skin integrity
Instructed patient If you do put tape around the skin barrier edges do not remove the tape after water activities. Removing the
tape may cause the skin barrier to loosen. It is helpful to hold your skin smooth as you put your pouching system on to avoid wrinkles that may lead to leakage.
Instructed patient the stoma is your bowel. It is protected by mucus so stool or urine won’t hurt it. A stoma rarely becomes infected. The most important thing is to protect the skin around your stoma. A correct fitting pouching system is the best way to prevent an infection of your skin. If there is a small leak under my skin barrier, is it okay to patch it with tape or paste: Always change your pouching system at the first signs of leakage.
Instructed patient If there is a small leak under my skin barrier, is it okay to patch it with tape or paste: Do not try to patch the pouching system with tape or paste. A leak under the skin barrier should not be fixed. Leaving a leaking pouch on can cause skin irritation. Always empty your pouch before it is half-full. Release gas before the pouch gets too full. If you have a lot of gas, you may want to consider using a pouch with a vent or filter.
SN instructed patient and caregiver about Fentanyl Patch. This medication is used to help relieve severe ongoing pain. Fentanyl belongs to a class of drugs known as narcotic ( opiate ) analgesics. It works in the brain to change how your body feels and responds to pain. Use this medication on a regular schedule as directed by your doctor, not as needed for sudden ( breakthrough) pain. Apply this medication to the skin as directed by your doctor. Do not apply on burns, cuts, irritated skin, or skin that has been exposed to radiation ( x-ray treatment ). Select a dry, non - hairy area on a flat part of your body, such as the chest, sides, back, or upper arms. To avoid irritation, apply to a different area each time. Be sure to remove the old patch before applying a new patch. The used patch still contains enough fentanyl to cause serious harm, even kill a child or pet, so fold it in half with the sticky sides together and discard properly. Some side effects are nausea, vomiting, constipation, lightheadedness, dizziness, drowsiness, or headache may occur. Mild irritation, itching, or redness at the application site may also occur. Some of these side effects may decrease after you have been using this medication for a while. If any of these effects persist or worsen, tell your doctor. To prevent constipation, eat a diet adequate in fiber, drink plenty of water, and exercise. Ask your pharmacist for help in selecting a laxative ( such as a stimulant type with stool softener ).
SN instructed patient about how the thyroid hormone helps regulate metabolism. When this hormone is abnormally low the energy production decreases, disrupting many vital functions. This can include skin issues such as: Coldness in the fingers and feet with pale and dry coarse skin, eczema, a yellowish hue to the skin, sparse and brittle hair, which comes out in handfuls, loss of hair in the outer third of eyebrows, slow growing, ridged and brittle nails, edema in face, eyelids, hands and feet, and delayed wound healing. Some of these things can be avoided if you are taking your replacement medication daily as ordered and are getting regular blood work to assure the medication is at the correct dose.
SN instructed patient / caregiver regarding medication Cephalexin. SN explained that Cephalexin is used to treat urinary tract infections, respiratory tract infections, and skin and soft tissue infections. SN explained that the side effects of this medication includes: diarrhea, dizziness, headache, indigestion, joint pain, stomach pain and tiredness. SN explained that the drug can also cause yellowing of the eyes or skin; red, blistered, swollen or peeling skin, unusual bruising or bleeding, decreased urination, severe cramps and confusion. SN instructed to notify physician if experiencing persistence or worsening of side effects.
SN teaching patient / caregiver on measures to prevent pressure ulcers, such as: Clean skin at times of soiling, avoid irritating cleaning agents, use moisturizers on dry skin, do not message bony prominences, keep skin clean and dry, and comply with proper lifting and positioning techniques.
Ostomy care Rinse the soap off the skin around your stoma very well because the residue may keep your skin barrier from sticking and may also cause skin irritation.
SN instructed patient and care giver that Silvadene is used with other treatments to help prevent and treat wound and skin infections. Silver sulfadiazine (silvadene) works by stopping the growth of bacteria. Silver sulfadiazine belongs to a class of drugs known as sulfa antibiotics. Possible SE may include: pain, burning, or itching of the treated skin. Skin and mucous membranes (such as the gums) may become blue/gray in color. If any of these effects persist or worsen, tell your doctor or pharmacist promptly.
Instructed patient about the skin around your stoma should look like it did before surgery. The best way to protect their skin is by:
using a bag or pouch with the correct size opening, so waste does not leak, taking good care of the skin around your stoma.