SN instructed on ways to help reduce Edema: to elevate lower extremities above the level of the heart approximately 8-12 inches for at least 30 minutes 3/4 times a day to improve circulation, promote venous drainage and reduce swelling.
SN Instructed on measures to detect and alleviate edema: Gently compress the soft tissue with your thumb over both shins for a few minutes and observe for indentation. If indention is noted, edema is present. Notify SN or Md if there is a deep indention. Reduce sodium (Na) in diet and exercise as tolerated to help reduce edema.
Instructed patient It recommended that you safety pin the drainage bottle to your clothing during the day and to your clothes during the night. Allow enough slack to Prevent the tube from being pulled do up or from pulling on the drain sutures.
Patient was explained that having a nephrostomy tube in for a long time increases the risk of getting an infection. Nephrostomy tube care focuses on preventing infection. Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor or nurse call line if you are having problems. It's also a good idea to know your test results and keep a list of the medicines you take.. understanding was verbalized
Instructed patient that for healthy living with your LVAD, you’ll need to make sure that: the equipment is working properly,you have sufficient power sources at all times, your driveline exit site is clean and dry, following a healthy diet, exercising regularly, as you’re able to tolerate it, are taking your medications and supplements as directed by your doctor. Understanding was verbalized.
Instructed patient to remember that shorter "trips" take planning too: Any time you leave your home whether it’s a one-hour drive to visit friends or a ten-minute walk to get groceries you will need to bring your backup controller and power sources with you, plus any medications you’re scheduled to take. Understanding was verbalized.
Instructed patient that when traveling with an LVAD will involve some extra planning and preparation.When scheduling a trip, discuss your plans ahead of time with your LVAD team. They‘ll help you be as independent as possible, and still stay safe and healthy. They can also provide you with the necessary travel documents, as well as helpful tips. Understanding was verbalized.
Instructed patient and caregiver what not do with her LVAD. Kink, bend or pull your driveline, disconnect the driveline from the controller (under normal circumstances), Sleep on your stomach, Take a bath or swim, Play contact sports, Have an MRI (CT Scans or X-Rays are OK), Attempt to repair LVAD equipment yourself, Leave the house without backup equipment. understanding was verbalized.
SN instructed patient / caregiver on proper incontinence care as to check every 2-3 hours if needed. Educated on pressure reduction measures as to change patient's position in bed/chair every 2-3 hours, avoid positioning on affected areas and use pressure reduction mattress or chair cushion.
SN instructed on the need for adequate fluid intake, establishing a toilet schedule such as every 2 hours, or before or after activities, meals, sleep, and rest periods.