foot
Patient was instructed about feet wash with warm - not hot
Patient was instructed about how make sure the shoes fit well. Even the slightest rubbing or misfit shoe can cause a blister that turns into a sore that becomes infected and never heals. Buy better-fitting shoes, or try different socks, even at the most minor signs of redness or irritation, since you may not be able to feel when it's getting worse. Before buying or putting on the shoes check your shoes for rough seam, sharp edges or other objects that could hurt your feet. Further teaching is needed.
Patient was instructed about the feet care: always wear shoes or slippers. Always wear socks with the shoes, since leather, plastics, and manmade shoe materials can irritate your skin and quickly bring on blisters. While the Diabetic patient might prefer the look of hose, nylon knee-highs, or thin socks, may find that these doesn't give to the toes or heels enough protection. Wear thicker socks to pad the feet and cushion any calluses or sore spots. Further teaching is needed.
Patient was instructed on peripheral arterial disease that is a hardening of the arteries that prevents proper blood flow. The improper flow is one of the risk factors for foot ulcers, which can lead to amputation.
Patient was instructed on diabetes with injury. People who have diabetes are vulnerable to nerve and vascular damage that can result in loss of protective sensation in the feet, poor circulation, and poor healing of foot ulcers. Careful attention needs to be paid to any abrasion or wound to ensure the quickest healing possible. It is important for people with diabetes to routinely inspect feet, in particular, to check for any issues.
Instructed on the importance of reporting any foot problems to podiatrist or physician.
SN suggested patient to have nails, calluses and corns trimmed by podiatrist because those with diabetes have poor circulation. A good blood circulation is known to aid your body in all healing processes, so when it becomes sluggish, it takes longer for any injuries to on feet to heal.
The patient was instructed in buerger’s disease in the role nicotine plays in advancing the disease. The patient was advised on daily foot care, wear well-fitted shoes, avoiding going barefoot, use cotton or wool socks.
The patient was instructed in diabetes mellitus ketoacidosis discussing blood sugar monitoring, when the test will take place, the technique, the necessary blood sugar range, how to read test results, what to do for abnormal results, the cleaning of equipment. The patient was taught when she or he is sick monitoring is increased to every 4 hours because illness or injury increases glucose demand. The patient was advised to maintain meticulous dental hygiene to prevent infection, wear shoes all the time to prevent foot injury. The patient was advised to monitor for vaginal infections. The patient was instructed the need to carry fast-acting sugar livesavers, sugar packets for treatment of hypoglycemia. The patient was advised to obtain appropriate items, equipment, and assistive devices for various diabetic needs, glucose monitor, medialert bracelet.
SN completed assessment done on all body systems and noted patient with elevated blood pressure during visit. SN completed treatment during visit and noted no drainage on old tx, wound callused and new area found to left medial top of foot remains intact with no drainage noted. SN noted patient complaint of pain to bilateral lower extremities with +2 edema noted. SN educated primary caregiver on the importance of elevation of bilateral lower extremities as well as pain management for patient.