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the very first case presentation made by BSN III - I,Batch 2012.It's our first time, so most probably, we need so much corrections from it. :))
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CASE PRESENTATION
BSN Level III – Block 1Adviser: Abayan, Elizabeth RN, MAN
Table of ContentsI. Biographic Data
II. Nursing Health HistoryIII. Physical Assessment
IV. Gordon’s Health Pattern
V. Laboratory/Diagnostic Examination Result
VI. Medications, IV Infusions, Blood Transfusion, Treatments given
VII. Review of Systems
VIII.Anatomy and Physiology
IX. Pathophysiology
X. Prioritized List of Nursing Problems
XI. Nursing Care Plan
XII. Discharge Plan
I. Biographic Data
This is a case of Cesarean delivery. Patient X who is 29 years old, born on Oct. 28,1981. Her weight is 41 kg and height is 5’2”. A Roman Catholic, married, housewife with two children.
II. Nursing Health History
Chief Complaint: Patient x went to the hospital due to labor pain
and seek care for immediate attention.
History of Present Illness:Patient x is a G2P2(2-0-0-2) with regular
prenatal check up. She doesn’t have any history of illness during pregnancy. Prior to admission the patient has no vaginal discharge.
II. Nursing Health History
Past History: The patient doesn’t have hypertension,
asthma, DM, and Hepatitis B. During her childhood she had sore eyes, chickenpox and mumps. She is a fully immunized child and has no psychiatric illness. In 2008, she has undergone cesarean delivery for her first baby. She has no allergies at all.
II. Nursing Health History
Family History of Illness: Her relatives has history of hypertension
and stroke.
Lifestyle and Activity of Daily Living: Patient x is non alcoholic drinker, non
smoker and not addicted to any drugs. She has poor nutritious food intake and no allergies in any food. She sleeps 10 hours a day, starting from 8 in the evening and awake at 6 in the morning. She takes a nap for 30 minutes every afternoon.
II. Nursing Health History
Social Data: She is a college graduate, unemployed and
currently residing in her mother’s house.
Psychological Data: The patient is responsive to voice and touch
and has the ability to carry a conversation and answer questions appropriately. She doesn’t have disabilities regarding reading and writing. The patient can speak Tagalog and some English.
III. GORDON’S FUNCTIONAL HEALTH PATTERNSNutritional Pattern
Patient X is 29 y/o with the height of 5’2” and weight of 41 kg – undernourished
She has a BMI of 17 – underweightThe skin is considered normal
Activity – Exercise PatternBefore admission, the patient served as a fulltime housewife,
she takes care of her child at home and able to do some household chores
During hospitalization, Patient X appears weak and complains about the pain on her incision site. She is able to perform ADL but with assistance in doing activities.
III. GORDON’S FUNCTIONAL HEALTH PATTERNSSleep – Rest Pattern
The patient gets an average sleep of 10 hours every night. She sleeps at around 8 p.m. and wakes up at 6 a.m.
During hospitalization, the patient experiences sleeping disturbances because of the pain on her incision site. She often has disrupted sleep. She wakes up at night and finds it hard to go to sleep again.
Elimination PatternBefore admission, the patient stated that she urinates about 6 -
8 times every day. She usually has bowel movement of 3 times a week, with slightly brownish colored stool.
During hospitalization, Patient X urinates about 3 - 5 times a day with straw-colored urine output. The patient is constipated. There was no pain during urination.
III. GORDON’S FUNCTIONAL HEALTH PATTERNS
Health – Perception/Health Management PatternThe client perceives herself as physically fit personShe takes a bath one to two times a dayShe doesn’t smoke or drink any liquor, she also doesn't use any
harmful drugs
III. GORDON’S FUNCTIONAL HEALTH PATTERNSCognitive – Perceptual Pattern
The patient is responsive to voice and touch. She has the ability to carry a conversation and answer questions properly. She is able to read and write, and a college graduate. It was also observed that she was able to read the signs and posters posted at the hospital ward, and can follow simple instructions and can easily comprehend to questions asked.
There are no complaints regarding reading and writing. The patient can speak Tagalog and a few English.
During hospitalization, Patient X is still responsive to anything and has the ability to use simple sentences in answering questions.
III. GORDON’S FUNCTIONAL HEALTH PATTERNSRole – Relationship Pattern
She lives with her husband and her first child. According to the patient, they have a good family relationship. She also emphasized that her family is very supportive to her especially now that she was hospitalized.
