bleeding
Instructed patient caregiver when you should call the doctor: continuous bleeding where the stoma meets the skin unusual change in your stoma size or color anything unusual going on with your ostomy.
Instructed patient call your provider if: Your stoma is swollen and is more than a 1/2 inch (1 cm) larger than normal.Your stoma is pulling in, below the skin level. Your stoma is bleeding more than normal.
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.
SN instructed patient and caregiver on some measures aimed to controlling/managing constipation, such as: establish regular times for evacuations usually after a meal and drink a warm liquid one-half hour before breakfast to stimulate bowel movement, avoid laxative and enema abuse. Instructed on some potential complications of constipation, such as: stool impaction bowel blockage, liquid bowel movement may ooze around hard stool in the colon, pain, valsalva maneuver may be caused by straining, causing a slowed pulse, decreased blood return and increased venous pressure, rectal bleeding and rectal pain.
Instructed patient how do I care for my skin around my trach tube. Clean your skin at least once each day. You may need to clean it more often if you cough up a lot of thick mucus. You may need someone to help you clean your skin. Wash your hands and put on gloves. This will prevent infection. Suction the area around your stoma. This will help remove mucus .Clean your skin around the stoma, clean the tube flanges, change wet or dirty trach ties., place a gauze between your skin and the flanges and check your skin every day for signs of infection. Look for redness or swelling of the skin around your tube. Also look for pus, bleeding, or a rash.
Instructed patient call your doctor if you have:fever or chills, redness, swelling, or pain that is getting worse, bleeding or drainage from the hole, cough or shortness of breath, even after you suction your tube, nausea or vomiting, any new or unusual symptoms.
Instructed patient if you are taking a blood thinner, be sure you get instructions about how to take your medicine safely. Blood thinners can cause serious bleeding problems.
Instructed patient Call 911 anytime you think you may need emergency care. For example, call if: You passed out (lost consciousness). You have signs of severe bleeding, such as: A severe headache that is different from past headaches. Vomiting blood or what looks like coffee grounds. Passing maroon or very bloody stools.
SN instructed patient and caregiver on SIMVASTATIN. Simvastatin is a cholesterol-lowering medicine. It inhibits the production of cholesterol by the liver. High blood cholesterol is first treated with exercise, weight loss, and a diet low in cholesterol and saturated fats. When these measures fail, cholesterol-lowering medications such as Simvastatin can be added. Simvastatin is generally well-tolerated and side effects are rare. Minor side effects of Simvastatin include constipation, diarrhea, fatigue, gas, heartburn, and headache. Major side effects of Simvastatin include abdominal pain or cramps, blurred vision, dizziness, easy bruising or bleeding, itching, muscle pain or cramps, rash, and yellowing of the skin or eyes.
Patient was instructed on leg wound's use direct pressure and elevation to control bleeding and swelling. When wrapping the wound, always use a sterile dressing or bandage. Very minor wounds may heal without a bandage.