FOLEY CATHETER CARE
Procedures
RN performed supervision with HHA present and reviewed that the HHA Care Plan is followed as ordered. Patient is satisfied with rendered services. RN instructed patient and caregiver on strategies that can significantly help decrease the risk of a fall such as: skid - proof mats or strips in the shower and bathtub, removal of furniture that can slip away if grabbed accidentally for support, supportive non - slip footwear and not walking in stocking feet. RN also explained that side effects of most medications taking can cause dizziness and advised to immediately report the occurrence of dizziness so that it can be addressed by physician. Patient and caregiver voiced understanding of all instructions given.
SN instructed patient about tracheotomy care dressing changes promote skin integrity and help prevent infection at the stoma site and
in the respiratory system. The patient should be instructed at least once per shift, apply a new dressing to the stoma site to absorb secretions and insulate the skin
. After applying a skin barrier, apply either a split - drain or a foam dressing. Change a wet dressing immediately.
SN instructed patient that fluid restrictions are usually necessary when dialysis is initiated, especially if dialysis only occurs three days a week and if urine production is decreased. Build up of fluid can lead to shortness of breath, swelling, and high blood pressure. There is a limit to the amount of fluid that can be safely removed during dialysis. If fluid limits are exceeded and extra water must be removed, negative effects such as muscle cramping, low blood pressure leading to nausea, weakness, dizziness, and possibly extra dialysis sessions to remove the fluid.
Physical assessment done to patient after chemotherapy . Medication checked and reconciled. Hydration and nutritional status checked. Diet reviewed. Denies chest pain. Tube care done per physician ( MD ) order. Dressing changed. Still complained in pain in fingers, patient taught that one side effect of chemotherapy is pain in fingers which is called peripheral neuropathy, it results from some type of damage to the peripheral nerves. Certain chemotherapy drugs can cause peripheral neuropathy such as Vinca alkaloids ( vincristine ), cisplatin, Paclitaxel, and the podophyllotoxins ( etoposide and tenoposide) . Other drugs used to treat cancer such as thalidomide and interferon also can cause peripheral neuropathy.
Tracheostomy care Instructed patient caregiver It is important to routinely clean the skin around the opening of the tracheostomy (stoma). This
will help prevent skin irritation and the build-up of secretions.
Instructed patient to cleanse feet daily, dry thoroughly especially in between toes. Examine feet daily for bruises/sores/blisters, if any noted, notify MD asap. (use a mirror if needed to visualize) Wear proper fitting shoes and wear slippers/shoes at all times, and exercise feet daily. Demonstrated feet exercises, verbalized understanding.
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.
SN instructed patient High blood pressure often has no warning signs or symptoms, so many people don’t realize they have it. Some symptoms may include headache, blurred vision, nervousness, sweating, difficulty sleeping or facial flushing. Even with no symptoms, hypertension needs ongoing treatment to protect the heart, kidneys and other organs from further damage.
Tracheostomy Care Instructed patient long term complications include acute airway obstruction, blocked tube, Infection localized to stoma or
tracheo-bronchial
Tracheostomy care Instructed patient to contact the doctors or nurse if there are any signs of infection at the stoma site including
any redness, odor, swelling.