bedbound-patient
SN instructed patient / caregiver regarding medication Glimepiride. SN instructed patient / caregiver that Glimepiride is a antidiabetic medication that lowers blood sugar level. SN instructed patient / caregiver to check blood sugar before taking the medication to avoid hypoglycemia. SN explained to patient / caregiver that low blood sugar ( hypoglycemia ) can occur during glimepiride therapy. SN explained that the symptoms of low blood sugar include hunger, nausea, tiredness, perspiration, headache, heart palpitations, numbness around the mouth, tingling in the fingers, tremors, muscle weakness, blurred vision, cold temperature, excessive yawning, irritability, confusion, or loss of consciousness. SN instructed patient / caregiver to notify physician ( MD ) if experiencing persistence of these side effects.
SN instructed patient / caregiver regarding medication Levaquin. SN taught patient / caregiver that levaquin is an antibiotic and that it is used to treat bacterial infections. SN explained to patient that taking levaquin can make the skin more sensitive to sunlight and also may cause swelling or tearing of a tendon. SN explained to patient / caregiver that the side effects of this medication includes headache, nausea, constipation, diarrhea, difficulty sleeping, dry mouth and ear problems. SN instructed patient to notify physician ( MD ) if experiencing persistence or worsening of side effects.
SN instructed patient / caregiver on service authorization, advance directives, rights and responsibilities, rights of the elderly and obtained necessary signatures. Instructed patient / caregiver on 24 hour nurse availability and provided / posted the agency telephone number. Also instructed that after hours, weekends and holidays an answering service will reach the nurse and he / she will return the patient / caregiver call and answer any questions or make a visit if needed. Patient and caregiver stated understanding. Patient and caregiver educated on diabetic diet, diabetic foot care, symptoms / signs ( s / s ) of depression, managing pain with medications, healthy skin, and pressure ulcer prevention. Leaflets left in home.
SN instructed patient / parent to ensure the drain is below the site of insertion but not pulling on the patient. Instructed the patient / parent that there is a risk of dislodgment, requiring increased care when moving. Patient should be aware that moving whilst drain is in situ will cause some pain, but this can be minimised with regular analgesia and the patient should be encouraged to mobilise with supervision when appropriate.
SN educated patient and caregiver on the importance of always using assistive device with ambulation and transfers to avoid falls or injuries. Nurse instructed patient and caregiver on the importance of home safety such as proper lighting, and to keep walkways free of debris and clutter. Patient was instructed to contact PCP or home health agency if they fall or if current health status declines. Patient was instructed to not walk unassisted when not feeling steady . Patient verbalized understanding
SN to educate patient on CPAP machine as follows: CPAP stands for continuous positive airway pressure. The machines help people with sleep apnea breathe more easily and regularly every night while they are sleeping. A CPAP machine increases the air pressure in your throat to prevent your airway from collapsing when you inhale. Patient admits that most nights he goes to bed with Cpap, but finds mask on floor after waking in AM. SN to advise patient of importance of wearing Cpap as follows: The CPAP breathing machine is used by people with chronic obstructive sleep apnea, a disorder which causes airways to close up during sleep. People with obstructive sleep apnea stop breathing while sleeping. When breathing stops the individual is suddenly jolted awake, gasping for air. Patient to deny any sleep issues lately. People with sleep apnea often do not remember these episodes, but instead experience chronic fatigue that they have no explanation for. Over time, sleep apnea can increase the risk of hypertension, heart failure, heart attack, and stroke. Patient verbalized understanding of teaching today. SN to continue to monitor.
The patient was instructed to develop skills need to self-care and improve independence with blindness (visual impairment). The patient was reviewed to explore furniture, steps, and doorways in his/her home through guidance and touch. When walking alone use cane or walking stick to identify obstacles. The patient was taught on caring for the eyes. The patient was reviewing the method of administering eyes drops or ointment.
The patient was instructed in bone marrow suppression that will be more susceptible to infection, bleeding, and anemia. The patient was encouraged in the prevention of the infection by eating healthy meals, keep mouth, teeth and gums clean, avoid people who are sick. The patient was encouraged in the prevention of the bleeding avoiding physical activities that could cause injuries. The patient was encouraged in the prevention in the anemia by eating a high-protein diet, and multivitamin supplement with minerals.
The patient was reviewed in breast cancer the prescribed surgical procedure and adjuvant therapy to be carried out. The patient was instructed that the decision is based on the phase of breast cancer, age, menopausal stage, hormonal receptor status, and patient preference. The patient was encouraged to discuss the feelings and emotions concerning awaiting surgery, adjuvant therapies, and prognosis. Explain misconceptions.
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.