hypertensive heart disease
The patient was instructed in COPD: Chronic Obstructive Pulmonary Disease or Chronic Obstructive Lung Disease the importance of avoiding bronchopulmonary irritants such as cigarettes smoking, industrial air pollutants, dust, powders, perfumes, aerosol sprays. The patient was encouraged to use of bronchodilator nebulizers. The patient was taught in adaptive breathing techniques such as deep-breathing exercises, coughing techniques, pursed-lip breathing, and abdominal breathing. The patient was reviewed to avoid persons with infections, especially upper respiratory tract infections. The patient was advised the importance of taking vaccines for influenza and pneumococcal pneumonia. The patient was recommended on cleaning of all home respiratory equipment. The patient was taught in the importance of environmental control, avoid dry air, avoid going out in cold temperatures.
The patient was instructed in lyme disease to evade tick infested areas. The patient was advised to dress shirt inserted into pants and long pants inserted into boots when going into a wooden area. The patient was recommended to put on repellent before going into the wood.
The patient was instructed in polycystic kidney disease in the need of stopping urinary zone infections. The patient was advised to rise fluid intake. The patient was taught in good perineal area care after urination and defecation. The patient was reviewed in proceeds, monitor, and record blood pressure.
The patient was instructed in ulcerative colitis (Crohn’s Disease, Inflammatory Bowel Disease in the need for perianal care daily and after each bowel movement. The patient was taught perianal and perianeal skin care. The patient was encouraged a diet is bland, low in residue, fiber, and fat, but high in protein, calories, carbohydrates, and vitamins. The patient was recommended to evade seasoned foods, raw fruits and vegetables, foods containing rough cereals, bran, seeds or nuts, milk, fatty or fried foods, caffeine, alcohol and carbonated beverages.
SN instructed that Breo Ellipta is used regularly as a long term (maintenance) treatment to prevent or decrease wheezing and trouble breathing caused by ongoing lung disease (chronic obstructive pulmonary disease-COPD, including chronic bronchitis and emphysema). Instructed that common side effects include, Headache, dry/irritated throat, hoarseness, runny nose, and coughing may occur as your body adjusts to the medication.
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.
SN instructed caregiver that Alzheimer’s disease progresses and a loss of appetite often becomes apparent. Primary caregiver may notice that the patient does not eat as much or refuses to eat at all. Possible causes of a poor appetite include: inability to recognize food, poorly fitting dentures, certain medications, lack of physical activity, diminished sense of smell and taste.
SN instructed patient on diabetes and kidney problem, that diabetes mellitus ( DM ) is one of the leading cause of kidney failure in the United States. Approximately one-half of people who need dialysis have kidney disease from diabetes.With that, tight control of blood sugar must be done by avoiding concentrated sweets and high-carbohydrate content foods.Diabetic patients with hypertension have a special lower blood pressure target of less than 130 / 80 mmHg to reduce cardiovascular risk and delay progression of kidney disease.
SN instructed on Alzheimer's. Patient shouts at moments; Assessed patient’s ability for thought processing. Observed patient for cognitive functioning, memory changes, disorientation, difficulty with communication, or changes in thinking patterns. Assessed patient’s ability to cope with events, interests in surroundings and activity, motivation, and changes in memory pattern. Instructed caregiver to orient patient to environment as needed, if patient’s short term memory is intact. Using of calendars, radio, newspapers, television and so forth, are also appropriate. Assessed patient for sensory deprivation, concurrent use of CNS drugs, poor nutrition, dehydration, infection, or other concomitant disease processes. Maintain a regular daily schedule routine to prevent problems that may result from thirst, hunger, lack of sleep, or inadequate exercise. Provide positive reinforcement and feedback for positive behaviors. SN instructed family in methods to use with communication with patient: listen carefully, listen to stories even if they’ve heard them many times previously, and to avoid asking questions that the patient may not be able to answer. Divert attention to a client when agitated or dangerous behaviors like getting out of bed by climbing the fence bed. Eliminate or minimize sources of hazards in the environment. Caregiver verbalized fair understanding.
SN teaching about Gastroesophageal reflux disease ( GERD ). Examples of things to reduce or steer clear of in your diet include: high fat foods, caffeine products, chocolate, onions, peppermint, carbonated beverages, citrus and tomato products. Do not lie down immediately after eating, avoid late evening snacks, avoid tight clothing and bending over after eating. Elevate the head of the bed six to eight inches to prevent reflux when sleeping. Extra pillows, by themselves, are not very helpful.