bedbound-patient
Procedures
Instructed patient caregiver knowledge of maintenance and care of PICC lines insures long term use. Problems, detected early, greatly decrease any complications that might be associated with this line.
Instructed patient / caregiver blood pressure readings in the arm cannulated with the PICC should be avoided.
Instructed patient / caregiver strenuous work, with hand cannulated, lifting objects greater than ten pounds, or repetitive motion should all be avoided.
Instructed patient / caregiver that if the catheter breaks, whether bleeding does or does not occur, do not panic. Using sterile gauze, apply sufficient pressure at the site so it is tightly and well covered and immediately report this to the physician. Maintain pressure on the site at all times.
Instructed patient about vacuum assisted closure ( VAC ) therapy as it promotes wound healing through negative pressure wound therapy.
Instructed patient about vacuum assisted closure ( VAC ) therapy helps draw wound edges together, remove infectious materials and actively promote granulation.
SN instructed patient to perform daily meticulous foot care, to be sure to dry feet completely after a bath, checking for any sores, cuts or scrapes and to report any wounds as soon as they appear to SN or MD. Also have a podiatrist cut toenails regularly to prevent ingrown toenails and other complications.
Skilled nurse teaching how patient performed colostomy care , washed the stoma itself and the skin around the stoma with soft paper towels, mild soap and water. Measured the stoma, cut out the opening, removed the paper back and set it aside. Finally hold the punch with the sticky side toward your body. Center the opening on the stoma , then press firmly abdomen for 30 seconds.
Patient is unable to perform wound care due to complexity of wound, location, size of wound, poor manual dexterity, forgetful (dementia), and knowledge deficit. No skilled/willing caregiver to perform wound care.
SN instructed patient on the importance of daily monitoring of the blood pressure; along with reporting an elevated BP of 160/90 and above to MD/SN stat.