Discharge Planning

Categories Plan Rationale

Medication

Instruct patient to take prescribed

medications regularly and comply with

the treatment regimen prescribed by the

physician.

Teach patient regarding the names of

the drug, its dosage, time of

administration, its contraindication and

side effects.

Inform patient and significant others not

to take drugs not prescribed by the

physician, especially OTC drugs.

Instruct the patient to check for the

expiration date of the drug before taking

it.

Do not administer any other drug with

same action without the physician’s

prescription.

Educate the patient and the significant

others about the expected responses of

drug to the body, side effects, adverse

effects that may possibly seen into the

patient.

Instruct the significant others to report

any remarkable adverse reactions or

any appearance of side effects noted.

-Compliance to appropriate

medication and treatment

prevents further complications

and resistance to antibiotics and

promote continuous recovery of

optimal health.

-The patient has the right to know

his drug’s therapeutic effects as

well as its adverse effects. He

also has the right to gain

awareness about why is it given

to him.

-Drug interactions may occur

which may be fatal to patient’s

current situation.

-Checking for the expiration date

of the drug before administering it

ensures it potency and safety. It

also prevents any unwanted

reactions like hypersensitivity.

-Non-prescription drug may have

antagonistic or synergistic effects

if taken with other drugs.

-To be geared up of enough

information that may lead to

immediate medical responses.

-For immediate remedial action

response and to prevent any

complicated reactions.

Exercise Explain to patient the significance of -Exercises promote proper blood

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regular exercise like walking and

stretching. If unable to mobilize alone,

instruct the watcher to give assistance

all the time. Encourage to use crutches

or any device for support. Stretching

upper extremities also promote healthy

living. Also instruct patient to perform

passive range of motion.

Teach patient to wait for 1 to 2 hours

after eating before performing any

physical activities.

If patient’s pleural effusion worsens,

instruct the patient to practice deep

breathing exercise.

circulation and prevent arterial and

venous stasis thus lessens platelet

coagulation to aged people. Older

people have weakened blood

vessel walls which can cause any

alteration in blood flow.

Also exercise prevents atrophy of

the muscles.

-Older people has slower digestion

rate, thus they need to conserve

more oxygen which will be

necessary for digestion of food.

Activities must be limited to

decrease oxygen demand by

organs and tissues other than the

digestive system.

-Deep breathing exercises promote

thoracic expansion which allows air

to enter the respiratory tract and

provide oxygen to the alveoli to

avoid atelectasis or lung collapse

due to increase fluid pressure in

the pleural space.

Treatment Instruct patient to comply with his

medication treatment like the continuous

use of beta blocker Metoprolol for

control of hypertension and Insulin for

diabetes mellitus.

Instruct client to seek medical help if any

unusualties are felt such as tingling

sensation or paresthesia, fatigue and

body malaise, dizziness, headaches,

irritability, tremors, diaphoresis, etc.

As part of long-time treatment, advise

patient to wear medical alert bracelet all

-Maintenance meds should not be

forgotten to achieve highest

therapeutic effect.

-These unusualties may be

indicative of worsening condition.

-Medical alert bracelet provides

basic information about the client in

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the time and wherever he goes. It

contains the patient’s name, disease

condition, address and contact person.

Advise to have a family member take

your blood pressure to check if you’re

maintaining a stable blood pressure.

Since the client has his own glucose

monitor, tell client to continue monitoring

blood glucose level, and immediately

seek for medical help if level is

abnormally high.

case of accidents.

-Monitor of blood pressure is

significant for evaluating the

medication’s effectiveness.

-Glucose monitoring is a big factor

in the management of diabetes

mellitus.

Hygiene Instruct patient to practice foot care to

prevent ulceration and formation of

gangrenous tissues to the lower

extremities.

- Check and carefully wash your feet

every day.

-Do not wear shoes that are too small or

socks that do not fit right inside your

shoes.

