hypertensive heart disease
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.
SN instructed patient and caregiver on measures to relieve legs edema : elevate legs above the level of your heart several times a day. In some cases, elevating legs while you sleep may be helpful; reduce salt intake, salt can increase fluid retention and worsen edema; moving and using the legs muscles, may help pump the excess fluid back toward your heart.
Instructed in that Osteoarthritis is a degenerative noninflammatory joint disease and it can affect all mobile joints, especially weight-bearing joints.
Instructed in possible complications of diabetes such as kidney disease. The early kidney damage has no symptoms. However, a blood test is now available to detect diabetic kidney damage at an early stage when it is still reversible. This is called the microalbumin test.
Instructed in measures to control or to live with Parkinson's disease such as exercising daily with regular rest periods, learning walking techniques, following safety precautions, obtaining adequate nutrition, obtaining emotional support, taking medication as ordered, getting help as needed, wearing an identification bracelet, etc.
Instructed in new medication Albuterol to prevent or treat bronchospasm in patients with reversible obstructive airway disease. In addition, warned of possible S/E such as tremor, nervousness, dizziness, insomnia, headache, hyperactivity, weakness, CNS stimulation, malaise, tachycardia, palpitations, hypertension, dry and irritated nose and throat (with inhaled form), nasal congestion, epistaxis, hoarseness, heartburn, nausea, vomiting, anorexia, bad taste in mouth, increased appetite, hypokalemia, muscle cramps, bronchospasm, cough, wheezing, dyspnea, bronchitis, increased sputum or hypersensitivity reactions. Warned patient about possibility of paradoxical bronchospasm. If this occurs, discontinue drug immediately. If more than one inhalation is ordered, instructed to wait at least 2 minutes before repeating procedure. Use of an aero chamber may improve drug delivery to the lungs. If steroid inhaler used, advised to use the bronchodilator first and then advised to wait about 5 minutes before using the steroid. This allows the bronchodilator to open the air passages for maximum effectiveness. Advised to remove canister and wash inhaler with warm, soapy water at least once a week.
Instructed in new medication Glucovance to improve glycemic control in patients with type-two diabetes whose hyperglycemia cannot be controlled with diet and exercise alone. In addition, warned of possible S/E such as headache, dizziness, diarrhea, nausea, vomiting, abdominal pain, hypoglycemia, lactic acidosis, or upper respiratory tract infection. Instructed to take one daily with breakfast and, if twice daily, then at breakfast and dinner. Stop drug and tell prescriber of unexplained hyperventilation, myalgia, malaise, unusual somnolence, or other symptoms of early lactic acidosis. GI symptoms are common with initial drug therapy but GI symptoms that occur after prolonged therapy may be related to lactic acidosis or other serious disease and should be reported promptly. Instructed not to take any other drugs, including OTC drugs, without checking with prescriber.
Instructed in new medication Aricept to manage moderate dementia of the Alzheimer type. In addition, warned of possible S/E such as headache, insomnia, dizziness, fatigue, depression, abnormal dreams, somnolence, seizures, tremor, irritability, paresthesia, aggression, vertigo, ataxia, restlessness, abnormal crying, nervousness, aphasia, syncope, pain, chest pain, hypertension, vasodilation, atrial fibrillation, hot flashes, hypotension, cataract, blurred vision, eye irritation, sore throat, nausea, diarrhea, vomiting, anorexia, fecal incontinence, GI bleeding, bloating, epigastric pain, frequent urination, ecchymosis, weight loss, dehydration, muscle cramps, arthritis, toothache, bone fracture, dyspnea, bronchitis, pruritus, urticaria, diaphoresis, influenza, and increased libido. The drug does not alter the underlying degenerative disease but can temporarily stabilize or relieve symptoms. Effective therapy depends on taking drug at regular intervals. Instructed to take drug in the evening, just before bedtime. Immediately report significant adverse effects or changes in overall health status. Inform health care team that patient is taking drug before he receives anesthesia. Avoid OTC cold or sleep remedies because of the potential for increased anticholinergic effects.
Instructed in factors that increase the risk of stroke such as age, family history, race, prior stroke, history of diabetes, cardiac and renal disease, among others.
Instructed in factors that affect healing, such as, age, disease, nutrition, and infection.