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CLIENT TEACHING GUIDE
COLIC: WAYS TO SOOTHE A FUSSY BABY (CONTINUED)
D.
You notice a change in your baby’s eating patterns, or they are vomiting, or have diarrhea or constipation.
E.
You notice a change in your baby’s pattern of behavior: Your baby refuses to suck, has a high-pitched cry, draws the legs up
when you touch the tummy, or your baby is limp with no activity.
F.
Crying could be the result of an injury or fall.
G.
Other:
Phone:
RESOURCE
Turner,
T.L., & Palamountain, S. (2019, Jan 22). Patient education: Colic (excessive crying) in infants (beyond the
basics). UpToDate. https://www.uptodate.com/contents/colic-excessive-crying-in-infants-beyond-the-basics
From FAMILY PRACTICE GUIDELINES, Sixth Edition. Copyright Springer Publishing Company, LLC. All Rights Reserved.
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CLIENT
TEACHING GUIDE
CONSTIPATION RELIEF
PROBLEM
CAUSES
A.
Not drinking enough liquids.
B.
Eating a low-ber diet.
C.
Sedentary lifestyle, lack of exercise.
D.
Ignoring the urge to go to the bathroom.
E.
Side effects of medicine taken, including blood pressure (BP) medications, antidepressants, pain medications and antacids, or
overusing laxatives.
F.
Depression.
G.
Other medical conditions.
PREVENTION/CARE
A.
Go to the bathroom as soon as you have the urge to have a bowel movement (BMs); do not wait.
B.
Establish a regular toilet time, such as after breakfast; 15 to 20 minutes after breakfast is a good time because spontaneous
colonic motility is greatest during this period.
C.
Use a footrest during elimination to provide support and reduce straining.
D.
Do not rely on laxatives; use prune juice as a natural substitute.
E.
Stimulate the intestine by drinking hot or cold water or prune juice before meals.
F.
Reduce the intake of sweets, which increases bacterial growth in the intestine and can lead to gas.
G.
Stop taking enemas and nonessential drugs and herbals.
Constipation
There
are many reasons why you have constipation. You may have just one or a combination of these common causes:
is an infrequent and difcult passing of hard stools and the sensation of not emptying or having to strain.
TREATMENT
A.
Follow the suggested prevention tips.
B.
Change to a high-ber diet.
C.
Get daily exercise.
Activity:
PLAN
Daily exercise, such as walking, helps maintain healthy bowel patterns.
Diet:
A.
Eat a high-ber diet.
B.
Restrict cheese: It causes constipation.
C.
Drink at least eight glasses of water each day.
D.
Avoid rened cereals and breads, pastries, and sugar.
E.
Coffee, tea, and alcohol reduce water to the colon. Limit your intake to two of these drinks per day.
Medications:
You may be prescribed a stool softener or a laxative for short-term use only. You may be prescribed a bulk-forming
agent to take on a regular basis to increase the bulk of your stool.
You
Have Been Prescribed:
You
Need to Take:
You
Need to Notify the Office If:
A.
Constipation continues in spite of the self-care instructions, including diet and exercise.
B.
You notice a change in your BMs. Changes in bowel patterns may be an early sign of cancer.
C.
You develop fever or severe abdominal pain with your constipation.
D.
There are any concerning features, such as blood on the toilet paper or stool, weight loss, fever, and weakness.
E.
Other:
Phone:
RESOURCE
Wald,
ate.com/contents/constipation-in-adults-beyond-the-basics
From FAMILY PRACTICE GUIDELINES, Sixth Edition. Copyright Springer Publishing Company, LLC. All Rights Reserved.
A. (2018, Sep 18). Patient education: Constipation in adults (beyond the basics). UpToDate. https://www.uptod
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CLIENT
TEACHING GUIDE
CROHN’S DISEASE
PROBLEM
absorption of nutrients through the intestine. CD is chronic, relapsing, and incurable. The symptoms are abdominal pain, diarrhea,
fatigue, and weight loss, and medications can help keep the disease and symptoms under control.
CAUSE
infection attacks the digestive tract.
TREATMENT
A.
Adequate nutrition is critical to the promotion of healing.
B.
Vitamin, mineral, and folic acid supplementation is necessary for proper healing and to avoid secondary complications such
as bone disease and low blood counts.
C.
To relieve pain, apply a heating pad or warm compress to your abdomen.
