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Instructed in possible adverse reactions to Lanoxin including, anorexia, nausea, vomiting, diarrhea, yellow-green halos around visual images, fatigue, headache, and generalized muscle weakness.
Instructed in possible adverse reactions to insulin, which include hypoglycemia, hyperglycemia, skin rash and local reaction at injection site.
Patient was instructed about the skin damage: the skin may be dry and cracked because of high glucose levels, and cracked skin means it's easier for bacteria to get under the skin and harder for infections to heal. Use a small amount of skin lotion daily, to be sure the feet feel dry - not damp or sticky - afterwards. Try not to get the lotion in between the toes. Keep the toenails trimmed and filed smooth to avoid ingrown toenails. Further teaching is needed.
Patient was instructed on the importance of a good skin care which can prevent most pressure sores (bedsores) which develop in people who have already skin damage, who are mentally confused, who are bed bound or cannot turn side to side.
Patient was instructed on personal hygiene. Soap and water are essential for keeping the skin clean. A mild soap will do the job adequately. Use a bath sponge for scrubbing but do not use abrasive material. Wash off well after soaping. Drying with a clean towel is very important. Avoid sharing soaps and towels.
Taught that balancing exercise with rest, as directed by MD, is a measure aimed to controlling/managing Rheumatoid Arthritis.
Instructed on the importance of reporting any foot problems to podiatrist or physician.
SN instructed patient to eat foods at a regular time each day. Eating 4 to 6 smaller meals may help to promote a regular bowel pattern.
SN assessment done on all body systems. Checked blood sugar daily monitoring on patient's log book, hydration, dietary, and medication compliance. Instructed patient on keeping blood glucose within normal range and preventing the development of long-term complication. Careful monitoring of diet, exercise and blood sugar levels are as important as the use of oral medications in preventing complications of diabetes. Also taught infection control, safety/fall precautions and preventions, and to contact MD for any emergency and/or medical concerns and changes.
SN instructed patient on arthropathy: Encouraged frequent changes of position. Assisted patient to move in bed, supporting affected joints above and below, instructed her to avoid jerky movements. Recommend that patient take warm bath or shower upon arising or at bedtime. Apply warm, moist compresses to affected joints several times a day. Monitor water temperature of compress, baths, and so on. Encouraged patient on stress management techniques such as progressive relaxation, biofeedback, visualization, guided imagery, self-hypnosis, and controlled breathing.Verbalized understanding.