catheter-teaching-guide
General
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
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.
SN instructed pt on hygiene r/t wound care. It is very important to maintain a clean environment as well as clean , dry skin. Do not pick at wounds, or at other areas of the skin. Our fingernails harbor bacteria under them, wash hands throughly and often throughout the the day with soap and water, hand sanitizer can be used in between but are not a substitute for proper hand washing.
SN instructed on the need for adequate fluid intake, establishing a toilet schedule such as every 2 hours, or before or after activities, meals, sleep, and rest periods.
SN instructed patient / caregiver on proper incontinence care as to check every 2-3 hours if needed. Educated on pressure reduction measures as to change patient's position in bed/chair every 2-3 hours, avoid positioning on affected areas and use pressure reduction mattress or chair cushion.
Instructed patient and caregiver what not do with her LVAD. Kink, bend or pull your driveline, disconnect the driveline from the controller (under normal circumstances), Sleep on your stomach, Take a bath or swim, Play contact sports, Have an MRI (CT Scans or X-Rays are OK), Attempt to repair LVAD equipment yourself, Leave the house without backup equipment. understanding was verbalized.
Instructed patient that when traveling with an LVAD will involve some extra planning and preparation.When scheduling a trip, discuss your plans ahead of time with your LVAD team. They‘ll help you be as independent as possible, and still stay safe and healthy. They can also provide you with the necessary travel documents, as well as helpful tips. Understanding was verbalized.
Instructed patient to remember that shorter "trips" take planning too: Any time you leave your home whether it’s a one-hour drive to visit friends or a ten-minute walk to get groceries you will need to bring your backup controller and power sources with you, plus any medications you’re scheduled to take. Understanding was verbalized.
Instructed patient that for healthy living with your LVAD, you’ll need to make sure that: the equipment is working properly,you have sufficient power sources at all times, your driveline exit site is clean and dry, following a healthy diet, exercising regularly, as you’re able to tolerate it, are taking your medications and supplements as directed by your doctor. Understanding was verbalized.
Patient was explained that having a nephrostomy tube in for a long time increases the risk of getting an infection. Nephrostomy tube care focuses on preventing infection. Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor or nurse call line if you are having problems. It's also a good idea to know your test results and keep a list of the medicines you take.. understanding was verbalized