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Patient was instructed on consequences of consuming alcohol having diabetes. Alcohol disrupts the liver
Instructed on some potential complications of constipation, such as: bowel blockage (no stool passes and pain occurs).
Nexium is indicated for treatment of heartburn and other symptoms associated with gerd.
The patient was instructed in carpal tunnel release on care of the hands and dressings, to keep the arm and hand elevated above heart level to reduce swelling and healing. The patient was reviewed to check the dressing daily for signs of bleeding or drainage, when bathing are permitted the patient should be shower with the dressing covered by a plastic bag. The patient was recommended to follow prescribed exercises to maintain circulation and improve range of motion such as sponge squeezing.
The patient was instructed in gastrostomy indicating the training and management of tube feedings, including quantity and regularity. The patient was advised to sit upright during feeding and for 1 hour after feeding to prevent reflux into the esophagus or backflow into the gastrostomy tube. The patient was explained to take care of the gastrostomy tube. The patient was taught that the tube may eventually be removed and inserted only for feeding. The patient was taught to protect the stoma with a small gauze pad.
Patient was instructed new medication Vitamin D, is used for preventing and treating weak bones (osteoporosis), bone pain (osteomalacia), and an inherited disease (osteogenesis imperfecta) in which the bones are especially brittle and easily broken. It is also used for preventing falls and fractures in people at risk for osteoporosis.
Patient was instructed on strategies that can significantly help decrease the risk of a fall such as: Skid-proof mats or strips in the shower and bathtub, Removal of furniture that can slip away if grabbed accidentally for support, supportive non-slip footwear and not walking in stocking feet. Patient currently uses cane while ambulating and states that it helps her with her balance. Patient advised that side effects of most medications taking can cause dizziness and to report and dizziness so that it can be addressed by MD. Patient voiced understanding SN will continue to monitor.
Instructed patient How can a urostomy fit into you lifestyle: Stay active and exercise as directed. Ask your caregiver about the best exercise plan for you. Wear your pouch when you swim. Use waterproof tape over the edges of your skin barrier to keep your pouch from leaking.
SN instructed patient / caregiver to always flush your PEG tube before and after each use. This helps prevent blockage from formula or medicine. Use at least 2 tablespoons (30 ml) of water to flush the tube. Follow directions for flushing your PEG tube. If the PEG tube becomes clogged, try to unclog it as soon as you can. Flush your PEG tube with a 60 ml syringe filled with warm water. Never use a wire to unclog the tube. A wire can poke a hole in the tube. Your healthcare provider may have you use a special medicine or a plastic brush to help unclog your tube.
SN instructed patient and caregiver about Lymphedema disease. Lymphedema may be inherited ( primary ) or caused by injury to the lymphatic vessels ( secondary ). It is most frequently seen after lymph node dissection, surgery and/or radiation therapy, in which damage to the lymphatic system is caused during the treatment of cancer, most notably breast cancer. In many patients with cancer, this condition does not develop until months or even years, after therapy has concluded. Lymphedema may also be associated with accidents or certain diseases or problems that may inhibit the lymphatic system from functioning properly. In tropical areas of the world, a common cause of secondary lymphedema is filariasis, a parasitic infection. It can also be caused by a compromising of the lymphatic system resulting from cellulitis. Patient verbalized understanding the teaching.