low fat diet
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.
Instructed patient for the first 4-6 weeks after placement of a new PEG, bath water should not be so deep that the tube is
under the water. Shower water should fall on your back only. For a balloon, low profile, or older PEG tube you can take a
bath or shower as you normally do. Instructed patient call nurse or doctor if your body changes: your skin around tube has signs of infection: redness, warm to touch, firm to touch , tender.
Skilled received patient sitting on the chair, noted difficulty when patient was trying to get up with the crutches, patient is at risk for fall. SN instructed pt to avoid sitting on low chair or chair without a hand rest for support in order to prevent fall.
SN taught patient that learning what affects your blood glucose levels and what to do when they are higher or lower than desired takes practice. Looking for patterns and trends can help you determine what is causing the blood glucose levels to go high or low, and can help you target what might need some adjusting.
Instructed patient on hip precautions after a hip replacement. Hip precautions are various maneuvers a patient who has undergone a hip replacement needs to avoid. Hip precautions include: Do not cross your legs, do not bend our legs up beyond 90 degrees, do not sit on sofas or in low chairs, do not sleep on your side.
Patient instructed Duloxetine is used to treat major depressive disorder in adults. It is also used to treat general generalized anxiety disorder. It is also used in adults to treat fibromyalgia (a chronic pain disorder), or chronic muscle or joint pain (such as low back pain and osteoarthritis pain). Take duloxetine exactly as prescribed by your doctor. Follow all directions on your prescription label. Do not take this medicine in larger or smaller amounts or for longer than recommended. You may take duloxetine with or without food. Do not crush, chew, break, or open an extended-release capsule. Swallow it whole.
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
SN educated patient about Neutropenia. Neutropenia is an abnormally low count of neutrophils, which is a type of white blood cell. Neutrophils are made in the bone marrow, so anything that inhibits or disrupts that process can result in neutropenia. Instructed patient to prevent infection; Promote oral care, Promote hygiene, Prevent skin breakdown, Promote nutrition and ensure food is prepared and stored appropriately. Educated on signs and symptoms of infection; which include fever, Red, swollen, warm, or painful skin areas or wounds, An area of orange, bumpy skin with blisters, Cough, chest pain, or trouble breathing, Burning feeling while you urinate. Patient verbalized understanding.
SN instructed that infrequent passage of hard, dry stool, low back pain, abdominal fullness and/or abdominal discomfort, decreased appetite, nausea and/or vomiting, and rectal pressure may constitute as signs/symptoms of constipation. Patient verbalized understanding.
SN provided teaching regarding hypokalemia. Low potassium (hypokalemia) refers to a lower than normal potassium level in your bloodstream. Potassium helps carry electrical signals to cells in your body. It is critical to the proper functioning of nerve and muscles cells, particularly heart muscle cells. S/s include weakness, muscle cramps, heart palpitations, and constipation. SN instructed that patient should report any of these to her nurse promptly. Verbal understanding noted.