carpal-tunnel-syndrome
The patient was instructed in carpal tunnel syndrome to avoid activities that increase stress on inflamed tissues, grasping and gripping action of hand and wrist, to keep the wrist in neutral position, to avoid the wrist in a bent flexed, twisted, turned position, and to minimize repetitive movements, including holding an object for extended periods of time. The patient was advised to wear a wrist splint to help keep the wrist in neutral position. The patient was taught on range-of-motion exercises and their importance for strengths of muscles.
The patient was instructed in carpal tunnel release on care of the hands and dressings, to keep the arm and hand elevated above heart level to reduce swelling and healing. The patient was reviewed to check the dressing daily for signs of bleeding or drainage, when bathing are permitted the patient should be shower with the dressing covered by a plastic bag. The patient was recommended to follow prescribed exercises to maintain circulation and improve range of motion such as sponge squeezing.
Instructed in new medication Vioxx to manage osteoarthritis. In addition, warned of possible S/E such as headache, asthenia, fatigue, dizziness, aseptic meningitis, hypertension, lower-extremity edema, sinusitis, diarrhea, dyspepsia, epigastric discomfort, heartburn, nausea, abdominal pain, GI bleeding, urinary tract infection, hyponatremia, back pain, bronchitis, upper respiratory tract infection, pulmonary edema and flu-like syndrome. Patient may experience signs and symptoms of GI bleeding, including bloody vomitus, blood in urine and stool and black, tarry stools. Advised to call MD if he experiences these signs or symptoms. Report rash, unexplained weight gain or edema. Avoid aspirin and products containing aspirin unless prescriber has instructed otherwise. Avoid OTC anti-inflammatories such as ibuprofen (Advil) unless prescriber has instructed it. All NSAIDs including Rofecoxib may adversely affect the liver. Signs and symptoms of liver toxicity include nausea, fatigue, lethargy, itching, jaundice, right upper quadrant tenderness and flu-like syndrome. Instructed to stop therapy and call MD immediately if patient experiences these signs or symptoms. Women must inform MD if they become pregnant, or they are planning on becoming pregnant while taking drugs. This drug may be taken without regard to food although taking it with food may decrease GI distress. The most common adverse effects of this drug are dyspepsia, epigastric discomfort, heartburn and nausea. Taking drug with food may help minimize these effects.
The patient was instructed in charcot’s syndrome how to apply warm compresses to relieve local joint pain and tenderness. The patient was reviewed to inspect the skin of affected joints daily, checking for abrasions, cuts, or ulcers. The patient was taught in the proper techniques for crutches or other immobilization devices and refer to the physical therapy in case for proper fitting and readjustment of devices.
The patient was instructed in compartment syndrome if surgical treatment was performed such as fasciotomy emphasize there is an increased potential for infection. The patient was reviewed in the proper technique for care of the surgical incision and aseptic procedures for dressing changes. The patient was advised to inspect the wound daily to check for increased drainage. The patient was recommended the need for rest and elevation of the extremity postoperatively. The patient was encouraged to use of assistive devices.
The patient was instructed in nephrotic syndrome in the significance of daily weights, same time, same clothing, after urination and before eating. The patient was advised on finding supplies for home blood pressure checking. The patient was taught to measurement blood pressure and how frequently to do it. The patient was instructed the need to keep good skin care of edematous body areas to stop excoriation and skin breakdown. The patient was instructed in fluid limitations, fluids may be contingent on how much urine is put out.
The patient was instructed in guillaint-barré syndrome in the importance to examine the patient skin daily for signs of irritation or breakdown. The patient was advised to evade persons who have infections. The patient was taught to get any adaptive devices, splints, wheelchairs, walker and its use. The patient was taught in good moving technique from bed to chair and from chair to toilet.
Instructed in new medication Advil and in S/E such as headache, dizziness, nervousness, aseptic meningitis, peripheral edema, fluid retention, tinnitus, epigastric distress, nausea, occult blood loss, peptic ulceration, diarrhea, constipation, dyspepsia, flatulence, heartburn, decreased appetite, acute renal failure, azotemia, cystitis, hematuria, prolonged bleeding time, anemia, neutropenia, pancytopenia, thrombocytopenia, aplastic anemia, leukopenia, agranulocytosis, hypoglycemia, hyperkalemia, hypouricemia, bronchospasm, pruritus, rash, urticaria and Stevens-Johnson syndrome.
Instructed in new medication Bextra to manage osteoarthritis. In addition. warned of possible S/E such as dizziness, headache, cerebrovascular disorder, peripheral edema, hypertension, angina pectoris, arrhythmia, heart failure, aneurysm, sinusitis, abdominal fullness, abdominal pain, diarrhea, dyspepsia, flatulence, nausea, renal impairment, thrombocytopenia, leukopenia, anemia, hepatitis, hyperglycemia, hypercholesterolemia, hyperkalemia, hyperlipidemia, hyperuricemia, hypocalcemia, hypokalemia, increased or decreased weight, back pain, myalgia, upper respiratory tract infection, bronchospasm, rash, flu-like syndrome, accidental injury.
Instructed in new medication Sulfaprim and in S/E such as headache, mental depression, aseptic meningitis, tinnitus, apathy, seizures, hallucinations, ataxia, nervousness, fatigue, vertigo, insomnia, thrombophlebitis, nausea, vomiting, diarrhea, abdominal pain, anorexia, stomatitis, pancreatitis, pseudomembranous colitis, toxic nephrosis with oliguria and anuria, crystalluria, hematuria, interstitial nephritis, agranulocytosis, aplastic anemia, megaloblastic anemia, thrombocytopenia, leukopenia, hemolytic anemia, jaundice, hepatic necrosis, arthralgia, myalgia, muscle weakness, pulmonary infiltrates, erythema multiforme, Stevens-Johnson syndrome, generalized skin eruption, toxic epidermal necrolysis, exfoliative dermatitis, photosensitivity, urticaria, pruritus, hypersensitivity reactions, serum sickness, drug fever and anaphylaxis.