Sexuality – Reproductive PatternThe patient is knowledgeable about sexual functions and sexual
intercourse. But after she undergone Caesarian Section, she was advised not to engage from sexual activity with her husband temporarily until the incision site on her abdomen has healed.
III. GORDON’S FUNCTIONAL HEALTH PATTERNSCoping – Stress Pattern
The patient usually decides for herself or sometimes she consult her familyDuring the interview, she was not attended by her husband due to certain circumstances.
Value – Belief PatternThe patient is Roman Catholic. She attends mass every week with her family.
IV. Physical Assessment
Vital Signs Findings Norms Interpretation
Temp. 37.4 C 36.5 – 37.5 Afebrile
PR. 88 bpm 60 - 100 Normal
RR 24 cpm 12 - 20 Tachypnea
BP 110/90 mmhg <120/<80 Pre-hypertensive
IV. Physical Assessment
Weight – 41 kgHeight – 5’2”
Findings Normal Range Interpretation
BMI 17 18 - 25 Underweight
IV. Physical Assessment Body Parts Findings Technique Interpretation Rationale
General Appearance
Conscious, Coherent, slightly fatigue, in pain, reduce activity level irritable
Inspection Abnormal The patient is slightly fatigue, in pain related to surgery.
Head Hair is evenly distributed, symmetrical features and movement, symmetrical eyebrow, intact skin, no discoloration, anicteric sclera/lids close symmetrical, pink palpebral conjunctiva
Inspection, Palpation
Normal
IV. Physical Assessment
Body Parts Findings Technique Interpretation Rationale
Neck Supple, (-) CLAD (Cervical Lymph Adenopathy), moves without discomfort
Inspection, Palpation
Normal
Breast Soft, warm, non-tender, nipples are intact, (-) lesion and redness
Inspection, Palpation
Normal
Chest/Lungs (-) retractions, (-) Adventitous breath sounds, Tachypnea
Inspection, Auscultation
Abnormal Rapid respiration because of fatigue caused by the surgery
IV. Physical Assessment Body Parts Findings Technique Interpretation Rationale
Abdomen Pfannensteil cut over hypogastric area with scant bloody discharge, dressing and plaster were clean and fully covers the incision site, no foul odor, incision is warm and reddened, bladder not distended, Uterus is 3 cm below the umbilicus
Inspection, light palpation
Abnormal Pfannensteil cut in hypogastric area brings destruction to skin integrity.
Genitals/Rectum Scant lochia, rubra odor similar to menstrual flow, (-) Hemorrhoids
Inspection Normal
IV. Physical Assessment Body Parts Findings Technique Interpretation Rationale
Extremities Can move without discomfort, (-) Homan’s sign
Inspection Normal
V. LABORATORY/DIAGNOSTICEXAMINATION RESULTS
RESULT NORMAL RANGE
FINDINGS
WBC 9.8 x 10^9/L 4.0-11.0 Normal
RBC 4.9 x 10^12/L 4.0-6.0 Normal
Hgb 116 g/L 120-180 Decreased
HcT 0.52 % 0.370-0.540 Normal
RESULT NORMAL RANGE
FINDINGS
LYMPHOCYTES 0.310 0.200-0.500 Normal
MONOCYTES 0.022 0.020-0.090 Normal
EOSINOPHILS 0.006 0.000-0.060 Normal
BASOPHILS 0.010 0.000-0.020 Normal
RESULT NORMAL RANGE
FINDINGS
PLATELET 165 x 10^9/L
150-450 Normal
NEUTRO- PHIL
0.510 0.500-0.700 Normal
V. LABORATORY/DIAGNOSTIC EXAMINATION RESULTS
RESULTS FOR BLOOD TYPING
ABO Typing Rh- typing Anti body
screen
A Positive
URINALYSIS
Physical Analysis
Color Light yellow
Transparency Clear
V. LABORATORY/DIAGNOSTIC EXAMINATION RESULTS
V. LABORATORY/DIAGNOSTIC EXAMINATION RESULTS
Chemical Analysis Result
Blood (-)
Bilirubin (-)
Ketones (-)
URINALYSIS
Chemical Analysis
Albumin (-)
Glucose (-)
pH 6.0
Specific gravity (-)
Leukocytes (-)
V. LABORATORY/DIAGNOSTIC EXAMINATION RESULTS
URINALYSIS
VI. MEDICATIONS. IV INFUSIONS, BLOOD TRANSFUSION,TREATMENTS GIVEN
IVF Name:Normal Saline
SolutionOther Name
0.9% NaCl Solution
Frequency: 55-56
gtts/min to run for 6 hours.
