chronic kidney disease
Instructed patient during periods of stress, the body releases so-called stress hormones, which cause a rise in blood glucose level. In the short term, this gives the body the extra energy it needs to cope with the stress. But if a person doesn’t have adequate insulin circulating in his bloodstream to enable his cells to use the extra energy, the result will be hyperglycemia. And if stress becomes chronic, hyperglycemia can also become chronic.
SN instructed patient on medication Sofosbuvir. Is used with other antiviral medications ( such as ribavirin, peginterferon, daclatasvir ) to treat chronic ( long-lasting ) hepatitis C, a viral infection of the liver. It works by reducing the amount of hepatitis C virus in your body, which may help your liver recover. Chronic hepatitis C infection can cause serious liver problems such as scarring ( cirrhosis ), or liver cancer.Sofosbuvir in combination with other antiviral medications reduces the amount of hepatitis C virus in the body and helps the body's immune system fight the infection. It is not known if this treatment can prevent you from passing the virus to others. Do not share needles, and practice "safer sex" ( including the use of latex condoms ) to lower the risk of passing the virus to others.Fairly understood the teaching.
SN instructed patient on medication Daclatasvir is used with another antiviral medication ( sofosbuvir ) to treat chronic ( long-lasting ) hepatitis C, a viral infection of the liver. Daclatasvir should never be used without sofosbuvir. Daclatasvir and sofosbuvir may also be used with another antiviral medication ( ribavirin ). These medications together reduce the amount of hepatitis C virus in your body, which helps your immune system fight the infection and may help your liver recover. Chronic hepatitis C infection can cause serious liver problems such as scarring (cirrhosis), or liver cancer.It is not known if this treatment can prevent you from passing the virus to others. Do not share needles, and practice "safer sex" ( including the use of latex condoms ) to lower the risk of passing the virus to others. Patient fairly understood the teachings.
Patient instructed Duloxetine is used to treat major depressive disorder in adults. It is also used to treat general generalized anxiety disorder. It is also used in adults to treat fibromyalgia (a chronic pain disorder), or chronic muscle or joint pain (such as low back pain and osteoarthritis pain). Take duloxetine exactly as prescribed by your doctor. Follow all directions on your prescription label. Do not take this medicine in larger or smaller amounts or for longer than recommended. You may take duloxetine with or without food. Do not crush, chew, break, or open an extended-release capsule. Swallow it whole.
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.
Instructed patient about factors that increase risk for pneumonia, such as smoking and air pollution, upper respiratory infections, prolonged immobility, malnutrition; chronicdiseases: diabetes, cancer, renal disease, cardiac disease; exposure to cold, damp weather, inhalation of noxious substances, use of immunosuppressive drugs; age: very young or very old, frequent intoxication from alcohol.
SN instructed on new medication Spiriva is used to control and prevent symptoms (such as wheezing, shortness of breath) caused by ongoing lung disease (chronic obstructive pulmonary disease-COPD which includes bronchitis and emphysema). It works by relaxing the muscles around the airways so that they open up and you can breathe more easily. Instructed that common side effects include, dry mouth, constipation, or dizziness.
Patient was instructed on diabetes symptoms. People with diabetes also are at increased risk of cardiovascular disease caused by atherosclerosis (thickening and hardening of the artery). Atherosclerosis can involve the heart (coronary heart disease), with symptoms of chest pain or heart attack. Brain (cerebrovascular disease), causing stroke. Arteries supplying the legs (peripheral vascular disease), causing leg pain while walking or exercising that stops quickly with rest.
The patient was instructed in coronary artery disease the importance of no smoking or using tobacco products, the effect nicotine has on the cardiac system causing the heart to work faster, constricting blood vessels, and decreasing the amount of oxygen delivered to the heart, and in the presence of coronary artery disease, increasing the probability of chest pain. The patient was advised that the role that stress plays in aggravating coronary artery disease. The patient was recommended the benefits of exercise, increase in high-density lipoproteins, which lowers blood pressure, weight loss, improved cardiovascular status.
Patient has Dx of hypertensive heart disease without heart failure. Hypertensive heart disease refers to heart conditions caused by high blood pressure. The heart working under increased pressure causes some different heart disorders. Hypertensive heart disease can cause thickening of the heart muscle, coronary artery disease, and other conditions such as heart failure if not controlled. Follow your MD's orders for diet and medications closely