-Soak your feet in warm soapy water for

10 minutes before cutting your nails.

Trim your toenails straight across to

prevent ingrown toenails. You may also

file down your toenails. Do not cut your

nails into the corners or close to the skin.

You should not dig under or around the

nail.

Emphasize the importance of bathing

everyday. Wash genitals with mild soap.

-Proper foot care prevents injury to

feet and toes.

-Proper bathing eliminates

proliferation of germs and bacteria

in the body. Mild soap does not

irritate the skin and the genitals.

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Instruct client to maintain good oral

hygiene.

Instruct to wear clean clothes and

underwear.

-Tooth brushing prevents build up

of plaques and cavities.

-Dirty or improperly washed

underwear may become a

sanctuary for microbial growth.

Microbes may enter the genitals

and might worsen the client’s

UTI/Cystitis.

Out-Patient

Referral

Encourage patient to undergo physical

therapy sessions.

-A Physical Therapist is a source of

information to understand age-

related changes and offer

assistance for regaining lost

abilities or develop new ones.

Physical therapy can be applied to

the client’s condition: arthritis,

urinary and fecal incontinence,

amputation, and cardiac and

pulmonary disorders. It can :

a). increase, restore or maintain

range of motion, physical strength,

flexibility, coordination, balance

and endurance

b.) aids adaptations to make the

home accessible and safe

teach positioning, transfers, and

walking skills

c.) promote maximum function and

independence within an individual's

capability

d.) increase overall fitness through

exercise programs

e.) prevent further decline in

functional abilities through

education, energy conservation

techniques, joint protection, and

use of assistive devices to promote

independence

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Advise to have check-ups after discharge.

Advise to have regular laboratory exams

for creatinine, albumin, sodium,

potassium and calcium.

Encourage to undergo ABG Test every

month or once every 2 months.

f.) improve sensation, joint

proprioception

g.) reduce pain

-Serves as an evaluation process

to note if condition has progressed

to better or worse.

-To assess for renal function.

Diet Instruct client to avoid simple sugars.

Take energy from complex carbohydrates

like unpolished rice, bread and

vegetables.

Encourage patient to eat fibrous foods

like fruits and vegetables. But do not eat

too much as it can irritate the GI tract and

causes bleeding. Other examples of

sources of fiber are: whole grains, cereals

and legumes.

Limit intake of purine rich foods such as

sardines, liver, beef kidneys, brains and

meat extracts. Encourage to eat in

moderate amount: asparagus, cauliflower,

spinach, mushrooms, green peas, dried

peas and beans.

Instruct patient’s family to prepare foods

low in fat and cholesterol. Also have

moderate amount of sodium in the diet.

-Simple sugars easily break down

and enter the blood stream.

Complex carbohydrates can

sustain the body’s energy

requirement for a longer time

because they are not broken down

easily.

-A diet rich in fiber relieves

constipation. It adds bulk to the

excreta and facilities expulsion.

-Accumulation of uric acid in the

joints causes arthritis. Uric acid is

the by product of purine break

down in the liver. Because of renal

malfunction, uric acid is retained in

the blood stream and is shunted to

connective tissues.

-Cholesterol build up can cause

atherosclerosis. Since elder people

have weakened blood vessel walls,

cholesterol or atherosclerotic

plaques (atheromas) can lodge in

the blood vessels and obstruct

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Maintain good oral hydration.

blood flow. If the atheroma is

dislodged, it might become an

emboli and travel through the

pulmonary circulation.

-Since the patient is suffering from

hyponatremia, do not deprive client

of sodium but just limit his intake,

because too much sodium can

result to fluid shifting and edema.

Hyponatremia stimulate

juxtaglomerular cells to activate

RAAS, the precursor of

hypertension. Also hypontremia

affects action-potential of the heart,

affecting repolarization and

depolarization. Low levels of

sodium can also result to

neurologic problems.

-Water replenishes the cells and

decreases the chance of

crystalluria.

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