D.
Check your bowel movements daily for signs of bleeding.
E.
Surgery may be required to help control symptoms.
F.
There may be a support group near where you live. The Crohn’s and Colitis Foundation website has an area to nd a support
group at www.ccfa.org/living-with-crohns-colitis/nd-a-support-group.
G.
Take your medicine as your healthcare provider ordered to help prevent an attack.
Activity:
normal activities, as tolerated.
The
Crohn’s
disease (CD) is an inammatory disorder of the gastrointestinal tract that produces ulceration and decreased
exact cause is unknown, but it can result from inammation as the body’s immune system that normally ghts the
PLAN
During acute attacks, rest in bed or in a chair. Get up only to go to the bathroom, bathe, or eat. Between attacks, resume
Diet:
A.
When you have diarrhea, increase the ber content of your diet.
B.
Restricting milk products may stop the diarrhea. Stop using milk products for a short time; then try them again in a few weeks.
C.
Decreasing the amount of fat and gluten in your diet may help.
D.
Ensure, Sustacal, and Isocal have been found to improve symptoms.
E.
Severe relapse may require you stop eating or drinking, called a partial bowel rest. Contact the ofce for instruction.
Medications:
There are different medications that are used to treat CD. Your medical healthcare provider prescribes your medication
depending on the severity of your disease and the part of your intestine that is affected. You may also be prescribed vitamins and minerals, medicine to control pain and relieve diarrhea, and a steroid for a limited time to reduce the inammation. Do not stop taking the
steroid abruptly. Your healthcare provider can tell you how to taper the dose over several days. Take all your medications as prescribed.
Have Been Prescribed the Following Vitamins and Minerals:
Yo u
You
Need to Take:
You
Have Been Prescribed the Following to Relieve Diarrhea:
You
Need to Take:
You
Have Been Prescribed the Following Steroids:
You
Need to Take:
Other
medications to treat CD include pills, intravenous infusions, and injectable medications to control the severity of symp-
toms. Your healthcare provider will discuss these with you and the need for close follow-up monitoring.
You
Have Been Prescribed:
You
Need to Take:
You
Need to Notify the Office If You Have:
A.
Black,
tarry stools or blood in the stool. A swollen abdomen. A temperature of 101.0°F or higher.
Phone:
From FAMILY PRACTICE GUIDELINES, Sixth Edition. Copyright Springer Publishing Company, LLC. All Rights Reserved.
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CROHN’S DISEASE (CONTINUED)
431
RESOURCES
Crohn’s
and Colitis Foundation of America: 386 Park Avenue South, 17th Floor, New York, NY 10013, 800-932-2423,
Info@ccfa.org, www.ccfa.org
Peppercorn,
M, A., & Kane, S.V. (2018, May 18). Patient education: Crohn disease (beyond the basics). UpToDate. https://www.
uptodate.com/contents/crohn-disease-beyond-the-basics
From FAMILY PRACTICE GUIDELINES, Sixth Edition. Copyright Springer Publishing Company, LLC. All Rights Reserved.
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CLIENT
TEACHING GUIDE
DIARRHEA
PROBLEM
have more than 1 day of diarrhea, please contact the ofce.
CAUSE
be caused by infection resulting from eating or drinking contaminated food or water.
PREVENTION/CARE
A.
Avoid raw seafood and undercooked foods. Cut away any damaged or bruised areas on fruits and vegetables before eating.
B.
Store food in the refrigerator within 1 hour of cooking to prevent the growth of bacteria. Store fruits and vegetables away from
raw meat, chicken, and seafood.
C.
Avoid buffet or picnic foods left out for several hours and food served by street vendors.
D.
Wash your hands well before and after preparing foods, after going to the bathroom, and after handling diapers.
E.
When traveling:
1.
2.
3.
F.
When hiking or camping, do not drink from streams, springs, or untested wells. Boil all water used for drinking or cooking.
G.
Do not allow people with diarrhea to handle food.
H.
Do not buy turtles, iguanas, or reptiles for pets: They carry Salmonella.
I.
Thoroughly cook eggs. Do not eat raw eggs or foods containing raw eggs, such as cookie dough. Store fruits and vegetables
away from raw meat, chicken, and seafood.
J.
Cook chicken, beef, and pork until the meat does not have any pink color.
K.
