bedbound-patient
The patient was instructed in venous thrombosis in amount and records the size of the affected extremity daily. The patient was taught in the good skin care, using mild soap, rinse well, and dry gently. The patient was instructed in the use of antiembolic stockings for ambulation and times of extended sitting. The patient was instructed to remove them every 8 hours to evaluate the leg and skin. The patient was recommended to use of the bed cradle. The patient was recommended to apply of warm packs to the affected extremity.
Instructed patient about the signs and symptoms to call 9-1-1 with regard to diagnosis Congestive Heart Failure (CHF), or congestive heart failure, that may point to the condition being worsened and needing immediate medical attention by 9-1-1, call MD to report to MD: crackling noise that can be audibly heard as patient exhales, pink, frothy sputum that patient coughs out, patient has markedly increased shortness of breath that is not relieved even after 15 minutes of rest, may also be non-productive but incessant cough that includes crackling sound, rapid heart rate that may last more than 30 minutes (with or without dizziness), weight gain of more than 2-3 pounds in one day, or 5-7 pounds in seven days, lower extremity swelling which may or may not include fluid seeping through the skin. With regard to increased/increasing shortness of breath that is not relieved, however, told PCG and patient to remain calm and call 9-1-1 and not wait/call MD as it needs to be taken care of right away, because the patient needs oxygen in the body immediately - a medical emergency.
SN instructed patient / caregiver on headache which is a pain in any region of the head. SN instructed patient / caregiver that headache can occur on one or both sides of the head, be isolated to a certain location, radiate across the head from one point, or have a vise -like quality. SN instructed patient / caregiver on that headache may be a sharp pain, throbbing sensation or dull ache. SN instructed patient / caregiver that headache can appear gradually or suddenly. SN instructed patient / caregiver that headache can be triggered by lifestyle factors such alcohol (particularly red wine), certain foods (processed meats that contain nitrates), lack of sleep, poor postures, skipped meals and stress. SN instructed patient / caregiver on emergency preparedness and to encourage to report any new or severe symptoms.
SN instructed patient / caregiver that Hydralazine medication relaxes and expands blood vessels and is used to treat high blood pressure ( hypertension ). SN explained to patient / caregiver that side effects of this medication includes: dizziness, drowsiness, headache, constipation, loss of appetite, fatigue and nasal congestion may occur as your body adjusts to the medication. SN explained to patient / caregiver that to avoid dizziness and lightheadedness when rising from a seated or lying position, get up slowly. SN instructed patient / caregiver to inform doctor if you develop: chest pain, muscle pain, swelling of the hands or feet, yellowing of the eyes / skin, joint pain, a change in the amount of urine. SN explained to patient / caregiver that this drug may cause numbness or tingling of the fingers and toes and that if this occurs, notify doctor. SN explained to patient / caregiver that symptoms of an allergic reaction include: rash, itching, swelling, dizziness, trouble breathing and should be reported immediately for prompt treatment.
SN instructed patient regarding medication Lipitor. SN informed patient / caregiver that Lipitor is a medication that reduces levels of bad cholesterol ( LDL ) and triglyceride in the blood while increasing the level of good cholesterol ( HDL ). SN explained that this medication is used to treat high cholesterol and to lower risk of stroke, heart attack or other heart complication in people with type 2 diabetes. SN informed patient / caregiver that patient should eat low cholesterol diet and avoid drinking alcoholic beverages when taking lipitor because it increase risk of liver damage. SN explained to patient / caregiver that side effects to watch out for are unexplained muscle pain, fever and dark colored urine, swelling urinating less than usual and weight gain. SN instructed patient / caregiver to report any persistence or worsening of side effects.
SN educated patient on the importance of daily vital sign monitoring. Due to patients disease processes it is important to monitor blood pressure, weight, pulse and oxygen daily if equipment is available. SN instructed patient to weigh correctly they need to wake up, pee and than weigh daily at the same time if possible, same amount of clothing, same area. Patient is to weigh prior to eating/drinking in the morning. Notify home health or PCP if -/+ 3 lbs in a day or +/-5 lbs in a week is seen. SN educated patient to monitor blood pressure and pulse, and instructed to check before medications and if elevated/low recheck in 1-2 hours. SN educated patient to always log vitals so patients MD has a larger snap shot on what is going on.Patient/CG verbalized understanding
The patient was instructed in bone marrow transplantation in preventing complications like infection, bleeding, and stomatitis. The patient was advised to prevent infections in to wear mask when outside the in public, avoid contact with persons who may be infectious, avoid crowds, grocery stores, theaters, etc. The patient was taught in measures to prevent bleeding maintaining a safe environment, avoid using sharp objects etc. The patient was encouraged in prevent stomatitis maintaining a routine oral hygiene in the morning, after meals and at bedtime, avoid patient to use mouthwash containing alcohol.
The patient was instructed in the breast surgery that if the axillary nodes are removed, the affected arm may inflate and is less able to fight infection. The patient was advised on daily arm exercises. The patient was taught to change dressing, evaluate appearance of the incision and drain site. The patient was encouraged not to abduct the affected arm or raise the arm or elbow above the shoulder until drains are removed. The patient was instructed to avoid use of deodorants, to avoid wearing constricting clothing or jewelry on the affected arm and to carry her handbag on the unaffected arm.
The patient was instructed in compartment syndrome if surgical treatment was performed such as fasciotomy emphasize there is an increased potential for infection. The patient was reviewed in the proper technique for care of the surgical incision and aseptic procedures for dressing changes. The patient was advised to inspect the wound daily to check for increased drainage. The patient was recommended the need for rest and elevation of the extremity postoperatively. The patient was encouraged to use of assistive devices.
The patient was instructed in burns and its classification. The patient was advised that the curative process with new skin progress is expected in 6 weeks with mature healing within 6 to 12 months, depending on the extended of injury. The patient was taught to care of healed burns, avoiding exposure to direct sunlight, harsh detergent, fabric softeners etc., avoid contact with persons with infections especially upper respiratory infections. The patient was recommended to obtain medical supplies for dressing and any special assistive devices for home care management. The patient was encouraged in the importance of physiotherapy to assist in the exercise regimen and water exercises to maintain limb mobility.