skin
SN Instructed to the urostomy care: How to change the Urostomy bag: Prepare the new bag. Gather everything you need in the bathroom: plastic bags, toilet paper, paper towels or a soft washcloth, a clean cloth wipe, an additional skin barrier in the form of a paper towel (if desired) and a new bag.If the bag you use does not come with a skin barrier already made, take the measurements and now form the opening with scissors. Slowly remove the skin barrier lining. Put aside the skin barrier. Empty the used bag before removing it. To empty the bag, sit on the toilet or stand in front of it: Remove the used bag. To remove the used bag, sit on the toilet or stand in front of it. Carefully separate the skin from the skin barrier with one hand. To do this, start at the top edge of the skin barrier. With the other hand, slowly release the skin barrier from top to bottom. Seal the used bag tightly inside a plastic bag and dispose of it in the trash: Clean the area around the stoma. Use toilet paper to clean urine and mucus in the stoma or the skin around it. Clean the skin with warm water and a soft cloth wipe or a paper towel. Clean up to the stoma border. You can also do this while showering. Dry the skin without rubbing, using a clean towel; and Place the new bag. Use a folded paper towel or a piece of gauze to keep the stoma dry while placing the new pouch. Once you have changed the bag, wash your hands.
Caregiver was instructed that most people pinch up a fold of skin and insert the needle at aangle to the skin fold. To pinch the skin properly, follow these steps: Squeeze a couple of inches of skin between the thumb and two fingers, pulling the skin and fat away from the underlying muscle. (If use a 5 millimeter mini-pen needle to inject, you don't have to pinch up the skin when injecting at aangle; with this shorter needle, you don't have to worry about injecting into muscle.)" Insert the needle, Hold the pinch so the needle doesn't go into the muscle, Push the plunger, "release the grip on the skin fold. Remove the needle from the skin.
Instructed patient how do I care for my skin around my trach tube. Clean your skin at least once each day. You may need to clean it more often if you cough up a lot of thick mucus. You may need someone to help you clean your skin. Wash your hands and put on gloves. This will prevent infection. Suction the area around your stoma. This will help remove mucus .Clean your skin around the stoma, clean the tube flanges, change wet or dirty trach ties., place a gauze between your skin and the flanges and check your skin every day for signs of infection. Look for redness or swelling of the skin around your tube. Also look for pus, bleeding, or a rash.
SN instructed patient and caregiver on preventing skin tears. In terms of prevention, protective arm sleeves are helpful. The use of paper or gentle release tapes is also a better alternative to nylon tape, when it comes to sensitive or aging skin. In addition, it is important to routinely moisturize dry skin with an appropriate moisturize barrier. As we age, hydrating dry skin helps to replenish missing skin and keep skin healthy and intact. Oral hydration is important as well. Patient and caregiver verbalize understanding instructions given.
Instructed patient to check your skin and the back of your skin barrier each time you change your pouching system. You can use a mirror to check your skin under the stoma. Look for any places where stool or urine may have leaked under the skin barrier and onto your skin. When you apply your next pouching system these areas may need some extra reinforcement with skin barrier strips, rings or paste.
Instructed patient when you have a stoma that drains urine or loose stool you may want to consider using an extended wear skin barrier because it will give your skin added protection. Itching or burning under the skin barrier may indicate that you have leakage, a skin rash, or a skin infection. You need to remove your pouching system as soon as possible to check your skin for any irritation.
SN instructed that doxycycline is a tetracycline antibiotic. It fights bacteria in the body. Take doxycycline exactly as prescribed by your doctor. Follow all directions on your prescription label. Do not take this medicine in larger or smaller amounts or for longer than recommended. Take doxycycline with a full glass of water. Drink plenty of liquids while you are taking this medicine. Most brands of doxycycline may be taken with food or milk if the medicine upsets your stomach. Different brands of doxycycline may have different instructions about taking them with or without food. Take Oracea on an empty stomach, at least 1 hour before or 2 hours after a meal.Call your doctor at once if you have: changes in your vision; severe stomach pain, diarrhea that is watery or bloody, fever, swollen glands, body aches, flu symptoms, weakness, skin rash, pale skin, easy bruising or bleeding, severe tingling, numbness, pain, muscle weakness; upper stomach pain ( may spread to your back ), loss of appetite, dark urine, jaundice ( yellowing of the skin or eyes ); chest pain, irregular heart rhythm, feeling short of breath; confusion, nausea and vomiting, swelling, rapid weight gain, little or no urinating; new or worsening cough with fever, trouble breathing;increased pressure inside the skull - skin pain, followed by a red or purple skin rash that spreads ( especially in the face or upper body ) and causes blistering and peeling. Severe headaches, ringing in your ears, dizziness, nausea, vision problems, pain behind your eyes; or severe skin reaction - fever, sore throat, swelling in your face or tongue, burning in your eyes.
Patient was instructed about the skin damage: the skin may be dry and cracked because of high glucose levels, and cracked skin means it's easier for bacteria to get under the skin and harder for infections to heal. Use a small amount of skin lotion daily, to be sure the feet feel dry - not damp or sticky - afterwards. Try not to get the lotion in between the toes. Keep the toenails trimmed and filed smooth to avoid ingrown toenails. Further teaching is needed.
Empty your pouch when one-third to one-half full. Change your skin barrier every 3-7 days. You should not experience frequent leakage of your pouch seal. If you do, consult a WOC Nurse. Usually soap is not needed to clean the peristomal skin. If you use soap, make sure it does not contain any oils or lotions that can interfere with adhesives. Always rinse your skin and dry completely before you adhere the new pouch. After you apply your skin barrier, hold it in place against your skin for about one minute. This will help to activate the adhesive. You can shower, bathe, or swim with your ostomy after you are cleared by your physician. If you are using a bedside collection bag, clean it daily with a recommended solution to help minimize odor, crystal formation, and bacteria.
SN instructed patient/CG to seek medical attention if you have signs of an allergic reaction to Augmentin such as: hives; difficult breathing; swelling of your face, lips, tongue, or throat. Call your doctor at once if you have: severe stomach pain, diarrhea that is watery or bloody; pale or yellowed skin, dark colored urine, fever, confusion or weakness; loss of appetite, upper stomach pain, jaundice (yellowing of the skin or eyes); easy bruising or bleeding; little or no urination; or severe skin reaction - fever, sore throat, swelling in your face or tongue, burning in your eyes, skin pain followed by a red or purple skin rash that spreads (especially in the face or upper body) and causes blistering and peeling.