high blood pressure/1000
SN instructed patient that the Xarelto is used to prevent or treat a type of blood clot called deep vein thrombosis ( DVT ), which can lead to blood clots in the lungs ( pulmonary embolism ). A DVT can occur after certain types of surgery. Xarelto is also used in people with atrial fibrillation ( a heart rhythm disorder ) to lower the risk of stroke caused by a blood clot. If you take Xarelto 1 time each day: Take the missed dose as soon as you remember. Take your next dose the following day and stay on your once-daily schedule. Do not take extra medicine to make up the missed dose.
SN instructed patient / caregiver regarding medication Coumadin / Warfarin. SN explained to patient / caregiver that Coumadin / Warfarin is an anticoagulant which is prescribed to people with an increased tendency for thrombosis or as secondary prophylaxis ( prevention of further episodes ) in those individuals that have already formed a blood clot ( thrombus ). Explained that Warfarin treatment can help prevent formation of future blood clots and help reduce the risk of embolism. Informed that Warfarin will prolong bleeding time, instructed to avoid activities that increase risks of trauma. SN explained to patient / caregiver that the adverse effects of this medication includes: hemorrhage, nosebleeds and blood in urine or stool ( black tarry stools ). Instructed to notify physician if experiencing unusual bleeding while on this medication.
SN instructed patient / caregiver that Actos is an antidiabetic med that is used to lower blood sugar. SN explained that it is important to not take medication when blood sugar is low. SN instructed to patient / caregiver to check blood sugar level before taking the medication to avoid hypoglycemia. SN instructed that side effects of the medication include: SOB, swelling or rapid weight gain, chest pain, N / V, jaundice, blurred vision, pale skin, easy bruising. SN instructed patient / caregiver to inform physician if experiencing any of these side effect.
SN instructed patient / caregiver on medication Avandaryl. Explained that it is a medication indicated for Diabetes Mellitus ( DM ) type II to decrease the blood sugar by stimulating the production of insulin and increasing receptor site sensitivity. SN explained to patient / caregiver that the side effects include dizziness, photosensitivity, low blood sugar, constipation, nausea and vomiting. SN instructed patient / caregiver to monitor blood sugar daily and to not skip or double doses. SN instructed patient / caregiver to notify physician ( MD ) if experiencing unusual weight gain, swelling of ankles, drowsiness, dyspnea ( SOB ), muscle cramps, weakness, sore throat, rash, unusual bleeding or if bruising occurs.
SN explain about a couple of things going on that make your glucose rise in the morning. One of these is insulin resistance, a condition that means your body's muscle and fat cells are unable to use insulin effectively to lower blood glucose. However, insulin resistance also affects how your liver processes, stores, and releases sugar, particularly at night. The liver is supposed to release small amounts of glucose when you're not eating. But in type 2 diabetes, the liver dumps more glucose than is needed into the bloodstream, especially at night. So, while your hormones are causing a natural rise in blood glucose, your liver is releasing even more sugar into your system. Because your insulin resistance prevents your muscle and fat cells from using the sugar, your blood glucose level rises.
SN explained that the Diabetes can affect the small blood vessels of the body that supply the skin with blood. Changes to the blood vessels because of diabetes can cause a skin condition called diabetic dermopathy. This appears as scaly patches that are light brown or red, often on the front of the legs.
SN explained that the symptoms / signs of congestive heart failure ( CHF ) may include: Shortness of breath ( also called dyspnea ) most commonly during activity, at rest, or while sleeping, which may come on suddenly and wake you up. You often have difficulty breathing while lying flat and may need to prop up the upper body and head on two pillows. You often complain of waking up tired or feeling anxious and restless. Blood backs up in the pulmonary veins ( the vessels that return blood from the lungs to the heart ) because the heart can't keep up with the supply. This causes fluid to leak into the lungs. Persistent coughing or wheezing, coughing that produces white or pink blood - tinged mucus. Fluid builds up in the lungs. Buildup of excess fluid in body tissues ( edema ) swelling in the feet, ankles, legs or abdomen or weight gain. You may find that your shoes feel tight.
SN explained that the Chronic venous insufficiency ( CVI ) can’t be cured, but you can control leg swelling to reduce the likelihood of ulcers ( sores ). Recognizing the symptoms Be aware of the following: If you stand or sit with your feet down for long periods, your legs may ache or feel heavy. Swollen ankles are possibly the most common symptom of Chronic venous insufficiency ( CVI ). As swelling increases, the skin over your ankles may show red spots or a brownish tinge. The skin may feel leathery or scaly, and may start to itch. If swelling is not controlled, an ulcer ( open wound ) may form. What you can do Reduce your risk of developing ulcers by doing the following: Increase blood flow back to your heart by elevating your legs, exercising daily, and wearing elastic stockings. Boost blood flow in your legs by losing excess weight. If you must stand or sit in one place for a period of time, keep your blood moving by wiggling your toes, shifting your body position, and rising up on the balls of your feet. Pt verbalizes understanding.
SN instructed caregivers/patient on hyponatremia, which means your blood level of sodium (salt) is too low. Salt is needed for the body and brain to work. Very low blood levels of sodium can be fatal. Symptoms can include headache, confusion, fatigue, muscle cramps, hallucinations, seizures, and coma. To help prevent hyponatremia, take all medicines exactly as directed. Certain medicines can lower blood sodium levels. Have your sodium levels checked often. This is vital if you take a diuretic (medicine that helps your body get rid of water). Call your provider right away if you have any of the following: Severe tiredness, Fainting, Dizziness, Loss of appetite, Nausea or vomiting, Confusion or forgetfulness, Muscle spasms, cramping, twitching Seizures, or Gait disturbances. Caregiver voiced understanding.
SN instructed patient that having diabetes means you often need to make decisions about your care. The more you know about diabetes and how your daily activities affect your blood glucose levels, the easier it is to make wise decisions. Testing your blood glucose and keeping good track of your readings is essential to know how different activities, food, medication and stress levels affect your blood glucose readings.