high blood pressure/1000
SN instructed patient / caregiver on medication Hydrochlorothiazide. SN explained to patient that Hydrochlorothiazide ( HCTZ ) is a medication indicated for edema and hypertension. SN explained to patient / caregiver that it is a diuretic that reduces fluid volume overload which, in turn, lowers blood pressure. Explained that side effects of this medication includes dizziness, dehydration, weakness, pancreatitis, anemia and nausea. SN instructed patient / caregiver to notify physician ( MD ) if experiencing persistence or worsening of side effects.
SN instructed patient / caregiver about the medication Isosorbide. SN explained that Isosorbide is a medication given to reduce the blood pressure and that it also reduces the heart rate. SN explained that the side effects of this medication includes fatigue, anxiety, weakness, dizziness, tachycardia, pulmonary edema, constipation and dry mouth. SN instructed patient / caregiver to notify physician ( MD ) if experiencing persistence of side effects or if experiencing blurred vision, difficulty breathing, wheezing, dizziness, light - headedness, confusion, depression or dry mouth.
Sn instructed on monitoring vital signs blood pressure, temperature, oxygen and weight instructed on what equipment is needed and SN will instruct on equipment logging and reporting of vital signs. Sn instructed on importance in logging vital signs and monitoring if medication is working or change of condition. Sn will instruct patient after vitals are done on what to report to physician / nurse ( MD / SN ). Patient verbalized understanding.
SN instructed patient What can you do to control blood pressure? To minimize the risk of hypertension, control sodium, potassium, and other essential electrolytes the body uses to maintain fluid balance. The recommendation for patients with kidney disease: limit sodium intake to no more than 1,500 mg per day. Most sodium in today’s diet comes from processed foods and restaurants foods. Unhealthy lifestyles choices, such as smoking tobacco, obesity, and excessive alcohol consumption, may also contribute to hypertension.
Instructed patient that PCP only receives one snapshot of vitals signs including BP, and stressed importance of maintaining BP log so that PCP may adjust as needed.
Patient instructed on Symbicort as following: is used long-term to improve symptoms of COPD, including chronic bronchitis and emphysema, for better breathing and fewer flare-ups. Do not use Symbicort for sudden severe symptoms of COPD or asthma. Use only as directed. SE include chest pain, fast and irregular heartbeat, tremor, increased blood pressure, headache or nervousness, Fungal infection in your mouth or throat (thrush). Rinse your mouth with water without swallowing after using Symbicort to help reduce your chance of getting thrush. Call your healthcare provider if you notice any of the following symptoms: increase in mucus production or change in color, fever, increased cough, chills, or increased breathing problems.
Instructed patient on Prednisone which is used for allergy reactions, rheumatoid arthritis among other diseases. Side effects include: swelling in hands, face and feet, increased hunger, muscle weakness and abdominal distention. One interaction of Prednisone is it may cause hypernatremia, hypokalemia, fluid retention, and elevation in blood pressure.
SN completed all education for this SNV, and reminded patient on the importance of going to all medical appointments, bringing blood pressure log and all of his/her medications. Patient/Caregiver verbalized understanding.
SN instructed patient and caregiver on some measures aimed to controlling/managing constipation, such as: establish regular times for evacuations usually after a meal and drink a warm liquid one-half hour before breakfast to stimulate bowel movement, avoid laxative and enema abuse. Instructed on some potential complications of constipation, such as: stool impaction bowel blockage, liquid bowel movement may ooze around hard stool in the colon, pain, valsalva maneuver may be caused by straining, causing a slowed pulse, decreased blood return and increased venous pressure, rectal bleeding and rectal pain.
Instructed patient on how sometimes blood flows with enough force to weaken a vessel wall. If the vessel is small or damaged, the wall can break. When this happens blood leaks into nearby tissue and kills cells. Other cells may die because blood cannot reach them.