pressure ulcer
Others
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 a good foot care. Calluses indicate that areas of the feet are receiving too much pressure. If the increased pressure continues, the skin may break down and it is possible to get a foot ulcer.
SN instructed patient about high blood pressure. Normal blood pressure is when your blood pressure is lower than 120 / 80 mm / Hg most of the time. High blood pressure ( hypertension ) is when your blood pressure is 140 / 90 mm / Hg or above most of the time.
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 that reducing sodium intake lowers blood pressure and prevent the collection of fluid in the lower legs or abdomen. People with chronic kidney disease must control sodium intake to prevent volume overload, which increases blood pressure and causes swelling. Food to eat any fresh or frozen beef, lamb, pork, poultry and fish. Eggs and egg substitutes. Low-sodium peanut butter. Dry peas and beans (not canned) drained, water or oil packed canned fish or poultry foods to avoid canned food canned vegetables processed meats salted snacks such as, salted peanuts, salted almonds etc.
Patient was instructed on symptoms of leg edema. If having leg edema feet and legs will initially appear swollen as the day progresses. After a period of time, however, the swelling will set in first thing in the morning and worsen throughout the day. Over time other symptoms will develop: High blood pressure, headaches, increased urination, palpitations, swollen hands and/or wrists, puffy eyes, weight gain.
Patient was instructed on relieving and preventing leg edema. The first line of defense is: leg elevation. Elevate legs above the level of the heart which puts minimal pressure on the back of the knees and thighs and lower back. Other help to decrease swelling is limiting salt intake, drink plenty of water, avoid sitting with the feet dependent. Do not abuse diuretics and laxatives.
Patient was instructed on other reasons Why Older People Fall such as: Lightheadedness with standing caused by postural hypotension (blood pressure that drops dramatically with standing), other forms of dizziness, persistent pain in any part of the leg.
If your big toe slants sharply in toward your other toes, with a big bump on the knuckle of your big toe, you've got a classic bunion. Corns are spots of thick, rough skin, where the tissue builds up on toes constantly barraged by too much rubbing or pressure. A buckled-under toe, called a hammertoe, can result from muscle weakness caused by diabetic nerve damage. All of these make it hard to fit shoes comfortably. But a good podiatrist can help you fix these problems and take better care of your feet.
Patient was instructed on the importance of a good skin care which can prevent most pressure sores (bedsores) which develop in people who have already skin damage, who are mentally confused, who are bed bound or cannot turn side to side.