diabetic foot care
Procedures
SN instructed patient to perform daily meticulous footcare, 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.
Instructed caregiver the patient are at high risk if the patient have or do the following: Neuropathy, Poor circulation, A foot deformity (e.g., bunion, hammer toe), Wear inappropriate shoes, Uncontrolled blood sugar, History of a previous foot ulceration.
Instructed patient to cleanse feet daily, dry thoroughly especially in between toes. Examine feet daily for bruises/sores/blisters, if any noted, notify MD asap. (use a mirror if needed to visualize) Wear proper fitting shoes and wear slippers/shoes at all times, and exercise feet daily. Demonstrated feet exercises, verbalized understanding.
SN completed assessment done on all body systems and noted patient with elevated blood pressure during visit. SN completed treatment during visit and noted no drainage on old tx, wound callused and new area found to left medial top of foot remains intact with no drainage noted. SN noted patient complaint of pain to bilateral lower extremities with +2 edema noted. SN educated primary caregiver on the importance of elevation of bilateral lower extremities as well as pain management for patient.
The patient was instructed in cervical cancer explaining of type of cancer and the therapeutic or surgical procedures to be performed.
Patient Undergoing Surgery, the patient was reviewed avoid coitus and douching for 2 to 6 weeks after surgery, avoid heavy lifting and vigorous activities.
Patient Undergoing Cryosurgery/Laser Therapy , the patient was taught that perineal drainage is clear and watery initially progressing to a foul-smelling discharge that contains dead cells, reviewed perineal care and hygiene, recommended need for regular Papanicolaou and pelvic examinations.
Patient Undergoing Pelvic Exenteration, the patient was instructed to obtain appropriate supplies for ostomy care, the patient was taught on perineal care explaining the drainage may continue for several month, the patient was reviewed in wound irrigation procedures and application of sanitary pads, avoid prolonged sitting.
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.
Instructed caregiver the key to successful wound healing is regular podiatric medical care to ensure the following “gold standard” of care: Lowering blood sugar, appropriate debridement of wounds, treating any infection, reducing friction and pressure, restoring adequate blood flow.
Tracheostomy care Instructed patient patients with a tracheostomy have altered upper airway function and may have increased oral care
requirements. Mouth care should assessed by the nurse caring for the patient.
Taught the patient how to care of wound and dressing changes. The patient was instructed to care for drains if he/she was discharged with them. The patient was advised to avoid lifting anything over 10 pounds for the first 6 weeks.
The patient was instructed in cholecystectomy specific care of the surgical incision and dressing changes. The patient was taught how to care for the T-tube and drainage bag.
Laparoscopy, the patient was encouraged to increase mobility to reduce abdominal distention.
Open Cholecystectomy, the patient was instructed avoid lifting > 10 pounds for the first 4 to 6 weeks.