bedbound-patient
Patient also instructed on Clostridium difficile colitis (C. diff) and the increase risk due to the multiple ABT. Patient instructed that the most common symptoms of Clostridium difficile colitis (C. diff) infection include: watery diarrhea, fever, loss of appetite, nausea, belly pain and tenderness. Instructed to clean their hands with soap and water or an alcohol-based hand rub often and every after going to the restroom.
Skilled nurse remove PICC,line per doctor order, the catheter tip should also be examined and there is no breakage at the end, no S/S of infections noted. Skilled nurse applied at the insertion site with sterile gauze to prevent bleeding which and when the bleeding stops, the gauze is removed and a sterile dressing is applied. Instructed patient the dressing should remain for approximately 24 hours. After this time, the site should be assessed and a new dressing applied if needed. Patient understand the instructions given.
Skilled nurse teach patient's and describe each step of the procedure , encouraging participation in ostomy care,teach patient about a new stoma techniques to use for cleansing. No signs of symptoms of infections noted.
SN instructed patient about oxycodone/ acetaminophen ,non-serious adverse reactions include lightheadedness, dizziness, drowsiness or sedation, nausea, and vomiting. These effects seem to be more prominent in ambulatory than in no ambulatory patients, and some of these adverse reactions may be alleviated if the patient lies down. Other adverse reactions include euphoria, dysphoria, constipation, and pruritus. Serious SE/AR include respiratory depression, apnea, respiratory arrest, circulatory depression, hypotension, and shock .
SN instructed patient on low salt diet. SN instructed patient on how to read nutritional labels on commercially prepared foods. Other salt alternatives such as Mrs. Dash was encouraged. SN explained how sodium affects blood pressure and water retention.
Instructed caregiver to call patient's doctor if patient have: fever or chills, redness, swelling, or pain that is getting worse. Bleeding or drainage from the hole.
Instructed patient classic barriers to spontaneous closure include distal obstruction, mucocutaneous continuity (ie, a short or epithelialized tract), and infection or malignancy in the tract. Comprehensive and effective management of the patient with fistula requires attention to fluid and electrolyte replacement, per fistula, skin, protection, infection control.
Instructed patient through the use of negative pressure wound therapy, a standard surgical drain, and optimized nutrition, fistula drainage was redirected and the abdominal wound healed, leaving a drain controlled enterocutaneous fistula. Patient control of fistula drainage and protection of surrounding tissue and skin is a principle of early fistula management.
SN instructed patient on high risk medication, anticoagulant, warfarin. Use precautions such as, Tell care providers you take warfarin before you have any medical or dental procedures, Avoid situations that increase your risk of injury, Use safer hygiene and grooming products, Consider wearing a bracelet or carrying a card that says you take warfarin. Patient understanding.
SN to instruct patient on lifestyle and home remedies like stopping alcohol driving if applicable, avoiding medication that may cause liver damage, help prevent other from coming in contact with infected blood. SN to instruct patient and caregiver on emergency preparedness and when to notify the doctor with new symptoms and/or concerns.