SN instructed patient on the importance of daily monitoring of the blood pressure; along with reporting an elevated BP of 160/90 and above to MD/SN stat.
The patient was instructed in fractures in stress the importance of turning and moving frequently to evade skin breakdown. The patient was advised to handle hurt tissues softly by supporting the joint above and below the location. The patient was explained in how to wound care. The patient was recommended to elevate the extremity and apply ice bags. The patient was instructed in the use of ambulatory aids, crutch walking, cane, and walker. The patient was explained in the importance of range-of-motion exercises to maintain function of natural joints. The patient was taught in exercises to maintain strength and facilitate resolve of inflammation.
SN instructed patient that water helps flush your urinary tract, make sure you drink plenty of plain water daily. Don't hold it when you need to urinate. Holding it when you need to go can help any bacteria that may be present develop into a urinary tract infection. Wipe from front to back after a bowl movement. This is especially important to help prevent bacteria from the anus from entering the vagina or urethra.
The patient was instructed in gastrectomy indicating good wound management, dressing changes, process, regularity, and check of skin. The patient was advised in obtaining appropriate devices, such as ostomy appliances, sterile dressings, and tube feedings and feeding pump. The patient was explained in characteristic relief of abandoning syndrome. The patient was advised to plan a low-carbohydrate, high-fat, high-protein diet. The patient was taught to eat small, frequent meals and to avoid taking liquids with meals. The patient was recommended to adopt a reclining position after meals.
Medication profile reviewed and reconciled. SN reviewed and instructed patient on medication regimen of spirivia. Instructed patient that medication is used for maintenance treatment of bronchospasm associated with chronic obstructive pulmonary disease (COPD). Spiriva HandiHaler is indicated to reduce exacerbations in COPD patients. Instructed patient that, with administration of Spiriva HandiHaler, a Spiriva capsule is placed into the center chamber of the HandiHaler device. The capsule is pierced by pressing and releasing the green piercing button on the side of the HandiHaler device. The tiotropium formulation is dispersed into the air stream when its inhaled through the mouthpiece. Instructed to inhale once or twice to get al medication inhaled. Instructed patient that dry mouth or constipation may occur. Instructed to notify MD/SN right away if any serious side effects, including: vision changes (such as blurred vision, seeing halos), eye pain, difficult/painful urination, fast heartbeat.
The patient was instructed in gastrostomy indicating the training and management of tube feedings, including quantity and regularity. The patient was advised to sit upright during feeding and for 1 hour after feeding to prevent reflux into the esophagus or backflow into the gastrostomy tube. The patient was explained to take care of the gastrostomy tube. The patient was taught that the tube may eventually be removed and inserted only for feeding. The patient was taught to protect the stoma with a small gauze pad.
Instructed caregiver in vacuum assisted closure (VAC) that is a type of therapy to help wounds heal. The process heal open wound through the application of negative pressure. Another benefits of the negative pressure wound therapy are draining excess fluid from the wound, keeping your wound moist and warm, helping draw together wound edges and increasing blood flow to your wound. Caregiver verbalized understanding.
Instructed patient about his social life he will be able to resume your social activities. Your colostomy should not interfere. You will gain confidence and security with the pouch remaining intact. You will be able to be independent in emptying and changing the pouch.
Patient was instructed about showering and bathing. The pouches are waterproof therefore you can wear it in the shower. Your pouch will remain intact when underwater, bathing bathing or swimming.
Instructed caregiver when to Call the doctor: If you have choking or difficulty breathing during a feeding, stop the feeding and call your doctor immediately.If you cannot unclog your tube, call your doctor immediately.
