high blood pressure
SN instructed patient / caregiver that Actos is an antidiabetic med that is used to lower blood sugar. SN explained that it is important to not take medication when blood sugar is low. SN instructed to patient / caregiver to check blood sugar level before taking the medication to avoid hypoglycemia. SN instructed that side effects of the medication include: SOB, swelling or rapid weight gain, chest pain, N / V, jaundice, blurred vision, pale skin, easy bruising. SN instructed patient / caregiver to inform physician if experiencing any of these side effect.
SN instructed patient / caregiver on medication Avandaryl. Explained that it is a medication indicated for Diabetes Mellitus ( DM ) type II to decrease the blood sugar by stimulating the production of insulin and increasing receptor site sensitivity. SN explained to patient / caregiver that the side effects include dizziness, photosensitivity, low blood sugar, constipation, nausea and vomiting. SN instructed patient / caregiver to monitor blood sugar daily and to not skip or double doses. SN instructed patient / caregiver to notify physician ( MD ) if experiencing unusual weight gain, swelling of ankles, drowsiness, dyspnea ( SOB ), muscle cramps, weakness, sore throat, rash, unusual bleeding or if bruising occurs.
SN explain about a couple of things going on that make your glucose rise in the morning. One of these is insulin resistance, a condition that means your body's muscle and fat cells are unable to use insulin effectively to lower blood glucose. However, insulin resistance also affects how your liver processes, stores, and releases sugar, particularly at night. The liver is supposed to release small amounts of glucose when you're not eating. But in type 2 diabetes, the liver dumps more glucose than is needed into the bloodstream, especially at night. So, while your hormones are causing a natural rise in blood glucose, your liver is releasing even more sugar into your system. Because your insulin resistance prevents your muscle and fat cells from using the sugar, your blood glucose level rises.
SN explained that the Diabetes can affect the small blood vessels of the body that supply the skin with blood. Changes to the blood vessels because of diabetes can cause a skin condition called diabetic dermopathy. This appears as scaly patches that are light brown or red, often on the front of the legs.
SN explained that the symptoms / signs of congestive heart failure ( CHF ) may include: Shortness of breath ( also called dyspnea ) most commonly during activity, at rest, or while sleeping, which may come on suddenly and wake you up. You often have difficulty breathing while lying flat and may need to prop up the upper body and head on two pillows. You often complain of waking up tired or feeling anxious and restless. Blood backs up in the pulmonary veins ( the vessels that return blood from the lungs to the heart ) because the heart can't keep up with the supply. This causes fluid to leak into the lungs. Persistent coughing or wheezing, coughing that produces white or pink blood - tinged mucus. Fluid builds up in the lungs. Buildup of excess fluid in body tissues ( edema ) swelling in the feet, ankles, legs or abdomen or weight gain. You may find that your shoes feel tight.
SN explained that the Chronic venous insufficiency ( CVI ) can’t be cured, but you can control leg swelling to reduce the likelihood of ulcers ( sores ). Recognizing the symptoms Be aware of the following: If you stand or sit with your feet down for long periods, your legs may ache or feel heavy. Swollen ankles are possibly the most common symptom of Chronic venous insufficiency ( CVI ). As swelling increases, the skin over your ankles may show red spots or a brownish tinge. The skin may feel leathery or scaly, and may start to itch. If swelling is not controlled, an ulcer ( open wound ) may form. What you can do Reduce your risk of developing ulcers by doing the following: Increase blood flow back to your heart by elevating your legs, exercising daily, and wearing elastic stockings. Boost blood flow in your legs by losing excess weight. If you must stand or sit in one place for a period of time, keep your blood moving by wiggling your toes, shifting your body position, and rising up on the balls of your feet. Pt verbalizes understanding.
SN instructed caregivers/patient on hyponatremia, which means your blood level of sodium (salt) is too low. Salt is needed for the body and brain to work. Very low blood levels of sodium can be fatal. Symptoms can include headache, confusion, fatigue, muscle cramps, hallucinations, seizures, and coma. To help prevent hyponatremia, take all medicines exactly as directed. Certain medicines can lower blood sodium levels. Have your sodium levels checked often. This is vital if you take a diuretic (medicine that helps your body get rid of water). Call your provider right away if you have any of the following: Severe tiredness, Fainting, Dizziness, Loss of appetite, Nausea or vomiting, Confusion or forgetfulness, Muscle spasms, cramping, twitching Seizures, or Gait disturbances. Caregiver voiced understanding.
SN instructed patient that having diabetes means you often need to make decisions about your care. The more you know about diabetes and how your daily activities affect your blood glucose levels, the easier it is to make wise decisions. Testing your blood glucose and keeping good track of your readings is essential to know how different activities, food, medication and stress levels affect your blood glucose readings.
SN instructed patient about the heart is a muscle that pumps oxygen-rich blood to all parts of the body. When you have heart failure, the heart is not able to pump as well as it should. Blood and fluid may back up into the lungs (congestive heart failure), and some parts of the body don’t get enough oxygen-rich blood to work normally. These problems lead to the symptoms of heart failure. Follow a heart healthy diet. And make sure to limit the salt (sodium) in your diet. Salt causes your body to hold water. This makes your heart work harder as there is more fluid for the heart to pump.
SN instructed patient and caregiver regarding new medication Entresto. This medication is used to treat certain types of heart failure. It may help you live longer and lower your chance of having to go to the hospital for heart failure. This product contains 2 medications: sacubitril and valsartan. They work by relaxing blood vessels so that blood can flow more easily, which makes it easier for your heart to pump blood to your body. Cough, dizziness, or lightheadedness may occur. If any of these effects persist or worsen, tell your doctor or pharmacist promptly. To reduce the risk of dizziness and lightheadedness, get up slowly when rising from a sitting or lying position. If you miss a dose, take it as soon as you remember. If it is near the time of the next dose, skip the missed dose. Take your next dose at the regular time. Do not double the dose to catch up.