Call your day-care center if your child has diarrhea, especially if they have fever. Keep your child away from childcare centers
if the diarrhea is too much for a diaper or if they are unable to get to the toilet.
There
Diarrhea
is a condition that causes loose, watery stools. Diarrhea is a symptom, not a disease. If you are a diabetic and
are many causes of diarrhea, including infections caused by virus, bacteria, and even parasites. Diarrhea can also
Avoid local water supplies (including ice) when they are in question: Drink bottled water instead.
Do not eat fresh vegetables that may have been washed in contaminated water.
If possible, travel with antiseptic hand lotion and wipes.
TREATMENT
A.
Diarrhea usually goes away in 24 to 48 hours.
B.
Keep drinking liquids.
C.
If you think a prescription drug is causing diarrhea, consult with the doctor before stopping the medication.
D.
Clean toys and hard surfaces with soap and water. Chlorine-based disinfectants inactivate rotavirus and may help prevent the
PLAN
spread in childcare centers.
Activity:
Decrease activities until diarrhea stops.
Diet:
A.
If diarrhea is accompanied by nausea, suck ice chips.
B.
Drink clear liquids frequently, such as 7-Up, Gatorade, ginger ale, broth, or gelatin, until diarrhea stops.
C.
Use popsicles for added liquid.
D.
After symptoms disappear, eat soft foods, such as cooked cereal, rice, baked potatoes, and yogurt, for 1 to 2 days.
E.
Resume your normal diet in 2 to 3 days after the diarrhea stops.
F.
Avoid fruits, alcohol, and highly seasoned foods for several more days.
Medications:
You
or Your Child Has Been Prescribed the Following Antidiarrheal Medication:
You
or Your Child Need to Take:
You
Need to Notify the Office If:
A.
You or your child has diarrhea lasting more than 2 days or has chronic diarrhea, or mucus, blood, or worms in the stool.
B.
You or your child has a fever of 101.0°F or higher or signs of dehydration (dry mouth, wrinkled skin, excessive thirst, decreased
urinary diapers).
C.
You or your child has severe pain in the stomach or in the rectum.
(continued)
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DIARRHEA (CONTINUED)
D.
Becomes listless, refuses to eat, or cries loudly and persistently, even when picked up.
E.
Has abnormal growth and development.
Phone:
433
RESOURCE
LaRoque,
R., & Harris, J.B. (2018, March 17). Patient education: Acute diarrhea in adults (beyond the basics).
UpToDate. https://www.uptodate.com/contents/acute-diarrhea-in-adults-beyond-the-basics
From FAMILY PRACTICE GUIDELINES, Sixth Edition. Copyright Springer Publishing Company, LLC. All Rights Reserved.
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CLIENT
TEACHING GUIDE
GASTROESOPHAGEAL REFLUX DISEASE (GERD)
PROBLEM
“acid brash.”
CAUSE
smoking, pregnancy, obesity, certain medications, and nervous tension are all causes of gastroesophageal reux disease (GERD).
PREVENTION/CARE
A.
Avoid smoking.
B.
Avoid things that increase abdominal pressure:
1.
2.
3.
4.
C.
Avoid medications, such as aspirin or ibuprofen, that may irritate your stomach.
D.
Avoid alcohol.
E.
Avoid large meals.
TREATMENT
A.
Weight loss is advised to relieve symptoms.
B.
Stop smoking.
C.
You may be instructed to elevate the head of your bed on 6-in. blocks, or sleep on a wedge bolster pillow.
D.
Review all of your medications, over-the-counter (OTC) medications, and herbal products with your healthcare provider to help
identify any side effects that may cause your symptoms.
E.
Take your medications at the correct times.
Relaxation
Heartburn
of the lower esophageal (stomach) sphincter causes reux of gastric acid or a feeling of “heartburn” and
occurs when acidic stomach contents come back into the esophagus. Improper diet, spicy foods, alcohol,
Wearing tight clothes and belts.
Lying down or bending over for 3 hours after eating, which is when there can be a lot of reux.
Coughing.
Straining.
PLAN
Activity:
Postpone vigorous exercise until your stomach is likely to be empty, about 2 hours after eating.
Diet:
A.
Eat a lower fat, bland diet.
B.
Eat four to six small meals a day instead of three larger meals.
C.
Do not eat 2 to 3 hours before bedtime.
D.
