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Instructed in new medication Vioxx to manage osteoarthritis. In addition, warned of possible S/E such as headache, asthenia, fatigue, dizziness, aseptic meningitis, hypertension, lower-extremity edema, sinusitis, diarrhea, dyspepsia, epigastric discomfort, heartburn, nausea, abdominal pain, GI bleeding, urinary tract infection, hyponatremia, back pain, bronchitis, upper respiratory tract infection, pulmonary edema and flu-like syndrome. Patient may experience signs and symptoms of GI bleeding, including bloody vomitus, blood in urine and stool and black, tarry stools. Advised to call MD if he experiences these signs or symptoms. Report rash, unexplained weight gain or edema. Avoid aspirin and products containing aspirin unless prescriber has instructed otherwise. Avoid OTC anti-inflammatories such as ibuprofen (Advil) unless prescriber has instructed it. All NSAIDs including Rofecoxib may adversely affect the liver. Signs and symptoms of liver toxicity include nausea, fatigue, lethargy, itching, jaundice, right upper quadrant tenderness and flu-like syndrome. Instructed to stop therapy and call MD immediately if patient experiences these signs or symptoms. Women must inform MD if they become pregnant, or they are planning on becoming pregnant while taking drugs. This drug may be taken without regard to food although taking it with food may decrease GI distress. The most common adverse effects of this drug are dyspepsia, epigastric discomfort, heartburn and nausea. Taking drug with food may help minimize these effects.
Caregiver was instructed that most people pinch up a fold of skin and insert the needle at aangle to the skin fold. To pinch the skin properly, follow these steps: Squeeze a couple of inches of skin between the thumb and two fingers, pulling the skin and fat away from the underlying muscle. (If use a 5 millimeter mini-pen needle to inject, you don't have to pinch up the skin when injecting at aangle; with this shorter needle, you don't have to worry about injecting into muscle.)" Insert the needle, Hold the pinch so the needle doesn't go into the muscle, Push the plunger, "release the grip on the skin fold. Remove the needle from the skin.
Patient was instructed on Hyperglycemia. If dehydrated the body burns protein and fat rather than sugar for energy, causing acids and ketones to build up in your blood. These ketones can be partially released into the urine. If ketoacidosis develops, emergency care is needed immediately to keep the condition from getting worse.
Taught that depression is an alteration in mood, characterized by sadness, pessimism, despondence and hopelessness.
Instructed on some signs/symptoms of Emphysema, such as: loss of appetite and weight loss, among others.
Instructed on some signs/symptoms of Osteoarthritis, such as: heberdens nodes (nodular bony enlargements within the joint).
The patient was reviewed in breast cancer the prescribed surgical procedure and adjuvant therapy to be carried out. The patient was instructed that the decision is based on the phase of breast cancer, age, menopausal stage, hormonal receptor status, and patient preference. The patient was encouraged to discuss the feelings and emotions concerning awaiting surgery, adjuvant therapies, and prognosis. Explain misconceptions.
Instructed patient call doctor if increase pain in the abdomen or the incision,fever, redness or drainage of the incision, irritation, or redness , or drainage of the incision, change bowel habits, such as:diarrhea, or constipation or skin irritation.
Instructed patient during periods of stress, the body releases so-called stress hormones, which cause a rise in blood glucose level. In the short term, this gives the body the extra energy it needs to cope with the stress. But if a person doesn’t have adequate insulin circulating in his bloodstream to enable his cells to use the extra energy, the result will be hyperglycemia. And if stress becomes chronic, hyperglycemia can also become chronic.
Instructed patient when to resume usual activities, light housekeeping (dusting, setting the table, washing dishes, folding clothes) light gardening (potting plants, trimming flowers) needlework, reading, cooking meals, climbing stairs, Small mechanical jobs, shopping, attending sports events, church, movies, and restaurants, passenger in car, Walking, treadmill, stationary bike, shampooing hair and playing cards/games.