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Procedures
SN instructed patient/cg if you notice leakage of bile around the biliary tube, this may be a sign that the catheter is blocked, call your nurse.
Instructed patient call your doctor if the following persist: diarrhea, constipation, nausea, or dehydration, call your doctor if you have redness, pain, swelling, or unusual drainage at the stoma site.
Instructed caregiver include ensuring that the tracheotomy tube is securely in place and is patent.
Instructed patient sterile technique includes: Hand washing, Wearing sterile gloves. Using a new trach tube, inner cannula, and trach tie. Using sterile water (new bottle or bag every 24 hours). Discarding suction catheters after each use.
Instructed patient Clean technique includes: Hand washing, Using gloves is optional. Re-using a trach tube and/or inner cannula that has been properly cleaned, Using prepared sterile water and normal saline. Re-using the same trach ties if they are properly cleaned. Re-using suction catheters if they are properly cleaned(up to 8 hrs or 3/per day)
Instructed patient as much as possible, the skin should be kept clean and dry. You may need to clean the skin around the trach tube several times throughout the day. Call your doctor if you notice thick secretions that are yellow or green in color.
Instructed patient if you has a problem trouble flushing the PICC, unable to give medicines or fluid into catheter Unclamp it (if clamp is present). Remove the kink, if the catheter is not kinked or clamped, do not force the solution into the tube. Call the home care nurse to report the problem
Physical assessment done to patient after chemotherapy . Medication checked and reconciled. Hydration and nutritional status checked. Diet reviewed. Denies chest pain. Tube care done per physician ( MD ) order. Dressing changed. Still complained in pain in fingers, patient taught that one side effect of chemotherapy is pain in fingers which is called peripheral neuropathy, it results from some type of damage to the peripheral nerves. Certain chemotherapy drugs can cause peripheral neuropathy such as Vinca alkaloids ( vincristine ), cisplatin, Paclitaxel, and the podophyllotoxins ( etoposide and tenoposide) . Other drugs used to treat cancer such as thalidomide and interferon also can cause peripheral neuropathy.
Instructed patient you may need to keep track of how much formula and other liquids you have each day. You may also need to keep track of how much you urinate and how many times you have a bowel movement each day. Bring this record to your follow-up visits.
You may need to check your weight daily or weekly. Keep a record of your weights and bring it to your follow-up visits. Your healthcare provider may need to change your feedings if your weight changes too quickly.