Avoid chocolate, garlic, onions, citrus fruits, coffee (including decaffeinated), alcohol, highly seasoned foods, and carbonated
beverages.
E.
Eat slowly.
Medications:
Sit or stand when taking solid medications (pills or capsules). Follow the drug with at least one cup of liquid. When
OTC antacids do not make your symptoms better, please notify the ofce for medications that decrease gastric acid secretions.
You may require lifelong therapy.
You
Have Been Prescribed:
You
Need to Take:
You
Need to Notify the Office If You Have:
A.
No relief from antacids or second medication, so that the next step of medication therapy may be prescribed.
B.
New symptoms, such as blood in vomit.
C.
Other:
Phone:
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CLIENT
TEACHING GUIDE
HEMORRHOIDS
PROBLEM
known you have them until bleeding occurs. They may cause rectal pain, itching, or a sensation that you have not emptied completely after a bowel movement (BM). Hemorrhoids are often found after painless rectal bleeding with a BM. Hemorrhoids are very
common.
CAUSE
stipation, inactive lifestyle, and liver disease.
PREVENTION/CARE
A.
Avoid heavy lifting.
B.
Try to prevent constipation or straining.
C.
Eat a high-ber diet.
D.
Drink 8 to 10 glasses of water a day.
E.
Lose weight if you are overweight.
F.
Exercise regularly.
TREATMENT
A.
Spend less time sitting on the toilet to reduce pressure in the veins around the anus.
B.
Pat with toilet paper instead of rubbing.
C.
Take sitz baths or soak in a warm bathtub three or four times a day for comfort.
D.
Apply cold packs or witch hazel (Tucks) compress for symptom relief.
E.
Take a stool softener two to three times a day to prevent straining with BMs.
F.
A hemorrhoid treatment, such as ligation, freezing, or surgery, may need to be done for severe cases.
hemorrhoid is an enlarged or swollen vein in the anus and rectum. You can have hemorrhoids for years but not
Repeated
pressure in the anal or rectal veins causes hemorrhoids. They are commonly seen with obesity, pregnancy, con-
PLAN
Activity:
Medications:
No restrictions are required. Bowel function improves with good physical activity.
Hemorrhoid cream or suppository containing hydrocortisone may help relieve pain, inammation, and itching associated with hemorrhoids. Many of these medications are available over the counter.
You
Have Been Prescribed the Following Stool Softener:
You
Need to Take:
You
Have Been Prescribed the Following Local Cream:
You
Need to Apply:
You
Need to Notify the Office If You Have:
A.
A hard lump that develops where a hemorrhoid has been.
B.
Hemorrhoids that cause severe pain that is not relieved by the aforementioned treatment.
C.
Excessive rectal bleeding: more than a trace or streak on the toilet paper or BM. Rectal bleeding may be an early sign of
cancer.
D.
Other:
Phone:
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CLIENT
TEACHING GUIDE
IRRITABLE BOWEL SYNDROME
PROBLEM
change in bowel habits. You may have diarrhea, you may have constipation, or you may have problems with alternating constipation and diarrhea.
CAUSE
be triggered by eating.
PREVENTION/CARE
A.
Try to reduce stress or modify your response to it. Keep a stress diary to avoid stress triggers.
B.
Good food habits also help.
C.
No specic food has been identied as responsible for all IBS symptoms. Keep a food diary to identify and avoid your food
triggers.
TREATMENT
A.
Quit smoking: Nicotine may contribute to the problem.
B.
Apply a warm heat compress to your abdomen for comfort.
Activity:
techniques include self-hypnosis and biofeedback.
IBS
Irritable
bowel syndrome (IBS) is a chronic condition of the gastrointestinal system that causes abdominal pain and
is not contagious, inherited, or cancerous. It has no known direct cause, but it ares with severe stress and may also
PLAN
Exercise, such as walking 20 minutes a day, improves bowel function and helps reduce stress. Other stress-reduction
Diet:
A.
Eat a high-ber diet. Fiber is good for both diarrhea and constipation.
B.
Avoid sorbitol-containing (sugar-free) candies and gum, as well as lactose-containing milk products, to see if this eases your
diarrhea symptoms.
C.
Do not eat or drink anything that aggravates your symptoms, such as the following:
1.
Coffee may be a major food trigger.
2.
Avoid spicy and gas-producing foods.
3.
Avoid large meals, but eat regularly.
4.
Limit alcohol.
