skin care
Procedures
RN performed supervision with HHA present and reviewed that the HHA Care Plan is followed as ordered. Patient is satisfied with rendered services. RN instructed patient and caregiver on strategies that can significantly help decrease the risk of a fall such as: skid - proof mats or strips in the shower and bathtub, removal of furniture that can slip away if grabbed accidentally for support, supportive non - slip footwear and not walking in stocking feet. RN also explained that side effects of most medications taking can cause dizziness and advised to immediately report the occurrence of dizziness so that it can be addressed by physician. Patient and caregiver voiced understanding of all instructions given.
SN instructed patient about tracheotomy care suctioning always involves: assessment , oxygenation management, use of correct suction pressure,
liquefying secretions, using the proper-size , suction catheter and insertion distance appropriate patient positioning,
evaluation, using the proper - size suction catheter and insertion distance appropriate patient positioning evaluation.
SN instructed patient that fluid restrictions are usually necessary when dialysis is initiated, especially if dialysis only occurs three days a week and if urine production is decreased. Build up of fluid can lead to shortness of breath, swelling, and high blood pressure. There is a limit to the amount of fluid that can be safely removed during dialysis. If fluid limits are exceeded and extra water must be removed, negative effects such as muscle cramping, low blood pressure leading to nausea, weakness, dizziness, and possibly extra dialysis sessions to remove the fluid.
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 to cleanse feet daily, dry thoroughly especially in between toes. Examine feet daily for bruises/sores/blisters, if any noted, notify MD asap. (use a mirror if needed to visualize) Wear proper fitting shoes and wear slippers/shoes at all times, and exercise feet daily. Demonstrated feet exercises, verbalized understanding.
SN instructed patient High blood pressure often has no warning signs or symptoms, so many people don’t realize they have it. Some symptoms may include headache, blurred vision, nervousness, sweating, difficulty sleeping or facial flushing. Even with no symptoms, hypertension needs ongoing treatment to protect the heart, kidneys and other organs from further damage.
Tracheostomy Care Instructed patient long term complications include acute airway obstruction, blocked tube, Infection localized to stoma or
tracheo-bronchial
Tracheostomy care Instructed patient to contact the doctors or nurse if there are any signs of infection at the stoma site including
any redness, odor, swelling.
PICC line removal Education provided on site care following PICC line removal: positioning, keep dressing clean, dry and intact 24 hrs, do not lift over 5 lbs, report immediately S&S complications to on call RN: fever; chills;redness at site, swelling or purulent drainage at site, bruising or bleeding at site, increased shortness of breath.
Instructed caregiver provide consistent care. Increase communication verbal and tactile stimulation . Give simple instructions and repeat, give positive reinforcement on child outcomes. Caregiver verbalized.