Action: Non-
pyrogenic solution for fluid
and electrolyte replenishm
ent. Contains no anti-
microbial agent
Indications: •Source of water and
electrolytes•Use to
replenish fluids
Contraindication:
•Severe hypertensio
n•Pulmonary
edema
Adverse/Side
Effects:•Febrile
response•Infection at the site of infection•Venous
thrombosis/phlebitis•Extravasa
tion•hypervole
mia
Nursing Implications:
•Check for renal function
•Check individual medication before
administration•Store the IVF at
room temp (25°C) to does not adversely affect the product
VI. MEDICATIONS. IV INFUSIONS, BLOOD TRANSFUSION,TREATMENTS GIVEN
Drug Name:
Mefenamic Acid
Dosage: 500
mg/capsuleFrequency:
prn
Action: Analgesic
Anti-pyretic
and Anti-Inflammat
ory
Indication: Pain
Reliever
Contraindications:
Contraindicated during lactation with ulcer
and chronic inflammation
, poor platelet
function, kidney and
liver impairment.
Adverse/Side
effect: GI
discomfort, constipation, nausea, vomiting, drowsines
s and dizziness.
Nursing implications:
•Assess patients pain before therapy: Lactation, duration,
and alleviating factors.
•Monitor for possible drug
adverse reactions.•Administer drugs with food or in full
stomach.•Assess patient’s
family and knowledge about
drug therapy.
VI. MEDICATIONS. IV INFUSIONS, BLOOD TRANSFUSION,TREATMENTS GIVEN
Genetic Name:
Ketorolac Tromethami
neBrand Name:ToradolDosage
15 mg, IVFrequency:
q6°
Action: Anti-
inflammatory and Analgesi
c. Inhibits
Prostaglandin
Indication: Short term management. of pain
up to 5 days.
Contraindications
: •With
significant renal
impairment.
•During labor and delivery.
•Use cautiously
with impaired
CV conditions
& allergies.
Adverse/Side Effects:
•Headache, dizziness,
insomnia(CNS)•Rash,
sweating, dry mucous
membrane(dermatologic).\
•Dysuria, renal impairment(GU)
•Bleeding, platelet
inhibition with higher doses, bone marrow depression,
menorrhagia(hematologic)
Nursing Implication:
•Assess patient and family
knowledge about drug
administration.•Assess the vital signs (BP, P, R);
cautiously administer to decrease vital
signs.•Assess for renal
impairment, allergies and impaired CV conditions.
•Inform the patient before
administering…
VI. MEDICATIONS. IV INFUSIONS, BLOOD TRANSFUSION,TREATMENTS GIVEN
Adverse/Side Effects:
•Dyspnea, bronchospasm (Respiratory).
•Peripheral edema,
anaphylactic shock (others).
Nursing Implications:
the drug that she may experience dizziness and drowsiness.
•Teach the patient to report fever,
rash, itching and swelling of
ankles/fingers after taking the
medications.
VI. MEDICATIONS. IV INFUSIONS, BLOOD TRANSFUSION,TREATMENTS GIVEN
GenericName:
CephalexinBrand Name:Cefalin
Dosage:500mg,
PO, capsuleFrequency:
q6°
Action:Bactericidal:
Inhibits synthes
is of bacterial cell wall
causing cell
death.
Indication:Skin and
skin structure infections caused by staphyloco
ccus/ streptococc
us
Contraindications:
•Allergy to cephalosporins/penicillins
•Use cautiously with renal
failure.
Adverse/Side Effects:•Headache, dizziness,
lethargy (CNS)•Nausea, vomiting, diarrhea,
anorexia,abd.pain, flatulence, liver toxicity(GI)•Nephrotoxicity
(GU)•Anaphylaxis
(hypersensitivity)•Superinfections
(others)
Nursing Implications:•Assess the pt
and family knowledge
about the drug administration.
•Assess for cephalosporin/ penicillin allergy
through skin test.
•Assess the renal function before giving a
medication.
