bedbound-patients
General
Instructed caregiver how to prevent Pressure Ulcers for Bed bound patients: Protect the Skin patient from injury - Avoid massaging the skin on bony parts of the patient body. Limit pressure on bony areas by changing positions frequently. If the patient in a bed, preferably every 2 hours.
SN reviewed patients medication with primary caregiver and instruct on medication compliance to better control the patients disease process. SN refilled patient’s medication box for daily routine implementation during visit.
SN educated patient on the importance of daily vital sign monitoring. Due to patients disease processes it is important to monitor blood pressure, weight, pulse and oxygen daily if equipment is available. SN instructed patient to weigh correctly they need to wake up, pee and than weigh daily at the same time if possible, same amount of clothing, same area. Patient is to weigh prior to eating/drinking in the morning. Notify home health or PCP if -/+ 3 lbs in a day or +/-5 lbs in a week is seen. SN educated patient to monitor blood pressure and pulse, and instructed to check before medications and if elevated/low recheck in 1-2 hours. SN educated patient to always log vitals so patients MD has a larger snap shot on what is going on.Patient/CG verbalized understanding
Instructed caregiver persons with mental retardation are living longer and integrating into their communities. Primary medical care of persons with mental retardation should involve continuity of care, maintenance of comprehensive treatment documentation, routine periodic health screening, and an understanding of the unique medical and behavioral disorders common to this population. Office visits can be successful if physicians familiarize patients with the office and staff, plan for difficult behaviors, and administer mild sedation when appropriate. Some syndromes that cause mental retardation have specific medical and behavioral features. Health issues in these patients include respiratory problems, gastrointestinal disorders, challenging behaviors, and neurologic conditions. Some commonly overlooked health concerns are sexuality, sexually transmitted diseases, and end-of-life decisions.
Instructed patient a really important part of planning patients for stomas is to ensure the site is appropriate. Poor siting leads to a stoma which the patient has difficulty in changing and cleaning. This leads to increased risk of skin, and other, complications.
Instructed patient / caregiver having a stoma is a major event and patients can become very anxious and depressed. Adequate counseling is vital and this may need to include mental health specialists.
Sn instructed patient on ways to prevent Urinary tract infection ( UTI ). If the patient is elderly be careful with cleaning, be sure that the perineal area is being cleansed properly. Women should always wipe themselves from the front to the back. If you are tending to perineal care, take steps to ensure that you always wipe your starting in front of the urethra and wiping towards the anus. Before wiping the area again, fold the rag to a clean section. The idea is that residue from the anus should never be dragged toward or against the urethra. Patients that wear adult diapers, or briefs, should be changed on a regular basis. They should be checked every two hours or so and they should never be allowed to sit in dirty briefs for prolonged periods. You should also wiped and cleansed after every brief change and bowel movement. Douches should never be used. The right drinks - what you drink can make a difference. Caffeinated drinks and alcohol can irritate the bladder and should be avoided as much as possible. Patient and caregiver verbalized understanding.
SN instructed patient on ways to prevent Urinary tract infection ( UTI ). Cranberry juice contains active compounds that are able to survive the digestive process. In the urinary tract system, these compounds actively work to fight bacteria. Its effectiveness at treating urinary tract infections has been proven, and regularly consuming cranberry juice can help prevent them. You don’t have to choose straight cranberry juice, it can be blended with apple juice or even water for taste without losing its effectiveness. Water helps to keep the system flushed out, preventing bacteria from accumulating and causing problems. Cranberry juice or cranberry juice cocktails should be offered on a regular basis and water intake should be tracked daily to ensure the patients are consuming enough water. Never Force yourself and wait - when you need to go the bathroom, your needs should be tended to immediately. Do not, under any circumstances, wait for a long period of time. Holding a full bladder for long periods of time can quickly lead to a urinary tract infection. Patient / caregiver verbalized understanding.
SN instructed patient/ CG about thickened liquids. SN explained that thickened liquids are used to treat patients with Dysphagia. Thick liquids decrease aspiration. Thick liquids may give the patient more time to perform additional swallows or other swallowing strategies. Thickened liquids slow down the bolus flow to compensate for a delayed swallow and reduced airway closure.
SN instructed on intermittent claudication which is a condition caused by narrowing of the arteries that supply the legs with blood. Intermittent claudication causes pain in your calves when walking, Patients with intermittent claudication develop pain when they walk because not enough oxygen-containing blood reaches the active leg muscles. There are two main ways to treat claudication: medication and a surgical treatment, called revascularization. Medication therapies are often used initially as they are non-invasive. Compression therapy can also be used as a noninvasive way to treat symptoms of claudication. Intermittent calf compression has been shown in studies to improve symptoms-free walking distance.