skin care
Others
If your big toe slants sharply in toward your other toes, with a big bump on the knuckle of your big toe, you've got a classic bunion. Corns are spots of thick, rough skin, where the tissue builds up on toes constantly barraged by too much rubbing or pressure. A buckled-under toe, called a hammertoe, can result from muscle weakness caused by diabetic nerve damage. All of these make it hard to fit shoes comfortably. But a good podiatrist can help you fix these problems and take better care of your feet.
Patient was instructed on the importance of a good foot care. Calluses indicate that areas of the feet are receiving too much pressure. If the increased pressure continues, the skin may break down and it is possible to get a foot ulcer.
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.
The patient was instructed in burns and its classification. The patient was advised that the curative process with new skin progress is expected in 6 weeks with mature healing within 6 to 12 months, depending on the extended of injury. The patient was taught to care of healed burns, avoiding exposure to direct sunlight, harsh detergent, fabric softeners etc., avoid contact with persons with infections especially upper respiratory infections. The patient was recommended to obtain medical supplies for dressing and any special assistive devices for home care management. The patient was encouraged in the importance of physiotherapy to assist in the exercise regimen and water exercises to maintain limb mobility.
SN instructed on hyperthermia. Explained that hyperthermia is when the body's core temperature is below the normal and one start to shiver tremendously which and can turn worse into a glassy stare, pale in color, even frost bite, also altered mental status if severe enough. If by chance pt or any loved one was to start experiencing this, and if in wet clothes, one must get out of them into warm dry clothes. Gradually start warming the body with blankets and avoid giving any liquids if in the stage of altered mental state, due to possibility of person going unconscious. Never give person alcohol, or anything with caffeine. Skin to skin contact can help bring ones body temperature up. If frost bit occurs, one can warm body part usually fingers and toes up in warm to hot water up to 110degrees by soaking for awhile, if person is going to moved out of warm place do not re-warm feet just apply 4x4's in-between toes to avoid them sticking to each other.
Instructed patient Be sure to treat any skin redness or skin changes right away, when the problem is still small. Do not
allow the sore area to become larger or more irritated before asking your doctor about it.
SN instructed patient / caregiver on service authorization, advance directives, rights and responsibilities, rights of the elderly and obtained necessary signatures. Instructed patient / caregiver on 24 hour nurse availability and provided / posted the agency telephone number. Also instructed that after hours, weekends and holidays an answering service will reach the nurse and he / she will return the patient / caregiver call and answer any questions or make a visit if needed. Patient and caregiver stated understanding. Patient and caregiver educated on diabetic diet, diabetic foot care, symptoms / signs ( s / s ) of depression, managing pain with medications, healthy skin, and pressure ulcer prevention. Leaflets left in home.
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.
Patient was instructed about foot care, trying non-impact exercise such as swimming, cycling, yoga, and tai chi are increasingly popular ways to exercise - with minimal impact on the feet. Talk with the doctor before starting an exercise program. Further teaching is needed.
Patient was instructed on foot care: a podiatrist can also fit patient with shoe inserts called orthotics to support the feet if have diabetic nerve pain or the muscles have become weak from nerve damage. If pain or weakness is so severe that it's too painful or even impossible to walk, a foot brace or orthopedic shoes might help. Further teaching is needed.