VI. MEDICATIONS. IV INFUSIONS, BLOOD TRANSFUSION,TREATMENTS GIVEN
Nursing Implications:
•Administer the drug with meals to minimize
adverse reactions.•Administer the drug with small frequent
meals if GI complications occurs.•Inform the pt that she
may experience stomach upset, loss of appetite, nausea and
diarrhea•Instruct the patient to take medication in a
complete course even if she feels better.
VI. MEDICATIONS. IV INFUSIONS, BLOOD TRANSFUSION,TREATMENTS GIVEN
GenericName:Ferrous SulfateBrand Name:Rhea
Ferrous Sulfate
Dosage:30mg/day ,
capsule, PO
Frequency:Qd
Actions:Elevates
the serum iron
concentrations which helps form Hgb and
eventually convert to useable form of iron.
Indications:
•Prevention and
treatment of iron
deficiency anemia•Dietary supplement for iron.
Contraindications:
•Allergy to ingredients of ferrous
sulfate•Use
cautiously with normal
iron balance.
Adverse/Side Effects:
•CNS toxicity, coma, and death
(CNS)•GI upset,
nausea, vomiting and constipation
(GI)
Nursing Implications:•Assess the pt
and family knowledge about
the drug administration.
•Obtain baseline assessment of
pt’s iron deficiency before
starting the therapy.•Assess
hypersensitivity to ferrous sulfate.
•Be alert for adverse reaction
VII. Review of SystemsNeurological System
pupil size : 5 mm best verbal response : responsivereaction : PERRLA best motor response : activeeyes open : spontaneously
Integumentary Systemtemperature : warm skin turgor : normalcolor : normal JVD : not distendedskin : unintact skin as evidence by the incision on her abdomen
Respiratory Systemchest : symmetricallungs : equal chest expansionrespirations : no distressbreath sounds : clearcough : absent
VII. Review of SystemsCardiac System
heart sounds : normal
Gastrointestinal Systemabdomen : Pfanneinsteil cut over suprapubic area with scant bloody drainaige; dressing and plaster were clean and fully covers the incision site; no foul odor, incision is warm and softBladder not distended(+) mass tenderness at LLQBowel sounds : Hypoactive
Muscular Systempulses : (+) Homan’s sign : ( - )edema : ( - ) capillary refill : < 3 secondsperipheral calf tenderness : ( - )
VIII. ANATOMY AND PHYSIOLOGY
The Female Reproductive System
Fallopian tube/Oviduct :4 inches long (each
side)transports the mature
ova form the ovaries to the uterus
provide a place for fertilization of the ova by the sperm in it’s outer 3rd or outer half.
The Female Reproductive System
Fallopian tube/Oviduct:Interstitial – lies within
the uterine wallIsthmus – tubal ligationAmpulla – where
fertilization usually occurs
Infundibulum - covered by fimbriated cell
The Female Reproductive System
Ovaries:Oval, almond sized, dull
white sex glands on either side of the uterus
4 by 2 cm in diameter and 1.5 cm thick
responsible for the production, maturation and discharge of ova and secretion of estrogen and progesterone.
The Female Reproductive System
Uterus:hollow, pear-shaped
muscular organ3 x 2 x 1 inches,
weighing 50-60 gramsOrgan of menstruationsite of implantationprovide nourishment to
the products of conception.
The Female Reproductive System
Uterus:Perimetrium
(outermost)offers added strenght
and support to the structure.
Myometrium (middle layer)expels fetus during birth
process then contracts around blood vessels to prevent hemorrhage.
The Female Reproductive System
Uterus:Endometrium (Inner
layer )vascular and is shed
during menstruation and following delivery.
The Female Reproductive System
Divisions of the Uterus:Fundus – upper
rounded, dome-shaped portioncan be palpated to
determine uterine growth during pregnancy
The Female Reproductive System
Divisions of the Uterus:Corpus – body of the
uterus.Isthmus forms part of
the lower uterine segmentportion that is cut
when a fetus is delivered by a caesarian section.
The Female Reproductive System
Divisions of the Uterus:Cervix – lower
cylindrical portion that represents 1/3 of the total uterus.
The Female Reproductive System
Divisions of the Uterus:Vagina – a 3-4 inch
long dilatable canalorgan of
intercourse/copulationpassageway for
menstrual discharges and fetus
Layers of Anterior Abdominal Wall
Skin (functions):Protection: an
anatomical barrier from pathogens and damage
Sensation: nerve endings that react to heat and cold, touch, pressure, vibration, and tissue injury.
