high blood pressure
Instructed in new medication Amitriptyline to manage depression. In additon, warned of possible S/E such as coma, seizures, hallucinations, delusions, disorientation, ataxia, tremor, peripheral neuropathy, anxiety, insomnia, restlessness, drowsiness, dizziness, weakness, fatigue, headache, extrapyramidal reactions, MI, stroke, arrhythmias, heart block, orthostatic hypotension, tachycardia, ECG changes, hypertension, edema, blurred vision, tinnitus, mydriasis, increased intraocular pressure, dry mouth, nausea, vomiting, anorexia, epigastric distress, diarrhea, constipation, paralytic ileum, urine retention, agranulocytosis, thrombocytopenia, leukopenia, eosinophilia, hypoglycemia, hyperglycemia, rash, urticaria, photosensitivity, diaphoresis and hypersensitivity reaction. Instructed to take full dose at bedtime but warned patient of possible morning orthostatic hypotension. Avoid alcohol during drug therapy. Consult MD before taking other medications. Avoid activities that require alertness and good psychomotor coordination until CNS effects of drug are known. Drowsiness and dizziness usually subside after a few weeks. Dry mouth may be relieved with sugarless hard candy or gum. Saliva substitutes may be needed. Instructed to use a sun block, wear protective clothing and avoid prolonged exposure to strong sunlight. To prevent photosensitivity reactions. Do not stop drug therapy abruptly.
Instructed to keep pressure off wound area to promote circulation which is essential to healing.
Instructed in materials used in wound care. However, even with proper treatment, a wound infection may occur. Check the wound daily for signs of infection like increased drainage or bleeding from the wound that won’t stop with direct pressure, redness in or around the wound, foul odor or pus coming from the wound, increased swelling around the wound and ever above 101.0°F or shaking chills.
Instructed in the use of NTG for chest pain/pressure. To take at onset of pain, 1 tablet every 5 minutes, up to 3 tablets over 15 minutes. If not complete relief of pain after the 3rd tablet, call 911.
Patient was instructed on how to prevent pressure ulcer. A proper skin care is crucial and involves inspecting skin daily and an individualized bathing schedule, using warm (not hot) water and mild soap. Avoid massage over bony prominences and use lubricants if skin is dry.
Patient was instructed on how to manage pressure that is necessary to avoid future complications. Provide appropriate support surface, repositioning every two hours in bed, off-load heel using pillows or positioning boot, use pillow between legs for side lying.
Patient was instructed on pain caused by pressure ulcers. Pain can be classified as acute or chronic. Cyclic acute pain, which is periodic and corresponds to the pain experienced during repeated management, such as dressing changes or patient repositioning and non-cyclic acute pain, which is accidental, including pain experienced during occasional procedures such as debridement or drain removal.
Patient was instructed on relieving and preventing leg edema. The first line of defense is: leg elevation. Elevate legs above the level of the heart which puts minimal pressure on the back of the knees and thighs and lower back. Other help to decrease swelling is limiting salt intake, drink plenty of water, avoid sitting with the feet dependent. Do not abuse diuretics and laxatives.
Instructed patient about some signs and symptoms of pressure ulcers, such as, skin tissue that feels firm or boggy, local redness, warmth, tenderness or swelling.
If your big toe slants sharply in toward your other toes, with a big bump on the knuckle of your big toe, you've got a classic bunion. Corns are spots of thick, rough skin, where the tissue builds up on toes constantly barraged by too much rubbing or pressure. A buckled-under toe, called a hammertoe, can result from muscle weakness caused by diabetic nerve damage. All of these make it hard to fit shoes comfortably. But a good podiatrist can help you fix these problems and take better care of your feet.