skin-protection
Instructed patient about how help decrease edema and keep it from coming back -Protection. Keep the affected area clean, moisturized and free from injury. Dry, cracked skin is more prone to scrapes, cuts and infection. Always wear protection on your feet if that's where the swelling typically occurs.
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.
SN Instructed to the urostomy care: How to change the Urostomy bag: Prepare the new bag. Gather everything you need in the bathroom: plastic bags, toilet paper, paper towels or a soft washcloth, a clean cloth wipe, an additional skin barrier in the form of a paper towel (if desired) and a new bag.If the bag you use does not come with a skin barrier already made, take the measurements and now form the opening with scissors. Slowly remove the skin barrier lining. Put aside the skin barrier. Empty the used bag before removing it. To empty the bag, sit on the toilet or stand in front of it: Remove the used bag. To remove the used bag, sit on the toilet or stand in front of it. Carefully separate the skin from the skin barrier with one hand. To do this, start at the top edge of the skin barrier. With the other hand, slowly release the skin barrier from top to bottom. Seal the used bag tightly inside a plastic bag and dispose of it in the trash: Clean the area around the stoma. Use toilet paper to clean urine and mucus in the stoma or the skin around it. Clean the skin with warm water and a soft cloth wipe or a paper towel. Clean up to the stoma border. You can also do this while showering. Dry the skin without rubbing, using a clean towel; and Place the new bag. Use a folded paper towel or a piece of gauze to keep the stoma dry while placing the new pouch. Once you have changed the bag, wash your hands.
Caregiver was instructed that most people pinch up a fold of skin and insert the needle at aangle to the skin fold. To pinch the skin properly, follow these steps: Squeeze a couple of inches of skin between the thumb and two fingers, pulling the skin and fat away from the underlying muscle. (If use a 5 millimeter mini-pen needle to inject, you don't have to pinch up the skin when injecting at aangle; with this shorter needle, you don't have to worry about injecting into muscle.)" Insert the needle, Hold the pinch so the needle doesn't go into the muscle, Push the plunger, "release the grip on the skin fold. Remove the needle from the skin.
Instructed patient how do I care for my skin around my trach tube. Clean your skin at least once each day. You may need to clean it more often if you cough up a lot of thick mucus. You may need someone to help you clean your skin. Wash your hands and put on gloves. This will prevent infection. Suction the area around your stoma. This will help remove mucus .Clean your skin around the stoma, clean the tube flanges, change wet or dirty trach ties., place a gauze between your skin and the flanges and check your skin every day for signs of infection. Look for redness or swelling of the skin around your tube. Also look for pus, bleeding, or a rash.
SN instructed patient and caregiver on preventing skin tears. In terms of prevention, protective arm sleeves are helpful. The use of paper or gentle release tapes is also a better alternative to nylon tape, when it comes to sensitive or aging skin. In addition, it is important to routinely moisturize dry skin with an appropriate moisturize barrier. As we age, hydrating dry skin helps to replenish missing skin and keep skin healthy and intact. Oral hydration is important as well. Patient and caregiver verbalize understanding instructions given.
Patient was instructed about the feet care: always wear shoes or slippers. Always wear socks with the shoes, since leather, plastics, and manmade shoe materials can irritate your skin and quickly bring on blisters. While the Diabetic patient might prefer the look of hose, nylon knee-highs, or thin socks, may find that these doesn't give to the toes or heels enough protection. Wear thicker socks to pad the feet and cushion any calluses or sore spots. Further teaching is needed.
Instructed patient classic barriers to spontaneous closure include distal obstruction, mucocutaneous continuity (ie, a short or epithelialized tract), and infection or malignancy in the tract. Comprehensive and effective management of the patient with fistula requires attention to fluid and electrolyte replacement, per fistula, skin, protection, infection control.
Instructed patient through the use of negative pressure wound therapy, a standard surgical drain, and optimized nutrition, fistula drainage was redirected and the abdominal wound healed, leaving a drain controlled enterocutaneous fistula. Patient control of fistula drainage and protection of surrounding tissue and skin is a principle of early fistula management.
SN assessed portacath insertion site every visit. SN instructed s/sx to report to SN / MD such as redness, pain, puffiness around port, drainage from insertion site, temperature above 100 degrees, shortness of breath and chest pain. Sn instructed on portacath care and protection of the skin over the port.