Layers of Anterior Abdominal Wall
Skin (functions):Heat regulation:
increase perfusion and heatloss
Control of evaporation: dry and semi-impermeable barrier to fluid loss
Storage and synthesis: storage center for lipids and water
Layers of Anterior Abdominal Wall
Skin (functions):Absorption: Oxygen,
nitrogen and carbon dioxide can diffuse into the epidermis in small amounts
Water resistance: so essential nutrients aren't washed out of the body.
Layers of Anterior Abdominal Wall
FasciaCamper's fascia - fatty
superficial layer.Scarpa's fascia - deep
fibrous layer.
passive structures that transmit mechanical tension generated by muscular activities or external forces throughout the body
Layers of Anterior Abdominal Wall
Fascia(function) Reduce
friction of muscular force thus allow muscles to glide over each other.
Layers of Anterior Abdominal Wall
Muscle1. Transversus
abdominus –to stabilize the trunk and maintain internal abdominal pressure.
2. Rectus abdominus –commonly called ‘the six pack’ that move the body between the ribcage and the pelvis.
Layers of Anterior Abdominal Wall
Muscle3. External oblique
muscles –allow the trunk to twist
4. Internal oblique muscles –flank the rectus abdominus, operate in the opposite way to the external oblique muscles
Layers of Anterior Abdominal Wall
Fascia transversalisA thin aponeurotic membrane
which lies between the inner surface of the Transversus abdominis and the extraperitoneal fascia.
Layers of Anterior Abdominal Wall
Fascia transversalisThick and dense in
structure and is joined by fibers from the aponeurosis of the Transversus, but it becomes thin as it ascends to the diaphragm, and blends with the fascia covering the under surface of this muscle.
Layers of Anterior Abdominal Wall
Peritoneumthe serous
membrane that forms the lining of the abdominal cavity or the coelom
covers most of the intra-abdominal (or coelomic) organ
IX. PATHOPHYSIOLOGY
X. PRIORITIZED LIST OF NURSING PROBLEMS
1. Acute Pain
2. Impaired Skin
3. Constipation
4. Deficient knowledge
XI. NURSING CARE PLANAssessment Diagnosis Planning Interventions Evaluation
Subjective:• “makirot ang hiwa ko sa tiyan, lalo na pag umuupo ako” as stated by the patient.• 8 out 10 pain scale P – with movement Q – stabbing R – throughout the abdomen towards the back S – at abdomen, 8 out of 10 T – with movement
Objective:• V/S: BP – 110/90 mmhg PR – 80 bpm RR – 24 cpm
Acute Pain related to abdominal incision secondary to surgery.
Goal:• Within 30 minutes to 1 hour nursing intervention, the patient will be able to verbalize that the pain is relieved or controlled.
Short Term:• The patient will verbalize pain intensity from 4 – 6 to 3 – 4 intensity pain scale.• Participates in demonstrating techniques to relieve pain.
• Assess clients pain using scale 1 to 10 (rationale: assessment provides objective measurement of the clients perception of pain.• Observe client for non-verbal signs of pain, grimacing and pallor (rationale: observation helps identify discomfort when the client doesn’t ask for help.• Assess location and character of pain each time client reports discomfort (rationale: assessment provides information about the cause of pain.
• After an hour of nursing intervention, the patient was able to verbalize that the pain has lessened
• Goal partially met
XI. NURSING CARE PLANAssessment Diagnosis Planning Interventions Evaluation
Objective: Temp. – 38.2°C• Wound site - dry, scant discharge of blood. - dressing and plaster were clear and fully covers the incision site. - no foul odor - incision site warm and reddened
• S/Sx: - observed evidence of pain - expressive behavior: irritability
• Administer appropriate pain medications ordered (rationale: taking medicines can lessen the pain).• Promote proper position, Low fowler’s position (rationale: reduces intra-abdominal pressure).• Employ non-pharmacologic pain destruction such as music therapy (rationale: to prevent dependence on medicine).• Teach client to eat fresh fruits and vegetable and increase protein and fluid intake in the diet…
XI. NURSING CARE PLANAssessment Diagnosis Planning Interventions Evaluation
(rationale: teaching provides information about the patient needs to make diet decision that will help wound healing).• Encourage ambulation as soon as possible after birth (rationale: ambulation decreases venous stasis & increase platelets).• Encourage adequate rest period (rationale: to prevent fatigue).• Discuss the impact of pain on lifestyle/ independence (rationale: to maximize level of functioning).
