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Urostomy Teaching 2216

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.

Osteoarthritis Teaching 2217

Skilled Nursing visited PT, PT alert and oriented x 3 PERRL. SN assessed PT head to toe , Vital signs taken and recorded using universal precaution standard . Lungs Bilateral even , unlabored respiration, abdomen soft non distended, skin warm and dry to touch , no distress and complications noted at this time. Osteoarthritis can occur in any joint. It occurs most often in the hands, knees, hips, and spine. Warning signs are: Stiffness in a joint after getting out of bed or sitting for a long time. Swelling or tenderness in one or more joints. A crunching feeling or the sound of bone rubbing on bone. Taught that eating well-balanced meals and avoiding.Taught that avoiding excess sugar intake and avoiding excess salt intake are measures aimed to preventing/controlling Osteoarthritis.Taught that using assistive and/or protective devices, as needed, is a measure aimed to preventing/controlling Osteoarthritis.

Peg Tube Teaching 2229

Instructed patient check for redness, swelling, any drainage or excess skin growing around the tube. A small amount of clear tan drainage can be normal. Call your care team with any concerns. Instructed patient remove old dressing (if dressing is being used). Look at the area where the tube enters the skin

Peg Tube Teaching 2234

Instructed patient for the first 4-6 weeks after placement of a new PEG, bath water should not be so deep that the tube is 
under the water. Shower water should fall on your back only. For a balloon, low profile, or older PEG tube you can take a 
bath or shower as you normally do. Instructed patient call nurse or doctor if your body changes: your skin around tube has signs of infection: redness, warm to touch, firm to touch , tender.

Dialysis Teaching 2238

SN instructed patient What can you do to control blood pressure? To minimize the risk of hypertension, control sodium, potassium, and other essential electrolytes the body uses to maintain fluid balance. The recommendation for patients with kidney disease: limit sodium intake to no more than 1,500 mg per day. Most sodium in today’s diet comes from processed foods and restaurants foods. Unhealthy lifestyles choices, such as smoking tobacco, obesity, and excessive alcohol consumption, may also contribute to hypertension.

Ileostomy Teaching 2252

Instructed patient To care for your skin:Wash your skin with warm water and dry it well before you attach the pouch.
Avoid skin care products that contain alcohol. These can make your skin too dry.

Constipation Teaching 2257

SN instructed patient/ CG about laxatives. Laxatives should be taken as ordered. Drink plenty of fluids. Overuse of laxatives can cause constipation.

Heart Failure Teaching 2265

SN instructed about arteriosclerotic heart disease (ASHD), also called coronary artery disease (CAD) or coronary heart disease (CHD), refers to arteriosclerosis of heart or coronary arteries. Arteriosclerotic heart disease can also be caused by calcium deposits (calcification) on the walls of arteries that harden them, or thickening of the artery walls due to chronic high blood pressure.

Abnormal glucose Teaching 2298

SN taught patient about importance of exercise with diabetes. For most people with diabetes, exercise is very important. Exercise helps your body use sugar better. As a result, your blood glucose level goes down. An exercise plan can be as simple as taking a walk every day. Get a friend to walk with you. When you do things with a buddy, it’s easier. You’ll be less tempted to skip a day. Before you start an exercise program, talk to your doctor. Exercise tends to lower blood glucose level, so your doctor may need to make some changes to your management plan.

Abnormal glucose Teaching 2299

SN instructed patient on diabetes and nutrition. If you take diabetes pills or insulin, your meal plan should have about the same number of calories every day. Meals should be spaced throughout the day. It’s important not to skip meals or “double up” on meals. A dietitian can help with your meal plan. The dietitian will take into account your schedule and foods you like and dislike. Each person is different, so every meal plan is different.