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.
Instructed patient in some cases of colostomy, skin irritation or infection can result from stool that leaks under the bag. A hernia can develop around a colostomy, and the bowel may become narrow. Taking good care of your stoma and eating a balanced diet can help you avoid these problems. Pouching systems are waterproof. However, you may feel more secure if you wear an ostomy belt or put tape around the edges of your skin barrier when you are in the water.
Instructed patient If you do put tape around the skin barrier edges do not remove the tape after water activities. Removing the tape may cause the skin barrier to loosen. It is helpful to hold your skin smooth as you put your pouching system on to avoid wrinkles that may lead to leakage.
Instructed patient measure your stoma once a week for the first 6 to 8 weeks after your ostomy surgery. Your stoma shrinks while it is healing and you need to keep measuring so you can make sure that the opening in the skin barrier is the right size for your stoma. Remeasure your stoma if any irritation develops between the stoma and skin barrier wafer.
Instructed patient to check your skin and the back of your skin barrier each time you change your pouching system. You can use a mirror to check your skin under the stoma. Look for any places where stool or urine may have leaked under the skin barrier and onto your skin. When you apply your next pouching system these areas may need some extra reinforcement with skin barrier strips, rings or paste.
Instructed patient when you have a stoma that drains urine or loose stool you may want to consider using an extended wear skin barrier because it will give your skin added protection. Itching or burning under the skin barrier may indicate that you have leakage, a skin rash, or a skin infection. You need to remove your pouching system as soon as possible to check your skin for any irritation.
Instructed patient the stoma is your bowel. It is protected by mucus so stool or urine won’t hurt it. A stoma rarely becomes infected. The most important thing is to protect the skin around your stoma. A correct fitting pouching system is the best way to prevent an infection of your skin. If there is a small leak under my skin barrier, is it okay to patch it with tape or paste: Always change your pouching system at the first signs of leakage.
Instructed patient If there is a small leak under my skin barrier, is it okay to patch it with tape or paste: Do not try to patch the pouching system with tape or paste. A leak under the skin barrier should not be fixed. Leaving a leaking pouch on can cause skin irritation. Always empty your pouch before it is half-full. Release gas before the pouch gets too full. If you have a lot of gas, you may want to consider using a pouch with a vent or filter.
Instructed patient it is very important to prevent infection, which might require removal of the PICC line. The nurse will show you how to keep your supplies sterile, so no germs will enter the catheter and cause an infection.
Instructed patient Home care nurses will teach you and help you become comfortable with the procedures before you do them yourself. These are the special things that need to be done preventing infection, flushing the PICC line, giving the medicine, solving problems, knowing when and who to call for help.
