Note from Susie Piper, RN at 1991-11-14 00:00

74 year old WM admitted with PVD with Type II insulin requiring diabetes.  Referred for diabetes education for wife use of glucose meter.

Nutrition: 1500 ADA 4gm Na at times glucerna Meal times.  

8/A-12-1/P- many times doesn't eat his snacks and has hypoglycemia.  Discussed improtance of his snack with wife.

Medications: taking 3on/10R q am 8-10N with dinner.  Previous injection of insulin in legs by pt.  Wife draws up insulin- Unit nurse, assisted wife with insulin adm NE reviewed procedure participating making insulins

Hypoglycemia: Wife verbalized his symptoms of cold and clammy at home gives OJ / graham crackers- Discussed prevention

Hyperglycemia: Thirsty-reviewed symptoms and TR

Monitoring: Instructed wife on OneTouch II glucose meter.  Use in DM management.  When to test, meter procedure sticking finger placement at blood on strip, recording and interpretation of values

Compliance: PVD, glucacoma and vision- uses reglan has dentures and at times skin problems

Footcare/Hygiene: Lori Lovejoy RN- saw pt for skin care right foot amp lt foot broken skin (duraderm applied) 2nd toe left foot skin broken- Skin dry.  Discussed skin care and foot care.  Protection, inspection, cleanliness decrease use of soap.  Use lotion.  Dont use scissors for toenails.

Psy Adjustment: past smoker; wife involved, but manny

Family involve: problems for care at home- need home care 

Exercise: at home activity- goes to BR and to the table PT working with pt need help at home

F/U Recommendation- to be D/C on Tues. 

Referrals: 

1) Pt and fam services F/U for home care

2) Return F/U to review meter instructions

3) Skin care and foot care F/U

Susie Piper

Signed by Susie Piper, RN at 1991-11-14 00:00