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Cardiac Teaching 1866

Instructed patient Eat a heart-healthy diet Eating a healthy diet can reduce your risk of heart disease. A diet rich in fruits,
 vegetables and whole grains can help protect your heart. Beans, other low-fat sources of protein and certain types of fish 
also can reduce your risk of heart disease. Stop your activity if you feel short of breath, dizzy, or have any pain in your chest. Do not do any activity
 or exercise that causes pulling or pain across your chest, (such as using a rowing machine, twisting, or lifting weights.

Alzheimer's disease Teaching 1962

SN instructed caregiver that Alzheimer’s disease progresses and a loss of appetite often becomes apparent. Primary caregiver may notice that the patient does not eat as much or refuses to eat at all. Possible causes of a poor appetite include: inability to recognize food, poorly fitting dentures, certain medications, lack of physical activity, diminished sense of smell and taste.

General information Teaching 2651

SN instructed patient and caregiver that smoking causes cancer, heart disease, stroke, lung diseases, diabetes, and chronic obstructive pulmonary disease (COPD), which includes emphysema and chronic bronchitis. Smoking also increases risk for tuberculosis, certain eye diseases, and problems of the immune system, including rheumatoid arthritis. It is very important for you to quit smoking to prevent chances of getting any or all of the diseases.

Dementia Teaching 1996

SN instructed patient/ ALF that the dementia is not a specific disease. It's an overall term that describes a wide range of symptoms associated with a decline in memory or other thinking skills severe enough to reduce a person's ability to perform everyday activities.

Spontaneous coronary artery dissection ( SCAD ) Teaching 2134

SN instructed patient on spontaneous coronary artery dissection ( SCAD ) and stent placement. A stent is a small rod made out of metal or fabric. It is inserted into a coronary artery when there is a blockage or when the artery is narrow. A coronary artery is a blood vessel that carries oxygen to the heart muscle. You received a stent due to coronary artery disease ( also called SCAD). That is caused by a thickening of the inside walls of the coronary arteries. This thickening is called atherosclerosis. A fatty substance called plaque builds up inside the thickened walls of the arteries, blocking or slowing the flow of blood. If your heart muscle doesn't get enough blood to work properly, you may have angina ( chest pain ) or a heart attack. The stent will help hold the artery open so blood can flow and help keep the artery from narrowing again. You will need to take medicine that keeps the stent open and blood flowing. It is very important to take the medicine exactly how your doctor tells you to take it. In addition to taking medicine, the best way to keep your heart healthy is to maintain a healthy lifestyle. Quit smoking. Make sure you keep your blood pressure and cholesterol at healthy levels. Exercise as recommended by your doctor. Eat a heart - healthy diet. Patient verbalized understanding well.

Joint damaged Teaching 2187

SN instructed that the joint that is damaged by injury or disease can be removed and replaced with a new one. There are times when only a part of the joint needs to be replaced or repaired. Your healthcare provider may try other treatments before joint replacement surgery, such as steroid injections or medicines. Pain relief and increased function are the goals of joint replacement. Knee, hip, and shoulder joints are the most common joints replaced. Joints in your elbows, fingers, and ankles can also be repaired or replaced. Your risk of infection, bleeding, and blood clots increase with surgery. You may be allergic to the material used in your new joint. Nerves, muscles, tendons, and blood vessels near your joint may become damaged during surgery. The new joint may loosen or come out of the socket. Sn instructed patient on symptoms / signs ( S/S ) of infection such as fever, drainage, swelling, redness. Patient recalls back partial teaching of redness. Patient instructed to report any symptoms should they occur to physician / nurse ( MD / SN ).

General medication Teaching 2263

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.

Vital signs Teaching 2327

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

General information Teaching 2334

Skilled nurse developed patient plan of care with patient/caregiver involvement to be countersigned by physician. SN to perform complete physical assessment each visit with emphasis on disease process. SN to assess other co-morbidities including list diseases and other conditions that present themselves during this episode of care. SN to recognize and intervene to minimize complications; notify physician immediately of any potential problems that impede completion of patient recovery and desired goals.