skin-protection
Others
Instructed caregiver how to prevent Pressure Ulcers for Bed bound patients: Take care of the Skin Inspect the skin at least once every day. Pay attention to any red areas that remain even after changing position.
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.
SN instructed patient instructed patient caregiver how to do Ostomy Care, as follow: Preparing, Applying, and Removing an Ostomy System to make the process easier and more effective, here are several easy steps you and your patients can follow when applying and removing an ostomy system: Remove Use an Adhesive Remover Wipe, Clean Clean & Dry Clean peristomal skin with non-moisturizing or non-oily soap, rinse well with clean water and pat dry, Measure Measure Stoma Place the stoma measuring guide over the stoma, measuring the stoma at the base., Protect use an Adhesive Remover Wipe, Apply New Pouching System/Skin Barrier. Make sure to have a good seal around the stoma.
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 and caregiver that the key difference between a suspected deep tissue injury (sDTI) and an unstageable pressure ulcer is that sDTI involves intact skin, whereas an unstageable ulcer involves a breakdown into at least the subcutaneous tissue. An unstageable ulcer is covered with necrotic tissue, such as slough or eschar, formed from remnants of the collagen matrix of subcutaneous tissue. So it’s always a full-thickness ulcer either stage III or stage IV.
Patient was instructed on nerve damage as a complication of diabetes. Because of the lost sense of feeling in the extremities it is possible to not feel any discomfort in the feet, and it is also possible to develop sores that can turn into skin ulcers without being aware of it.
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.
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 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.