foot care, symptoms / signs ( s / s ) of depression, managing pain with medications, healthy skin, and pressure ulcer prevention. Leaflets left in home.
SN instructed patient and caregiver that the key difference between a suspected deep tissue injury (sDTI) and an unstageable pressure ulcer is that sDTI involves intact skin, whereas an unstageable ulcer involves a breakdown into at least the subcutaneous tissue. An unstageable ulcer is covered with necrotic tissue, such as slough or eschar, formed from remnants of the collagen matrix of subcutaneous tissue. So it’s always a full-thickness ulcer either stage III or stage IV.
Patient was instructed on the importance of oxygen. Oxygen plays a vital role in the circulatory and respiratory systems. As breathing, oxygen that is inhaled purifies the blood by removing poisonous waste products circulating throughout our blood system.
Instructed patient about the importance of injecting insulin not exactly in the same place each time, but move around in the same area so the insulin reaches the blood with the same speed with each shot.
Patient was instructed on what cause leg edema. It can be caused by a serious condition of the kidney, heart, liver or blood vessels, but many other factors can contribute to its onset, including: abusing drugs, sodium retention, varicose veins and history of phlebitis, allergic reactions, neuromuscular disorders, trauma.
Patient was instructed on a healthy mouth. Poor oral mouth can make diabetes more difficult to control. Infections may cause the blood sugar to rise and require more insulin to keep it under control. In addition diabetes can diminish the ability to taste sweets influencing and changing food choices in favor of additional sweeter tasting foods, thereby affecting the dental health.
Patient was instructed that neuropathy is a long term complication of diabetes, which means it typically takes many years for it to develop. To prevent and reduce the risk of diabetic neuropathy: blood glucose control, a balanced eating and exercises can help fend off neuropathy.
The best treatment for nerve pain, ultimately, is to manage your diabetes well. In fact, a major study by the American Diabetes Association in 2006 showed that strict blood glucose control with intensive insulin therapy lowered the chances of having symptoms of peripheral neuropathy - tingling, burning, and pain - by 64%. While you can't control whether or not you get diabetic nerve pain, you can help control your glucose levels with diet, exercise, and mediations if you need them.
Patient was instructed on diabetes complications such as nerves damage (diabetic neuropathy). Nerve damage occurs because excess sugar injures the walls of the tiny blood vessels (capillaries) that nourish the nerves.
Patient was instructed on the importance of a good foot care. Keep the blood sugar level as normal as possible. Wash the feet every day with lukewarm water and mild soap. Dry them well, especially between the toes. Pat gently.