S.R. and the provider decide to begin S.R. on the least invasive treatment—continuous positive airway pressure (CPAP). The provider writes a prescription for CPAP
List three education topics you need to address with S.R. so he can safely self-manage CPAP therapy.
S.R. calls 2 weeks later with complaints of dry nasal membranes, nosebleeds, and sores
behind his ears. What instructions would you give S.R.?
Describe how you will document the phone call with S.R.
S.R. needs to have a working knowledge of the CPAP system.
• How to apply the mask and connect it to the machine
• How to manage the fit of CPAP mask or nasal device to reduce irritation and discomfort
• Ways to decrease anxiety associated with wearing the CPAP system
• How to perform daily equipment maintenance and clean the system
• What to do in case of respiratory distress or other complications
• Ask the durable medical equipment (DME) company to check for proper fitting of the mask and
tubing and whether adding humidification to his O2 is possible.
• Get saline nasal spray at any drugstore or make your own. Use two sprays in each nostril up to
every 2 hours as needed. A recipe for ocean saline spray: Boil water 20 minutes and let cool. Then
to 1 quart of water, add 1 teaspoon of salt, plus a pinch of baking soda. Store at room temperature
in a covered container for up to 72 hours, and then discard.
• Describe how to pad and protect the skin behind his ears.
• Have him gently cleanse the nares every 8 hours with a cotton-tipped applicator moistened with
saline.
First, state the date and time of the phone call and who was on the phone providing information.
Then describe the subjective information provided by S.R., providing enough detail to support the
plan of action and justify that his problem can be managed without an in-person visit. In this case,
you would document his complaints of dry nasal membranes, nosebleeds, and sores behind the ears,
noting details of your assessment, such as when symptoms started and symptom severity. You would
then detail the plan of action, describing the care instructions given him, concluding with when and
how to seek additional care.
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