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Patient was instructed on Osteoporosis. Once osteoporosis develops, getting enough calcium and vitamin D, along with other healthy habits, can slow the process and reduce the chances of bones breaking.
Patient was instructed on passive range of motion exercises, also called ROM exercises. ROM exercises can be active o passive. Active ROM is done when a person can do the exercises by himself. Active-assisted ROM is done by a person and a helper. Passive ROM exercises are done for a person by a helper. The helper does the ROM because the person cannot do them by himself.
Patient was instructed on proper skin care after bathing. Do not put oils or creams between the toes. The extra moisture can lead to infection. Also don't soak the feet that can dry the skin.
Caregiver was instructed that blood sugar may be check at different times of the day to get an idea of how well your treatment program is working for you. Typical times to check are before breakfast, before lunch, before dinner, and before bedtime. Sometimes it is helpful to check blood glucose one or two hours after a meal to see the effect of food on your glucose levels. There are certain times when should check the blood sugar more often than usual: During periods of illness or stress, when is suspect that blood glucose is low or high. When there are changes made in the treatment program - such as a change in medication doses, meal plan or activity, when taking new medications.
Instructed on proper method of medication intake, as many people taking prescription medications do not follow their doctors' instructions.
SN explained to patient/caregiver some risk factors of cellulites such as: cracks or peeling skin between toes, history of PVD, ulcers from blockage in the blood supply (ischemia), among others. Patient verbalized understanding of instructions given.
Partient is unable for diabetic care due to multiples functional limitation such as poor vision, poor eyes/ hand coordination. No caregiver available at this time.
Avoid any head, chest or abdominal trauma, to avoid any falls, to avoid sharp objects such as razor, scissors, and nail clippers. You may carefully use an electric razor. Blow your nose gently and avoid forceful blowing of the nose. Do not take rectal temperature. Do not strain for bowel movements. Consider using stool softeners or laxatives if you are straining during bowel movements. Do not use any rectal suppositories or enemas. Avoid tight clothing such as girdles and tight undergarments or pants.
Skilled nurse teaching how patient performed colostomy care , washed the stoma itself and the skin around the stoma with soft paper towels, mild soap and water. Measured the stoma, cut out the opening, removed the paper back and set it aside. Finally hold the punch with the sticky side toward your body. Center the opening on the stoma , then press firmly abdomen for 30 seconds.
SN instructed patient and caregiver on hypertensive urgency which is a situation where the blood pressure is severely elevated and that experiencing hypertensive urgency may or may not experience one or more of these symptoms: severe headache, shortness of breath, nosebleeds, and severe anxiety, chest or back pain, numbness or severe weakness, change in vision or difficulty speaking. Patient and caregiver were advised to seek immediately medical assistance and/or call 9-1-1 if any of these signs or symptoms appear. Patient and caregiver verbalized understanding. Family is independent with hypertension process.