Discharge Plan DISCHARGE PLAN MEDICATION Instructed patient to adhere to home medications religiously.

. Teach the patient each of the medications basic drug action, side effect and adverse effect. Reinforced instruction given regarding the proper timing, route, dosage of his medications as by the Doctor. Home medications: a.) Neurobion 1 tab TID for 2 weeks. b.) Fixcom 3 3 tabs once a day for 1 month. c.) Vastarel 35mg 1 tab BID (8am-6pm) d.) Misoprolol 2.5mg 1tab once daily (8am) e.) Rosuvastatin 40mg tab once daily (8am) f.) Clopidogrel 75mg 1tab once daily (6pm) EXERCISE Encouraged to continue performing active range of motion exercise every morning such as Flexion, extension hyperextension of neck, both arms and legs as tolerated. Instructed patient to perform deep-breathing and coughing exercises regularly. To promote selfinvolvement and interest towards promotion of wellness. To aid in loosening secretions for easier expectoration. Adjusting activities as During the home visit, patient had performed active ROM and had showed gradual increase of activities (brisk walking and performing ADLs independently), as tolerated by his condition. 117 RATIONALE To promote maximum wellness and recovery. To help client understand own situation and enhance interest/ involvement in own health needs. Medications should be taken according to the prescribed timing, route and dosage to achieve the desired goal of recovery from the said health condition. EVALUATION Home visit was done last September 3, 2011, during this time; patient's adherence to medication regimen was noted as evidenced by patient taking his medications in accordance to the right route, timing and dosage prescribed by the Doctor.

Discharge Plan tolerated by the patient will help preventing occurrence of overexertion thus establishing rest periods between activities will help to conserved energy. To liquefy secretions and promote hydration. To facilitate venous return. Strenuous activities will likely increase heart workload to compensate to the body's demand for oxygen To prevent fatigue and conserve energy. Aid in mobilizing and loosening up secretions thus facilitating easier expectoration. HEALTH TEACHINGS Discussed and Explained : Importance of infection control such as : To prevent from spread Upon home 118 During home visit, patient had performed the following instructions given to him : a) Increased fluid intake not less than 1500 ml. b) Elevated his lower legs while resting. c) Avoided strenuous activities. d) Established resting periods between activities. SO also performed backtapping and assisted patient on performing postural drainage.

Encourage patient to gradually increase activities as tolerated such as brisk walking and establish rest periods between activities. TREATMENT Encouraged to increase fluid intake up to 1500 mL unless contraindicated. Instruct patient to elevate his lower extremities when resting. Encouraged patient to avoid strenuous activities.

Provide rest periods between activities Instructed SO to do back tapping and assist patient to do postural drainage.

Discharge Plan a) Proper disposal of secretions (phlegm, saliva) b) Using of mask and/or covering of mouth when sneezing and coughing. Importance of adequate nutritional intake of microorganisms To prevent transmission of the pathogens which is Mycobacterium tuberculosis. To boost immune system and maximized body's response to the drug given. To aid for faster recovery. visit patient had able to compre hend what have been taught to him as he verbaliz ed the followin g: INFECTION CONTROL: karon namatudan jud nako na importante na protektahan nako ako pamilya sako sakit, sa mga pamaagi na ginagmay sama sa paglabay sakong plema sa saktong kabutngan , ug labaw sa tanan kanang pagtabon sa baba kung muubo ko. NUTRITIONAL INTAKE: di pareha sauna, karon mas gakaon kog utan ga-iwas nako sa mga pagkaon na parat ug daghan tambok sama sa bulad, ug humba MEDICATION COMPLIANCE: ginatumar nako ang mga 119

Importance of medication compliance especially anti-Tb drugs Avoidance of performing strenuous activities Activity increases the workload of the heart to compensate to the body's Importance of smoking cessation. increase demand for oxygen. Nicotine from the cigarette causes vasoconstriction thereby decreases blood flow into the heart leading to decreased myocardial perfusion which Teach relaxation techniques such as then leads to anaerobic deep breathing, self-talk, soft and calm metabolism that causes pain music to soothe the mind, meditation, (angina pectoris). guided imagery and positive thinking. To lessen anxiety and divert oneself from pain.

Discharge Plan tambal na gireseta ni doktor sa kay kini makatabang sa akoa ACTIVITY: ga-iwas naku sa mga trabahoi SMOKING CESSATION: gahina-hinay nakog undang ug pagpanigarilyo tungod sako kondisyon PAIN CONTROL: karon daghan nako nabaw-an na mga pamaagi sa pagcontrol kung magsakit ako dughan

OUT-PATIENT/ FOLLOW-UP Instruct patient to return to the hospital for check-up on July 27,2011 at Out-patient department of Maria Reyna Hospital Encourage to return to the hospital immediately if any abnormalities noted such as: chest pain or any hypotension manifestations. Encouraged to visit health center regularly to have hid BP checked

It is important to have the doctor monitor the progress of the patients condition. To render immediate action to the problem before the complication will occur. Having regular BP reading will help identify unusualities in patient's condition thereby preventing complication.

During home visit last September 3, 2011, patient verbalized that he had already visited his doctor at the scheduled time given to him for his check-up.

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Discharge Plan DIET Encourage to take adequate nutritional intake such as low fat, high protein, high fiber, carbohydrates and vitamins and minerals. a.) Protein rich foods: meat, fish, beans, corn, and peas. b.) Low fat foods: Omega 3 fatty acid such as tuna, cucumber, and lettuce. c.) High fiber foods: bananas, grapes, peanuts, avocado, and carrots. Patient had verbalized the following about his diet during our home visit last September 3, 2011: di pareha sauna, karon mas gakaon kog utan ga-iwas nako sa mga pagkaon na parat ug daghan tambok sama sa bulad, ug humba

To facilitate tissue repair. Decreases/ preventing deposition of fatty substances leading to plaque formation in the artery. High fiber foods serve as a laxative thus facilitating easier defecation. Thus avoiding valsalva manuever. To boost immune system. To promote spiritual growth not just to the patient but also to the family. To ask for guidance and pray for the healing and restoration of health. As this strengthens relationships that can be powerful force in one's spiritual health.

d.) Vitamin and mineral rich foods: oranges, tomatoes, squash, and okra. SPIRITUALITY Encouraged the family to go to Church together every Sunday Provide quite time and place for patient to mediate, reflect, pray, worship and have a peace of mind. Encouraged patient to make time for family Asked the patient to reflect on the Bible Scripture, For I will restore health to you and heal you on your

Patient verbalized concern regarding his spiritual life : Sa kapila nako pagka-admit kablo ku na ang Ginoo dili ku pasagdan, busa ako gasalig saiya na tabangan ku ani akong sakit busa ga.ampo jud ku kaniya dili lang para sako pati napud para sako pamilya

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Discharge Plan wounds. says the Lord. (Jeremiah 30:17).

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