XI. NURSING CARE PLANAssessment Diagnosis Planning Interventions Evaluation
Subjective:• “makirot ang hiwa ko sa tiyan,” as stated by the patient.
Objective: • Incision site - reddened - has scanty blood draining - pain in suture site
Impaired Skin Integrity related to surgical incision.
Goal: After 3 – 4 days of nursing intervention the patient will be able to display gradual healing in the incision site.
• Assess the appearance, odor and drainage in the incision site (rationale: for documentation purposes and baseline data for future comparison).• Perform hand hygiene before touching the incision site (rationale: to prevent spread of microorganism).• Keep the area of incision site clean and dry, carefully dress wound/ support incision (rationale: to assist body’s natural process of healing.• Teach the client on proper wound dressing
• After 3 – 4 days of nursing intervention the patient was able to display gradual healing in the incision site.
• Goal partially met.
XI. NURSING CARE PLANAssessment Diagnosis Planning Interventions Evaluation
(rationale: to prevent accumulation of microorganism in the incision site).• Instruct the patient on how to provide optimum nutrition which includes vitamins and increase in protein intake (rationale: To aid in skin and tissue repair).
XI. NURSING CARE PLANAssessment Diagnosis Planning Interventions Evaluation
Subjective: • “hindi pa ako nakakadumi” as stated by the patient.
Objective: • (+) hypoactive bowel sounds• abdominal redness• current medication - ferrous sulfate - Mefenamic Acid
Constipation related to abdominal muscle weakness secondary to Cesarean delivery.
Goal: Within 8 hours of nursing intervention patient will be able to establish and regain normal pattern of bowel function.
• Review surgical history often associated with constipation (rationale: to identify causative /contributing factors).• Record fluid intake and output of the patient (rationale: to evaluate hydration status).• Assess the patient’s medications (rationale: there are medications that can promote constipation; to know if one of her medicine is the cause)• Administer laxatives to the patient as prescribed by the physician (rationale:
• After 8 hours of nursing intervention patient was able to establish and regain normal pattern of bowel function.
• Goal partially met
XI. NURSING CARE PLANAssessment Diagnosis Planning Interventions Evaluation
to aid the non-pharmacologic interventions).• Instruct the patient to increase fluid intake (rationale: to soften stool and for hydration).• Advise the patient to increase in fiber intake by eating green leafy vegetables, cereals, grains and fruits (rationale: by increasing roughage to diet, stool is passed more easily.
XII. DISCHARGED PLAN
MedicineAdvise the patient to take the medicine prescribed by
the doctor.Mefenamic Acid 500 mg as necessary Cephalexin 500 mg/capsule once a day for 7 daysFerrous Sulfate 30 mg/day
XII. DISCHARGED PLAN
ExerciseEncourage Ambulation to the patient to promote fast
healing, avoid strenuous activity to prevent wound dehiscence.
XII. DISCHARGED PLAN
TreatmentGet plenty of rest, adequate rest is important to maintain
progress towards full recovery and to avoid relapse.Drink lots of fluids, especially water, liquids will keep
patient from becoming dehydrated.
XII. DISCHARGED PLAN
HygieneAdvise the patient to take a bath everyday but avoid the
incision site from being wet to prevent on increasing risk of infection and for faster wound healing. Instruct the patient to cover it with clean plastic.
Instruct the patient to clean and dress the incision site everyday with iodine povidone (Betadine) to avoid infection and promote healing.
Others Instruct the patient to go back for hospital visit after a
week for follow up check up.
XII. DISCHARGED PLAN
DietTell the patient to increase protein intake for wound
healing and increase fluid intake and fiber to prevent constipation.
Advise the patient to eat green leafy vegetables (like malunggay) and fruits for lactation.
XII. DISCHARGED PLAN
Sexual and Spiritual Activity Sexual
She can resume coitus as soon as the act is comfortable or her, possibly as early as 1 week after discharge.
Warn the patient to abstain form intercourse if the discharges (lochia) haven’t disappeared yet because it will cause unhygenic intercourse.
Spiritual Tell the patient to continue her daily spiritual activities to
enhance spiritual health.
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