including damage eyes retinopathy which can lead blindness damage nerves neuropathy
Procedures
Instructed patient DO NOT massage the skin near or on the ulcer. This can cause more damage. DO NOT use donut-shaped or ring-shaped cushions. They reduce blood flow to the area, which may cause sores.
Patient was instructed to help your ulcer heal more quickly, follow the advice below: try to keep active by walking regularly, whenever you're sitting or lying down, keep your affected leg elevated with your toes level with your eyes.
Instructed patient If you do put tape around the skin barrier edges do not remove the tape after water activities. Removing the
tape may cause the skin barrier to loosen. It is helpful to hold your skin smooth as you put your pouching system on to avoid wrinkles that may lead to leakage.
Phlebitis, or an inflammation of the vein, may occur when receiving IV antibiotics whichcan be irritating to smaller veins. Symptoms of phlebitis include redness, tenderness and swelling. Education about recognition of these complications allows the patient to be involved and can help reduce the risk of further complications related to IV therapy.
Patient was instructed on strategies that can significantly help decrease the risk of a fall such as: Skid-proof mats or strips in the shower and bathtub, Removal of furniture that can slip away if grabbed accidentally for support, supportive non-slip footwear and not walking in stocking feet. Patient currently uses cane while ambulating and states that it helps her with her balance. Patient advised that side effects of most medications taking can cause dizziness and to report and dizziness so that it can be addressed by MD. Patient voiced understanding SN will continue to monitor.
RN performed supervision with HHA present and reviewed that the HHA Care Plan is followed as ordered. Patient is satisfied with rendered services. RN instructed patient and caregiver on strategies that can significantly help decrease the risk of a fall such as: skid - proof mats or strips in the shower and bathtub, removal of furniture that can slip away if grabbed accidentally for support, supportive non - slip footwear and not walking in stocking feet. RN also explained that side effects of most medications taking can cause dizziness and advised to immediately report the occurrence of dizziness so that it can be addressed by physician. Patient and caregiver voiced understanding of all instructions given.
The patient was instructed in gastrostomy indicating the training and management of tube feedings, including quantity and regularity. The patient was advised to sit upright during feeding and for 1 hour after feeding to prevent reflux into the esophagus or backflow into the gastrostomy tube. The patient was explained to take care of the gastrostomy tube. The patient was taught that the tube may eventually be removed and inserted only for feeding. The patient was taught to protect the stoma with a small gauze pad.
Medication profile reviewed and reconciled. SN reviewed and instructed patient on medication regimen of spirivia. Instructed patient that medication is used for maintenance treatment of bronchospasm associated with chronic obstructive pulmonary disease (COPD). Spiriva HandiHaler is indicated to reduce exacerbations in COPD patients. Instructed patient that, with administration of Spiriva HandiHaler, a Spiriva capsule is placed into the center chamber of the HandiHaler device. The capsule is pierced by pressing and releasing the green piercing button on the side of the HandiHaler device. The tiotropium formulation is dispersed into the air stream when its inhaled through the mouthpiece. Instructed to inhale once or twice to get al medication inhaled. Instructed patient that dry mouth or constipation may occur. Instructed to notify MD/SN right away if any serious side effects, including: vision changes (such as blurred vision, seeing halos), eye pain, difficult/painful urination, fast heartbeat.
SN instructed patient / caregiver that urine drainage bag of the catheter should always be suspended below the level of the pubic bone, including during walking or sitting. Cleaning the groin and buttock areas regularly will decrease contamination of the catheter and the risk of infection. Anchoring the catheter to the leg with the provided strap prevents tugging injuries of the urethra.
Tracheostomy care Instructed patient to contact the doctors or nurse if there are any signs of infection at the stoma site including
any redness, odor, swelling.