hypertensive heart disease/1000
SN instructed on Alzheimer's. Patient shouts at moments; Assessed patient’s ability for thought processing. Observed patient for cognitive functioning, memory changes, disorientation, difficulty with communication, or changes in thinking patterns. Assessed patient’s ability to cope with events, interests in surroundings and activity, motivation, and changes in memory pattern. Instructed caregiver to orient patient to environment as needed, if patient’s short term memory is intact. Using of calendars, radio, newspapers, television and so forth, are also appropriate. Assessed patient for sensory deprivation, concurrent use of CNS drugs, poor nutrition, dehydration, infection, or other concomitant disease processes. Maintain a regular daily schedule routine to prevent problems that may result from thirst, hunger, lack of sleep, or inadequate exercise. Provide positive reinforcement and feedback for positive behaviors. SN instructed family in methods to use with communication with patient: listen carefully, listen to stories even if they’ve heard them many times previously, and to avoid asking questions that the patient may not be able to answer. Divert attention to a client when agitated or dangerous behaviors like getting out of bed by climbing the fence bed. Eliminate or minimize sources of hazards in the environment. Caregiver verbalized fair understanding.
SN teaching about Gastroesophageal reflux disease ( GERD ). Examples of things to reduce or steer clear of in your diet include: high fat foods, caffeine products, chocolate, onions, peppermint, carbonated beverages, citrus and tomato products. Do not lie down immediately after eating, avoid late evening snacks, avoid tight clothing and bending over after eating. Elevate the head of the bed six to eight inches to prevent reflux when sleeping. Extra pillows, by themselves, are not very helpful.
Discharge planning initiated on today's visit. Reviewed with patient /PCG s/s of disease exacerbation that need to be reported to health care providers including steps on what to do in an event of an emergency. Medication pill box set up checked and emphasized the importance of timely refill of medications to prevent missing or skipping doses, pain management, continue following prescribed diet regimen. Re-instructed on infection control measures and practicing standard precautions, most importantly, frequent proper hand washing to prevent disease complications.
Instructed that High blood pressure (hypertension) is a leading cause of kidney disease and kidney failure (end-stage renal disease). Hypertension can cause damage to the blood vessels and filters in the kidney, making removal of waste from the body difficult. SN instructed patient about some measures aimed to managing & controlling hypertension, such as: eating low sodium diet , increase more fruits to increase your potassium, walk daily for 30 minutes, and have regular check-ups, as directed by Physician.
Instructed caregiver about complications in patient with Alzheimer are memory and language loss, impaired judgment, and other cognitive changes caused by Alzheimer's can complicate treatment for other health conditions. A person with Alzheimer's disease may not be able to communicate that he or she is experiencing pain for example, from a dental problem, report symptoms of another illness, follow a prescribed treatment plan, notice or describe medication side effects.
Instructed caregiver as alzheimer's disease progresses to its last stages, brain changes begin to affect physical functions, such as swallowing, balance, and bowel and bladder control. These effects can increase vulnerability to additional health problems such as: inhaling food or liquid into the lungs (aspiration), pneumonia and other infections, falls fractures bedsores, malnutrition or dehydration. Caregiver verbalized.
SN to assess patient with Alzheimer disease, identify any signs and symptoms requiring intervention; report significant changes to physician.
SN to instruct caregiver on disease process management, medication regimen and management of behavior disturbances.
Instructed caregiver there is no cure for Alzheimer's disease, so the chief goals of treatment are to: maintain quality of life, maximize function in daily activities, enhance cognition, mood and behavior foster a safe environment promote social engagement, as appropriate. Caregiver verbalized.
SN to instructed patient on disease process, including who to prevent cardiovascular disease . educing the use of alcohol and tobacco, eating fresh fruit and vegetables, reducing salt, sugar, and saturated fat intake, avoiding a sedentary lifestyle. Patient verbalized understanding.