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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 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.
SN instructed patient about the heart is a muscle that pumps oxygen-rich blood to all parts of the body. When you have heart failure, the heart is not able to pump as well as it should. Blood and fluid may back up into the lungs (congestive heart failure), and some parts of the body don’t get enough oxygen-rich blood to work normally. These problems lead to the symptoms of heart failure. Follow a heart healthy diet. And make sure to limit the salt (sodium) in your diet. Salt causes your body to hold water. This makes your heart work harder as there is more fluid for the heart to pump.
SN instructed patient and caregiver regarding new medication Entresto. This medication is used to treat certain types of heart failure. It may help you live longer and lower your chance of having to go to the hospital for heart failure. This product contains 2 medications: sacubitril and valsartan. They work by relaxing blood vessels so that blood can flow more easily, which makes it easier for your heart to pump blood to your body. Cough, dizziness, or lightheadedness may occur. If any of these effects persist or worsen, tell your doctor or pharmacist promptly. To reduce the risk of dizziness and lightheadedness, get up slowly when rising from a sitting or lying position. If you miss a dose, take it as soon as you remember. If it is near the time of the next dose, skip the missed dose. Take your next dose at the regular time. Do not double the dose to catch up.
Entresto is used to treat certain types of heart failure. It will help you live longer and stay out of the hospital for heart failure. Entresto contains 2 medications: sacubitril and valsartan. They work by relaxing blood vessels so that blood can flow more easily, which makes it easier for your heart to pump blood to your body. Common SE: Coughing, dizziness, or lightheadedness, if this persist or worsen, tell your doctor or pharmacist promptly. To reduce the risk of dizziness and lightheadedness, get up slowly when rising from a sitting or lying position. Take medication as prescribed to get the better manage the disease process of Heart Failure.
SN instructed patient on stents. A stent is a tiny wire mesh tube. It props open an artery and is left there permanently. When a coronary artery (an artery feeding the heart muscle) is narrowed by a buildup of fatty deposits called plaque, it can reduce blood flow. If blood flow is reduced to the heart muscle, chest pain can result. If a clot forms and completely blocks the blood flow to part of the heart muscle, a heart attack results.
Instructed patient how Lovenox is used to reduce the chance of blood clots when another blood thinner is stopped for a short time. For example, if you take warfarin and need surgery, your doctor may ask you to stop taking warfarin for a short time before the surgery. You will take enoxaparin to help prevent blood clots before the surgery. After the surgery, your doctor will tell you when it is safe to start taking warfarin again. This is called bridge therapy.
Instructed in new medication Calcium and in S/E such as headache, weakness, dizziness, paresthesia, chest pressure, facial flushing, edema of feet, eye pain, nasal congestion, transient nausea, unusual taste, diarrhea, anorexia, vomiting, epigastric discomfort, abdominal pain, increased urinary frequency, nocturia, shortness of breath, rash, pruritus of ear lobes, inflammation at injection site, hypersensitivity reactions (anaphylaxis), chills and tender palms and soles.
Instructed in visiting an ophthalmologist, an MD who specializes in eye care inmediately if there are any of these symptoms of eye damage: blurred or double vision, narrowed field of vision, seeing dark spots, feeling of pressure or pain in the eyes and difficulty seeing in dim light.
Instructed in new medication Amitriptyline to manage depression. In additon, warned of possible S/E such as coma, seizures, hallucinations, delusions, disorientation, ataxia, tremor, peripheral neuropathy, anxiety, insomnia, restlessness, drowsiness, dizziness, weakness, fatigue, headache, extrapyramidal reactions, MI, stroke, arrhythmias, heart block, orthostatic hypotension, tachycardia, ECG changes, hypertension, edema, blurred vision, tinnitus, mydriasis, increased intraocular pressure, dry mouth, nausea, vomiting, anorexia, epigastric distress, diarrhea, constipation, paralytic ileum, urine retention, agranulocytosis, thrombocytopenia, leukopenia, eosinophilia, hypoglycemia, hyperglycemia, rash, urticaria, photosensitivity, diaphoresis and hypersensitivity reaction. Instructed to take full dose at bedtime but warned patient of possible morning orthostatic hypotension. Avoid alcohol during drug therapy. Consult MD before taking other medications. Avoid activities that require alertness and good psychomotor coordination until CNS effects of drug are known. Drowsiness and dizziness usually subside after a few weeks. Dry mouth may be relieved with sugarless hard candy or gum. Saliva substitutes may be needed. Instructed to use a sun block, wear protective clothing and avoid prolonged exposure to strong sunlight. To prevent photosensitivity reactions. Do not stop drug therapy abruptly.