including damage eyes retinopathy which can lead blindness damage nerves neuropathy
Patient was instructed on treating painful wounds. Persistent pain associated with non-healing wounds is caused by tissue or nerve damage
and is influenced by dressing changes and chronic inflammation. Chronic wounds take long time to heal and patients can
suffer from chronic wounds for many years.
Patient was instructed on foot care: a podiatrist can
also fit patient with shoe inserts called orthotics to support the feet if have diabetic nerve pain or the muscles have become weak from nerve damage
. If pain or weakness is so severe that it's too painful or even impossible to walk, a foot brace or orthopedic shoes might help. Further teaching is needed.
Patient was instructed on foot complications. People with diabetes can
develop many different foot problems. Foot problems most often happen when there is nerve damage
in the feet or when blood flow is poor. The protection of the feet is very important.
Patient was instructed on diabetes with injury. People who have diabetes are vulnerable to nerve and vascular damage
that can
result in loss of protective sensation in the feet, poor circulation, and poor healing of foot ulcers. Careful attention needs to be paid to any abrasion or wound to ensure the quickest healing possible. It is important for people with diabetes to routinely inspect feet, in particular, to check for any issues.
Patient was instructed on HTN and how it affects the heart and it's function. Over time HTN if uncontrolled can
damage
the vessels of the heart, leaving it unable to pump blood efficiently. This causes what is known as heart failure. Symptoms you may experience and should report to your MD are swelling in your feet or hands, crackles in your chest when breathing, increased shortness of breath.
SN instructed patient on atherosclerotic heart disease also known as Coronary Artery Disease (CAD); is the damage
or disease in the heart's major blood vessels. The usual cause is the buildup of plaque. This causes coronary arteries to narrow, limiting blood flow to the heart. Coronary artery disease can
range from no symptoms, to chest pain, to a heart attack. Treatments include lifestyle changes, medications, angioplasty, and surgery.
Instructed that High blood pressure (hypertension) is a lead
ing cause of kidney disease and kidney failure (end-stage renal disease). Hypertension can
cause damage
to the blood vessels and filters in the kidney, making removal of waste from the body difficult. SN instructed patient about some measures aimed to managing & controlling hypertension, such as: eating low sodium diet , increase more fruits to increase your potassium, walk daily for 30 minutes, and have regular check-ups, as directed by Physician.
SN instructed patient about High blood pressure. Normal blood pressure is when your blood pressure is lower than 120 / 80 mm / Hg most of the time. High blood pressure ( hypertension ) is when your blood pressure is 140 / 90 mm / Hg or above most of the time. SN explained that the "top number" systolic indicates the pressure in the vessels when the heart beats. The "bottom number" diastolic indicates the pressure in the vessels when the heart is at rest, to between beats. This number is the most concerning number because it tells your medical team the constant pressure on these vessels. Too high (over 80) can
cause damage
Instructed in the importance of including
more fiber in diet if not contraindicate. Instructed to take fresh fruit, cooked or stewed fruits, green vegetables, root vegetables and whole grain food.
Instructed in new medication Glucovance to improve glycemic control in patients with type-two diabetes whose hyperglycemia can
not be controlled with diet and exercise alone. In addition, warned of possible S/E such as headache, dizziness, diarrhea, nausea, vomiting, abdominal pain, hypoglycemia, lactic acidosis, or upper respiratory tract infection. Instructed to take one daily with breakfast and, if twice daily, then at breakfast and dinner. Stop drug and tell prescriber of unexplained hyperventilation, myalgia, malaise, unusual somnolence, or other symptoms of early lactic acidosis. GI symptoms are common with initial drug therapy but GI symptoms that occur after prolonged therapy may be related to lactic acidosis or other serious disease and should be reported promptly. Instructed not to take any other drugs, including
OTC drugs, without checking with prescriber.