The patient was instructed in carpal tunnel release on care of the hands and dressings, to keep the arm and hand elevated above heart level to reduce swelling and healing. The patient was reviewed to check the dressing daily for signs of bleeding or drainage, when bathing are permitted the patient should be shower with the dressing covered by a plastic bag. The patient was recommended to follow prescribed exercises to maintain circulation and improve range of motion such as sponge squeezing.
The patient was instructed in cataract surgery need to wear an eye shield at night for 2 to 6 weeks to avoid eye injury, warn that depth perception may be lost and 50% of peripheral vision will be lost because of the eye patch. The patient was advised to avoid falls by turning the head fully to the affected side to view objects. The patient was taught to use up-and-down head movements to judge stairs and oncoming objects and to move slowly. The patient was recommended to wear dark glasses during the day to avoid pupil constriction and glare.
The patient was instructed in electrophysiology study cardiac mapping on care of the puncture site. The patient was advised that bruising of and around the insertion site is normal. The patient was instructed in the importance of not smoking or using tobacco products. The patient was taught how to take the pulse for a full minute. The patient was advised the importance of leading a normal, productive life. The patient was instructed to understand what precautions to take at work and at home. The patient was advised the need to identify a health care facility near home and work.
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.
Skilled nurse remove PICC,line per doctor order, the catheter tip should also be examined and there is no breakage at the end, no S/S of infections noted. Skilled nurse applied at the insertion site with sterile gauze to prevent bleeding which and when the bleeding stops, the gauze is removed and a sterile dressing is applied. Instructed patient the dressing should remain for approximately 24 hours. After this time, the site should be assessed and a new dressing applied if needed. Patient understand the instructions given.
The patient was instructed in endoscopy that a sore throat or eructing may continue for 3 days after the practice. The patient was advised throat pills or warm gargles to ease throat pain. The patient was instructed to follow a prescribed diet for the original condition when gag and swallowing reactions coming back, in 2 to 4 hours. The patient was advised to beginning with soft, bland foods until soreness decreases.
The patient was instructed in enucleation explaining the importance of not rubbing, touching, or bounding the orbit or wearing eye makeup. The patient was taught in cleaning the lid and shows how to remove drainage by gently sweeping the cotton ball from the inner to the outer. The patient was instructed in the care of the eye socket how insert and remove if used. The patient was advised to wear an eye protection or patch to keep the socket clean until the prosthesis is fixed. The patient was instructed the need to protect the vision in the lasting eye. The patient was advised in the importance of good handwashing before managing ophthalmic medications. The patient was advised that with the loss of one eye, the field of vision is limited and profundity perception changes need to overstress head movements to achieve a full visual field. The patient was advised using caution during activities until patient adjusts to the loss.
Patient is unable to perform wound care due to complexity of wound, location, size of wound, poor manual dexterity, forgetful (dementia), and knowledge deficit. No skilled/willing caregiver to perform wound care.
The patient was instructed in fixator devices external fixator on pin and fixator care, wash fixator with sterile water and cover each pin head with plug or rubber tip to prevent injury. The patient who has gone through external fixation was reviewed in stress the need to increase movements and weight manner slowly to reduce tenderness and to permit muscles to recover strength. The patient was advised do not use the external fixator as a handle or support for the extremity but to support the extremity with pillows, two hands, or a sling to prevent excessive stress on the pins. The patient was advised to elevate the extremity when sitting or lying down. The patient was recommended of not changing or adjusting the fixator’s bars, since this can cause misalignment. The patient was explained that showering is permitted but that swimming should be evaded because chlorine and salt can corrode metal.
The patient was instructed in fixator devices internal fixator positions a risk for refracture and analysis preventive actions, care in support walking, and no weight manner in anticipation of well-ordered by the doctor. The patient was advised that some nails or large plates may be removed in a year.
