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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.
Patient was instructed about how to check both feet daily looking over them carefully every day, and be sure check between all of the toes. Blisters and infections can start between the toes, and with diabetic neuropathy, may not feel them until they've become irritated or infected. If physical challenges occur, ask a family member to help. Further teaching is needed.
Patient was instructed about how make sure the shoes fit well. Even the slightest rubbing or misfit shoe can cause a blister that turns into a sore that becomes infected and never heals. Buy better-fitting shoes, or try different socks, even at the most minor signs of redness or irritation, since you may not be able to feel when it's getting worse. Before buying or putting on the shoes check your shoes for rough seam, sharp edges or other objects that could hurt your feet. Further teaching is needed.
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.
Patient was instructed on skin care. Keep the skin clean and dry. When bathing or showering, use warm water and a mild, moisture-containing soap. After washing, make sure to rinse and dry the body well. (Pat the skin dry, do not rub). Check places where water can collect such as under the arms, between the legs and between the toes.
Patient was instructed on the importance of skin integrity to avoid future complication. With a good skin care it is possible to prevent most pressure sore (bed sores), that can develop quickly in people who are very thin or obese, or who collect fluids in their tissues, who have poor nutrition, who are elderly.
Patient was instructed on relaxing sight. Sighing and yawning during the day are signs that you are not getting enough oxygen. A sigh releases a bit of tension and can be practiced at will as a means of relaxing. Sit or stand up straight. Sigh deeply, letting out a sound of deep relief as the air rushes out of your lungs. Let new air come in naturally.
Patient was instructed on breathing methods. They are useful to settle the body and mind and induce a heightened sense of awareness. Breathing exercises have been practiced for thousands of years. Breathing exercises can be helpful for reducing anger, anxiety, depression, fatigue, irritability, muscular tension and stress.
The patient was instructed in head trauma in the importance of the wound/incision care in any laceration or medical cut. The patient was advised that possible remaining effects like dizziness, headaches, memory loss can be continue for up to 3 to 4 months after trauma. The patient was reviewed that may experience variations in character, inappropriate social behavior, hallucinations. The patient was taught in finding assistive devices for ambulation. The patient was reviewed in concussion to evade Valsalva maneuvers like pulling during defecation, coughing, nose blowing, sneezing.
Instructed patient if your trach tube comes out Don’t panic! Stay calm. Your stoma will stay open. If you do not know how to put the tube back in or you can’t get it in, have someone take you to the nearest Emergency Department, or go to your family doctor’s office. Take your extra trach tube with you.