low blood pressure
Instructed patient about medication Metoprolol is used to treat high blood
pressure. It also is used to prevent angina (chest pain) and to improve survival after a heart attack. If your doctor prescribes a low
-salt or low
-sodium diet, follow
these directions carefully. Metoprolol may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away: dizziness or lightheartedness, tiredness, depression, nausea and dry mouth.
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 low
er 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 follow
ing: 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 and caregiver about the low
concentrated sweets diet helps control blood
sugar levels by eliminating most simple sugars in the foods you eat. All carbohydrates break down to sugar as they are eaten and digested. There are two different types of carbohydrate complex and simple. Most simple sugars are considered concentrated sweets. Simple carbohydrates cause a quick increase in blood
sugar. Your doctor might order a low
concentrated sweets diet for you if you have diabetes or are at risk for developing diabetes mellitus you are on medications that can cause high blood
sugar you have diarrhea.
SN explained that the problems with the veins in the legs may lead to chronic venous insufficiency ( CVI ). CVI means that there is a long-term problem with the veins not being able to pump blood
back to your heart. When this happens, blood
stays in the legs and causes swelling and aching. Two problems that may lead to chronic venous insufficiency are: Damaged valves. Valves keep blood
flow
ing from the legs through the blood
vessels and back to the heart. When the valves are damaged, blood
does not flow
as well. Deep vein thrombosis ( DVT ). Blood
clots may form in the deep veins of the legs. This may cause pain, redness, and swelling in the legs. It may also block the flow
of blood
back to the heart. Seek immediate medical care if you have these symptoms. A blood
clot in the leg can also break off and travel to the lungs. This is called pulmonary embolism ( PE ). In the lungs, the clot can cut off the flow
of blood
. This may cause chest pain, trouble breathing, sweating, a fast heartbeat, coughing (may cough up blood
), and fainting. It is a medical emergency and may cause death. Call 911 if you have these symptoms. Healthcare providers call the two conditions,Deep vein thrombosis ( DVT ) and pulmonary embolism ( PE ), venous thromboembolism ( VTE ).
Sn instructed that reducing sodium intake low
ers blood
pressure and prevent the collection of fluid in the low
er legs or abdomen. People with chronic kidney disease must control sodium intake to prevent volume overload, which increases blood
pressure and causes swelling. Food to eat any fresh or frozen beef, lamb, pork, poultry and fish. Eggs and egg substitutes. Low
-sodium peanut butter. Dry peas and beans (not canned) drained, water or oil packed canned fish or poultry foods to avoid canned food canned vegetables processed meats salted snacks such as, salted peanuts, salted almonds etc.
SN instructed patient / caregiver regarding medication Benicar. Explained that this medication is a blood
pressure low
ering medication. Explained that the side effects includes hypotension ( low
blood
pressure ), dizziness, fatigue, headache and /or diarrhea. SN instructed patient / caregiver to notify physician ( MD ) if experiencing persistence or worsening of side effects.
SN instructed patient that fluid restrictions are usually necessary when dialysis is initiated, especially if dialysis only occurs three days a week and if urine production is decreased. Build up of fluid can lead to shortness of breath, swelling, and high blood
pressure. There is a limit to the amount of fluid that can be safely removed during dialysis. If fluid limits are exceeded and extra water must be removed, negative effects such as muscle cramping, low
blood
pressure leading to nausea, weakness, dizziness, and possibly extra dialysis sessions to remove the fluid.
SN educated patient on the importance of daily vital sign monitoring. Due to patients disease processes it is important to monitor blood
pressure, weight, pulse and oxygen daily if equipment is available. SN instructed patient to weigh correctly they need to wake up, pee and than weigh daily at the same time if possible, same amount of clothing, same area. Patient is to weigh prior to eating/drinking in the morning. Notify home health or PCP if -/+ 3 lbs in a day or +/-5 lbs in a week is seen. SN educated patient to monitor blood
pressure and pulse, and instructed to check before medications and if elevated/low
recheck in 1-2 hours. SN educated patient to always log vitals so patients MD has a larger snap shot on what is going on.Patient/CG verbalized understanding
Patient was instructed on another leading type of chronic wounds is pressure ulcers. That occurs when pressure on the tissue is grater than the pressure in capillaries, and thus restricts blood
flow
into the area. Muscle tissues, which needs more oxygen and nutrients than skin does, show the worst effects from prolonged pressure. As in other chronic ulcers, reperfusion injury damage tissue.
The patient was taught in hypertension in what way and at what time to take blood
pressure measurements using home monitoring equipment. The patient was instructed to take blood
pressure at the same time each day, have a record of blood
pressure readings. The patient was encouraged the importance of evading all tobacco products. The patient was advised the need to stop obesity.