Discharge And Home Healthcare Guidelines

MEDICATIONS. Patients need to understand the purpose, dosage, route, and possible side effects of all prescribed medications. If the patient is to self-administer insulin, have the patient demonstrate the appropriate preparation and administration techniques.

PREVENTION. The patient and family require instruction in the following areas to minimize or prevent complications of DM.

Diet. Explain how to calculate the American Diabetic Association exchange list to develop a satisfactory diet within the prescribed calories. Emphasize the importance of adjusting diet during illness, growth periods, stress, and pregnancy. Encourage patients to avoid alcohol and refined sugars and to distribute nutrients to maintain a balanced blood sugar throughout the 24-hour period.

Insulin. Patients need to understand the type of insulin prescribed. Instructions should include onset, peak, and duration of action. Stress proper timing of meals and planning snacks for the time when insulin is at its peak, and recommend an evening snack for those on long-acting insulins. Reinforce that patients cannot miss a dosage and there may be a need for increasing dosages during times of stress or illness. Teaching regarding the proper preparation of insulin, how to administer, and the importance of rotating sites is necessary.

Urine and Blood Testing. Teach patients the appropriate technique for testing blood and urine and how to interpret the results. Patients need to know when to notify the physician and increase testing during times of illness.

Skin Care. Stress the importance of close attention to even minor skin injuries. Emphasize foot care, including the importance of properly fitting shoes with clean, nonconstricting socks; daily washing and thorough drying of the feet; and inspection of the toes, with special attention paid to the areas between the toes. Encourage the patient to contact a podiatrist as needed. Because of sensory loss in the lower extremities, teach the patient to test the bath water to prevent skin trauma from water that is too hot and to avoid using heating pads.

Circulation. Because of the atherosclerotic changes that occur with DM, encourage patients to stop smoking. In addition, teach patients to avoid crossing their legs when sitting and to begin a regular exercise program.

288 Diffuse Axonal Injury

Diffuse Axonal Injury

DRG Category: Mean LOS: Description:

DRG Category: Mean LOS: Description:

DRG Category: Mean LOS: Description:

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