Procedures

Nursing Continuing Education

Knee bending Teaching 2168

SN instructed patient in knee replacement to get self - help devices to limit knee bending, elevated toilet seat, bath seat, and long - handled grippers. The patient was reviewed to evade putting extra weight on the knee and should use a walker, until totally recuperated. The patient was instructed the importance of joining in physical therapy to recover muscle strength and guarantee adequate lower extremity strength for ambulating with a walker or cane.

Drainage care Teaching 2142

SN instructed patient / parent to ensure the drain is below the site of insertion but not pulling on the patient. Instructed the patient / parent that there is a risk of dislodgment, requiring increased care when moving. Patient should be aware that moving whilst drain is in situ will cause some pain, but this can be minimised with regular analgesia and the patient should be encouraged to mobilise with supervision when appropriate.

Chemotherapy Teaching 2122

Physical assessment done to patient after chemotherapy . Medication checked and reconciled. Hydration and nutritional status checked. Diet reviewed. Denies chest pain. Tube care done per physician ( MD ) order. Dressing changed. Still complained in pain in fingers, patient taught that one side effect of chemotherapy is pain in fingers which is called peripheral neuropathy, it results from some type of damage to the peripheral nerves. Certain chemotherapy drugs can cause peripheral neuropathy such as Vinca alkaloids ( vincristine ), cisplatin, Paclitaxel, and the podophyllotoxins ( etoposide and tenoposide) . Other drugs used to treat cancer such as thalidomide and interferon also can cause peripheral neuropathy.

Dialysis care Teaching 2119

SN instructed patient that fluid restrictions are usually necessary when dialysis is initiated, especially if dialysis only occurs three days a week and if urine production is decreased. Build up of fluid can lead to shortness of breath, swelling, and high blood pressure. There is a limit to the amount of fluid that can be safely removed during dialysis. If fluid limits are exceeded and extra water must be removed, negative effects such as muscle cramping, low blood pressure leading to nausea, weakness, dizziness, and possibly extra dialysis sessions to remove the fluid.

Jackson Pratt care Teaching 2050

SN instructed patient about Jackson Pratt care. The JP drain removes fluids by creating suction in the tube. The bulb is squeezed
 flat and connected to the tube that sticks out of your body. The bulb expands as it fills with fluid. SN instructed patient use soap and water or saline ( saltwater ) solution to clean your JP drain site. Dip a cotton swab or 
gauze pad in the solution and gently clean your skin.

Tracheotomy Teaching 2037

SN instructed patient about tracheotomy care dressing changes promote skin integrity and help prevent infection at the stoma site and
 in the respiratory system. The patient should be instructed at least once per shift, apply a new dressing to the stoma site to absorb secretions and insulate the skin
. After applying a skin barrier, apply either a split - drain or a foam dressing. Change a wet dressing immediately.

Tracheotomy Teaching 2036

SN instructed patient about tracheotomy care suctioning always involves: assessment , oxygenation management, use of correct suction pressure,
 liquefying secretions, using the proper-size , suction catheter and insertion distance appropriate patient positioning, 
evaluation, using the proper - size suction catheter and insertion distance appropriate patient positioning evaluation.

Fall precautions Teaching 2009

RN performed supervision with HHA present and reviewed that the HHA Care Plan is followed as ordered. Patient is satisfied with rendered services. RN instructed patient and caregiver 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. RN also explained that side effects of most medications taking can cause dizziness and advised to immediately report the occurrence of dizziness so that it can be addressed by physician. Patient and caregiver voiced understanding of all instructions given.

JP drain Teaching 1998

SN instructed patient to contact your primary healthcare provider if: you drain less than 30 milliliters ( 2 tablespoons ) in 24 hours. This may mean your drain can be removed. You suddenly stop draining fluid or think your JP drain is blocked. You have a fever higher than 101.5°f ( 38.6°c ). You have increased pain, redness, or swelling around the drain site. You have questions about your JP drain care.

JP drain Teaching 1997

The patient was instructed to return to the emergency department if: your JP drain breaks or comes out. You have cloudy yellow or brown drainage from your JP drain site, or the drainage smells bad.