Non-pharmacological counseling points Flashcards
Migraine
Avoid substances (food, caffeine, alcohol, and medications) or situations (stress, fatigue, oversleeping, fasting, and missing meds) that you know can trigger a migraine
Avoid foods or food additives known to trigger migraines, including red wine, aged cheese, aspartame, monosodium glutamate, coffee, tea, cola beverages, and chocolate
Avoid foods to which you are allergic
Eat regularly to avoid hunger and low blood sugar
Consider taking magnesium supplements
Apply an ice bag or cold pack to the forehead or temples
Fever
Do not use isopropyl or ethyl alcohol for body sponging - alcohol poisoning can result from skin absorption or inhalation
For all levels of fever, wear lightweight clothing, remove blankets, and maintain room temperature of 68 degrees
Unless advised otherwise, drink or provide sufficient fluids to replenish body fluid losses
Musculoskeletal injuries (once they’ve occurred)
For pain related to muscle or joint injuries, begin treatment with RICE therapy
For periodic muscle cramps, stretch and massage the affected area immediately then rest or reduce activity of the muscle to allow it to loosen
For stiffness, apply heat to the affected area in the form of a warm wet compress, a heating pad, or a hot water bottle
For osteoarthritis, try a combination of nondrug measures, including applying heat or cold to the affected area, supporting the area with splints, and doing range of motion and strength-maintenance exercises
Preventing musculoskeletal injuries
To prevent muscle or joint strains and sprains, do warm-up and stretching exercises before playing sports or exercising, and wrap injured muscle or joint with protective bandage or tape.
To prevent repetitive strain, exercise the muscles that are vulnerable to the injury, and use ergonomic controls to adjust posture, stresses, motions, and other damaging physical factors.
To prevent tendonitis and cramps, warm up and stretch muscles before physical activity, drink sufficient fluids, and do not exercise to the point of exhaustion. To help prevent nocturnal leg cramps, raise the foot of the bed. For achilles tendonitis, wearing better-fitting shoes with heel lifts may help reduce the symptoms.
To prevent or reduce the occurrence of osteoarthritis, avoid a sedentary lifestyle, keep joints active, lose weight (if overweight), and use assistive devices if needed.
Vulvovaginal candidiasis
If significant irritation of the vulva is present, use a sodium bicarbonate sitz bath to provide relief and give the antifungal medication time to become effective (1tsp of sod bicarb to 1 pint of water then 2-4tbsp to 2 inches of water)
For recurrent infections try eating yogurt and decreasing dietary sugar and refined carbohydrates
Primary dysmenorrhea
If effective, apply topical heat to the abdomen, lower back, or other painful area
Stop smoking cigarettes and avoid second hand smoke
Consider eating more fish high in omega 3 fatty acids or taking a fish oil supplement
Participate in regular exercise if it lessens the symptoms
Premenstrual syndrome
Try to avoid stress, develop effective coping mechanisms for managing stress, and learn relaxation techniques
If possible, participate in regular aerobic exercise
During the 7-14 days before your menstrual period, reduce intake of salt, caffeine, chocolate, and alcoholic beverages. Eating foods rich in carbohydrates and low in protein during the premenstrual interval may also reduce symptoms.
Colds
To prevent: frequently wash your hands with soap for at least 20 seconds, cover your nose and mouth when coughing or sneezing, use antiviral products to clean surfaces
To provide relief or speed up recovery: get adequate rest, drink fluids and use a humidifier or vaporizer, suck on hard candy, gargle salt water, or drink fruit juice or hot tea with lemon to soothe a sore throat.
Allergic rhinitis
Avoidance of allergens
For symptoms that develop mostly outdoors: frequently check local pollen counts and air quality index, keep house and car windows shut, avoid yard work and outdoor sports on days with high levels of pollen/mold/pollution
For symptoms that occur mainly when indoors: try to remove the symptom triggers, lower the humidity in the house to reduce molds, wash bedding in hot water every week, and encase mattresses and pillows in coverings resistant to house-dust mites.
Nasal saline solutions may relieve nasal irritation and dryness and aid in the removal of dried, encrusted, or thick mucus from the nose.
Cough
Stay well hydrated
Reduce throat irritation by slowly dissolving nonmedicated lozenges and candies in the mouth, use humidifiers and vaporizers to increase the moisture in the air and possibly soothe irritated airways
Treat the underlying cause of the cough
Heartburn and dyspepsia
Avoid food, beverages, and activities that may precipitate or increase the frequency and severity of symptoms
If possible, avoid the use of medications that may aggravate heartburn or dyspepsia
Avoid eating large meals
Stop or reduce smoking
Lose weight if overweight and not pregnant
Wear loose-fitting clothing
If nocturnal symptoms are present: avoid lying down within 3 hours of a meal, elevate the head of the bed using 6-8” blocks or use a foam pillow wedge
Intestinal gas
If possible, avoid foods known to cause intestinal gas
Avoid activities known to introduce gas into the digestive system, such as drinking carbonated beverages
Constipation
To promote regular bowel movements, use nondrug strategies such as a high fiber diet (slowly increase intake to 25-35 grams per day), plenty of fluid intake, and regular exercise
Increase dietary fiber by eating foods with whole grains, oats, fruits, and vegetables.
