SN instructed about aspiration precautions. Consume honey thick liquids. Do not use a straw to drink fluid. Sit straight up when eating or drinking, have supervision with meals, do not eat alone. Sit up at least 1/2 hour after a meal.
SN instructed patient on importance of hand washing before and after eating, after using the bathroom , after blowing your nose, coughing, or sneezing, after being outside , in order to prevent spread of germs.
Patient was educated on how to wear ordered arm sling, Gently pull the sling over your arm and elbow. It should fit snugly around the elbow, reach around your neck and grab the strap behind your elbow and tighten the straps so your hand and forearm are elevated above the level of your elbow. Orders were to maintain sling at 90 degree angle and to avoid any activities with the arm. Patient verbalized understanding
SN instructed on arteriosclerosis is hardening and thickening of the walls of the arteries. This condition can occur because of fatty deposits on the inner lining of arteries (atherosclerosis), calcification of the wall of the arteries, or thickening of the muscular wall of the arteries from chronically elevated blood pressure. When arteriosclerosis affects the coronary arteries that supply blood to the heart muscle, a shortage of oxygen delivered to the heart itself may lead to a heart attack.
SN instructed that the main job of the kidneys is to filter wastes and extra water out of your blood to make urine. Your kidneys also help control blood pressure and make hormones that your body needs to stay healthy.High blood glucose, also called blood sugar, can damage the blood vessels in your kidneys. When the blood vessels are damaged, they don’t work as well. Many people with diabetes also develop high blood pressure, which can also damage your kidneys
SN instructed patient / caregiver on proper incontinence care as to check every 2-3 hours if needed. Educated on pressure reduction measures as to change patient's position in bed/chair every 2-3 hours, avoid positioning on affected areas and use pressure reduction mattress or chair cushion.
SN instructed on the need for adequate fluid intake, establishing a toilet schedule such as every 2 hours, or before or after activities, meals, sleep, and rest periods.
Skilled nurse developed patient plan of care with patient/caregiver involvement to be countersigned by physician. SN to perform complete physical assessment each visit with emphasis on disease process. SN to assess other co-morbidities including list diseases and other conditions that present themselves during this episode of care. SN to recognize and intervene to minimize complications; notify physician immediately of any potential problems that impede completion of patient recovery and desired goals.
SN instructed patient/ CG about thickened liquids. SN explained that thickened liquids are used to treat patients with Dysphagia. Thick liquids decrease aspiration. Thick liquids may give the patient more time to perform additional swallows or other swallowing strategies. Thickened liquids slow down the bolus flow to compensate for a delayed swallow and reduced airway closure.
SN instructed patient and care giver to take Carafate (sucralfate) on an empty stomach, at least 1 hour before or 2 hours after a meal and avoid taking any other medications within 2 hours before or after you take Carafate. Side effects of Carafate include: nausea, vomiting, GI upset/pain, constipation, diarrhea, insomnia, dizziness, drowsiness or headache.