diabetic
SN instructed the patient on good diabetic foot care and assessment as follows: using a handheld mirror if needed assess feet daily to include in between toes. Never cut toenails or file down calluses. Only a podiatrist should do this. Report any blisters, cracks, wounds or any other concerns to your podiatrist immediately. Wash and lotion feet very well daily. Do not lotion between toes as this may cause maceration and cause skin breakdown. Recommended wearing diabetic socks. Always wear good fitting shoes. Preferably tailor-made for the patient. Never walk around barefoot.
Instructed diabetic patient about the possible complications of kidney disease. Even though early kidney damage has no symptoms; there is a blood test called Microalbumin now available to detect early diabetic kidney damage while still reversible.
SN instructed patient / caregiver on service authorization, advance directives, rights and responsibilities, rights of the elderly and obtained necessary signatures. Instructed patient / caregiver on 24 hour nurse availability and provided / posted the agency telephone number. Also instructed that after hours, weekends and holidays an answering service will reach the nurse and he / she will return the patient / caregiver call and answer any questions or make a visit if needed. Patient and caregiver stated understanding. Patient and caregiver educated on diabetic diet, diabetic foot care, symptoms / signs ( s / s ) of depression, managing pain with medications, healthy skin, and pressure ulcer prevention. Leaflets left in home.
SN instructed on a importance of a healthy diabetic diet high in fiber, but low in fat, and eating at a regular time throughout the day. A bowl of oatmeal a day can really bring down cholesterol. Follow a diet rich in healthy fats like vegetable oils and fish. And avoid foods high in saturated fats and trans fats.
Sn instructed patient about diabetic wounds / ulcers have poor or delayed healing. Healing problems are caused by the peripheral arterial diseases and peripheral neuropathy that can occur with diabetes, wherein the small blood vessels in different parts of the body, especially in the extremities ( hands and feet ), grow narrower and reduce the blood circulation to those areas. A lack of circulation in the extremities can result in a reduced supply of oxygen and nutrients to the body tissue and nerves, which is necessary for healing. Over time, nerves in these areas may become damaged, decreasing the sensation of pain, temperature and touch, making patients vulnerable to injury.
Diabetic Chronic Kidney disease Treatment for diabetic kidney disease includes controlling blood pressure and blood sugar levels, reducing dietary protein intake, avoiding medications that may damage the kidneys, treating urinary tract infections and exercise and weight loss (under the supervision of a physician).
Instructed in possible complications of diabetes such as kidney disease. The early kidney damage has no symptoms. However, a blood test is now available to detect diabetic kidney damage at an early stage when it is still reversible. This is called the microalbumin test.
Instructed in measures important in foot care of the diabetic: wear shoes that support and fit properly, wear socks that are clean and fit properly, avoid going barefooted, etc.
Instructed in new medication Levaquin to manage infection. In addition, warned of possible S/E such as headache, insomnia, dizziness, encephalopathy, chest pain, palpitations, vasodilation, nausea, diarrhea, vomiting, abdominal pain, dyspepsia, flatulence, vaginitis, eosinophilia, hypoglycemia, back pain, tendon rupture, rash, pruritus, hypersensitivity reactions, etc. Instructed to take drug as prescribed, even if signs and symptoms disappear. Take drug with plenty of fluids and avoid antacids, sucralfate, and products containing iron or zinc for at least 2 hours before and after each dose. Avoid excessive sunlight, use sun block, and wear protective clothing when outdoors. Stop drug usage and notify prescriber if rash or other S/S of hypersensitivity develop. Notify prescriber if patient experiences pain or inflammation. Tendon rupture can occur with drug. Instructed to Diabetic patient to monitor glucose level and notify prescriber if a hypoglycemia reaction occurs. Notify prescriber if loose stools or diarrhea occurs.
Instructed in measures important in management of diabetes mellitus: follow prescribed diabetic diet, see physician, dentist, and eye doctor regulary, take medications as ordered, exercise regularly.