Avoid constipating foods, such as processed cheeses and concentrated sweets
Drink plenty of fluids to help soften your stool and move food through your GI tract
Develop and maintain a routine exercise program
Establish a regular pattern for bathroom visits. Do not delay in responding to the urge to use the bathroom; allow adequate time for elimination in a relaxed, unhurried atmosphere
Maintain general emotional well-being and avoid stressful situations
Diarrhea for less than 5yo
Mild-moderate diarrhea is 3-5 unformed bowel movements per day. Give ORS at 50-100mL/kg over 2-4 hours. Continue to give the solution until the child is rehydrated
If the child is vomiting, give 1tsp of ORS every few minutes
If the child is not dehydrated,give 10mL/kg for every episode of diarrhea and 2mL/kg for every episode of vomiting
After the child is rehydrated, reintroduce food appropriate for the child’s age while also continuing to administer ORS
If breast-feeding, continue. If bottle feeding, contact the pediatrician about switching to a lactose free formulation
Give children complex carbohydrate rich foods, yogurt, lean meats, fruits, and vegetables. Do not give them fatty or sugary foods.
Do not withhold food for more than 24 hours
Diarrhea for older than 5yo
For mild-moderate dehydration, indicated by a 3-9% drop in body weight or 3-5 unformed stools per day, drink 2-4 liters of ORS over 4 hours
If not dehydrated, drink 1/2- 1 cup of ORS or fluids after each unformed bowel movement
If no medical conditions exist, sports drinks, diluted juices, soups, and broths may be consumed until the diarrhea stops
Do not withhold food for more than 24 hours
Anorectal disorders
Maintain hydration and a healthy diet. If experiencing hard stools, straining, or constipation, increase the amount of fiber and fluids in the diet to reduce or prevent straining during bowel movements
Avoid medications that cause constipation if possible
Clean anorectal area after each bowel movement with a moistened, unscented, white toilet tissue or wipe
Use a sitz bath or soak in a bathtub two to four times a day
Avoid the use of soaps, salts, and oils
Pinworm infection
Educate in person hygiene, particularly the need to wash hands before eating or preparing food and after using the toilet. Encourage keeping fingernails short to prevent harboring of eggs and autoinoculation; discourage biting nails and scratching anal area
Eggs are destroyed by sunlight and ultraviolet rays, so ensure blinds or curtains are open in the affected room to enhance cleaning of the environment
Wash bed linens, underwear, bedclothes, and towels of the entire family in hot water daily
Shower (rather than bathe) daily in the morning
Change underwear, nightclothes, and bed sheets daily
Clean and vacuum (do not sweep) house for several days after treatment
Nausea and vomiting
To prevent NVP, eat small, frequent meals that are low in fat content. Sleep in a room with fresh air. Also, try eating crackers before getting up in the morning. Try lying down to relieve the symptoms once they occur
To prevent motion sickness in young children, place them in a car seat that allows them to look out the windows. Try acupressure wristbands to prevent motion sickness in adults or older children.
To prevent nausea associated with overeating, avoid foods or beverages known to cause nausea; consume foods and beverages in moderation
Excessive/Impacted cerumen
Use a washcloth draped over a finger to remove earwax from the outer canal
Do not insert objects in the ear to remove earwax. Such attempts may injure the ear canal or push the wax further into the canal
Water clogged ears
Tilt the affected ear down, and gently manipulate it to help drain the water from the ear. Immediately after swimming or bathing, use a blow dryer on low head and speed setting to help dry the ear canal. Do not blow air directly into the ear canal.
Recurrent aphthous stomatitis
If a deficiency of iron, folate, or vitamin B12 is diagnosed as a contributing factor, increase consumption of foods high in these nutrients, or take nutritional supplements.
Avoid spicy or acidic foods until the lesions heal.
Avoid sharp foods that may cause increased trauma to the lesion.
If desired, apply ice directly to the lesions in 10 minute increments but not longer than 20 minutes in a given hour.
Do not use heat (if infection is present, it will cause it to spread)
Minor oral mucosal injury or irritation
Rinse with a sodium bicarb solution to remove injured tissue and cleanse the affected area. Add 1/2 - 1tsp of sodium bicarbonate to water. Swish the solution in the mouth over the affected area for at least 1 minute, then spit out the solution. This can be done up to 4 times per day.
Use saline rinses to cleanse and soothe the affected area. Add 1-3tsp of salt to 4-8oz of warm tap water. This can be done up to 4 times per day.
For bruised lips or cheeks, apply ice in 10 minute increments to reduce swelling. Do not apply ice longer than 20 minutes in a given hour.
Teething
Massage the gum around the erupting tooth to provide relief.
Give the baby a cold teething ring or cold wet cloth, or food (toast or teething cookies) to chew.
The ADA recommends regular dental check ups beginning 6-12mo
Herpes Simplex Labialis
Keep labial or extraoral lesions clean by gently washing them with mild soap solutions.
Wash hands frequently to prevent contaminating the lesions and to avoid spreading the virus.
Avoid factors believed to delay healing such as stress, injury to the lesions, wind, excessive sun exposure, and fatigue
If outbreaks are related to sun exposure, use a lip and face sunscreen, with appropriate SPF protection, routinely.