Medications:
Your provider may prescribe medications to help relieve symptoms of IBS. These medications do not cure the condition. The choice of medications depends on the nature and severity of your symptoms.
You
Have Been Prescribed:
You
Need to Take:
You
Need to Notify the Office If You Have:
A.
Fever.
B.
Black or tarry-looking bowel movements.
C.
Vomiting.
D.
Unexplained weight loss of 5 lbs or more.
E.
Symptoms that do not improve despite changes in diet, exercise, and medication.
F.
Other:
Phone:
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CLIENT
TEACHING GUIDE
JAUNDICE AND HEPATITIS
PROBLEM
a symptom, not a disease. It occurs when the blood contains too much bilirubin—a yellow pigment found in bile, which is a uid
secreted by the liver.
When
with jaundice are dark urine, light-colored bowel movements, fatigue, fever, chills, appetite loss, nausea, and vomiting.
Hepatitis
most common causes of hepatitis. Other causes include certain medications, alcohol, and an autoimmune condition or a disorder
that affects your immunity.
CAUSE
However, it can also be a symptom of other disorders such as anemia or severe heart failure. Sometimes jaundice results from
taking a drug that damages the liver.
PREVENTION/CARE
prevent the spread of hepatitis:
A.
There are vaccinations for hepatitis A and for hepatitis B. There is no vaccination for hepatitis C. The hepatitis B vaccination is
recommended for all infants. It is recommended that babies get the rst hepatitis B shot before leaving the hospital.
B.
Do not prepare or handle food for others until cleared by your healthcare provider.
C.
Wash your hands well after using the toilet and changing diapers.
D.
If you have hepatitis A, B, or C, avoid intimate sexual contact until cleared by your healthcare provider. Discuss safe sex prac-
tices with your healthcare provider.
E.
If you have hepatitis B or C, do not share razors, toothbrushes, and other personal items.
F.
Never donate blood after a hepatitis B or C infection.
G.
Your family and sexual partners may need an injection of immune globulin or a vaccination, depending on the type of hepatitis
you have.
H.
School exposure to hepatitis A does not generally pose a risk to others.
I.
Risk of hepatitis B transmission in day-care centers appears to be extremely rare.
J.
If you become pregnant, inform your provider if you are positive for hepatitis or at risk of getting hepatitis. Hepatitis can be
transmitted from the mother to the baby during the birth process.
Jaundice
is a yellow tinge of the skin or mucous membranes that line the mouth and other body cavities. Jaundice is
the liver is damaged, bilirubin builds up in the body and skin, turning the skin yellow and itchy. Other symptoms that occur
is inammation of the liver. There are several causes of hepatitis. Viral infections such as hepatitis A, B, C, D, or E are the
Jaundice
usually comes from a liver disorder such as cirrhosis, hepatitis, or a disease of the gallbladder or pancreas.
Although
hepatitis is considered contagious, you do not need to be conned to your home. However, to help
TREATMENT
A.
Use good hygiene with bathing, using the bathroom, and handwashing.
B.
Apply anti-itch lotions such as calamine.
C.
Rest, drink plenty of uids, and eat healthy diet.
D.
Review all of the medications, over-the-counter medications, and herbal products that you are taking. Your medications may
PLAN Treatment
for jaundice includes the following:
need to be stopped or have their dose strength changed. Never start any new medications or supplements without consulting your
provider.
E.
Surgery may be required to remove a gallstone or to have a procedure called lithotripsy to crush it, if a stone blocking the bile
duct is causing jaundice.
F.
If you have hepatitis, you may need to be referred to a specialist.
G.
The public health department will be notied by your healthcare provider for acute hepatitis.
H.
Your healthcare provider may discuss the need for a liver biopsy.
I.
Your healthcare provider may discuss treatment to help treat a virus that is causing hepatitis. It is important that you keep all
your follow-up appointments with your provider.
J.
Avoid alcohol.
Activity:
Plan rest periods throughout the day. Avoid strenuous exercise. Gradually resume activities and mild exercise during the
time you are getting better. You may get extra teaching about ways to protect yourself and others while having sex to prevent giving hepatitis to your partners.
(continued)
From FAMILY PRACTICE GUIDELINES, Sixth Edition. Copyright Springer Publishing Company, LLC. All Rights Reserved.
Соседние файлы в папке Библиотека им академика М.И. Перельмана