Discharge Plan

A case of a primi pregnant woman, 22 years old, Married, Filipino, Roman Catholic was
admitted to Eversly Childs General Hospital on August 20,2019 for being in the labor
stage with a final diagnosis of 6cm Cervical Dilation, Hours later the patient gave birth to
a healthy baby boy August 20, 2019 at 10:10 am. The patient can go home after the
episiotomy is fully healed and all the Hospitals Bills are cleared.

Subjective

“Kung ma okay na akoang gibati sir og kanang mabayaran na namo ang mga
kinahanglan bayranan” as verbalized by the patient

Objective

-Received directions from the physician

-Episiotomy is starting to heal

-Seen preparing things

Analysis

-Patient’s condition and compliance related to cost of hospital bills and stay are slowly
being met.

Planning

-Resume patients Religious activity

-After 15-30 minutes of health teaching, the patient will be able to enumerate activities
that will enhance her knowledge and independence in the monitoring of her health and
as well as her New born baby, thus results her into being a Good Mother for her Child.

Interventions

At admission

• Identify caregivers who will be at home with the patient

• Elicit the patient’s and family’s goals for the hospital stay

• Inform the patient and family about steps toward discharge

• Let the patient and family know they can use the white
 board to write questions or concerns

Daily during hospital stay

• Educate the patient and family about the patient’s

condition at every opportunity using teach back

• Explain medications to the patient and

family using teach back

• Discuss progress toward goals and discharge

• Involve the patient and family in care practices to prepare

for home care

Prior to discharge

• Prepare the patient and family for transition to home

• Schedule the discharge planning meeting with the

patient and family

• Offer to make followup appointment for the patient

On day of discharge

• Use teach back to assess how well providers have explained

diagnosis, condition, and discharge instructions to the

patient and family

• Review the reconciled medication list with the

patient and family

• Write down the followup appointment times for the patient

and family

• Write the name, position, and phone of the hospital person

to contact if there is a problem after discharge

Evaluation

Goal has not been met, “ Muadto lang unya mi og sentro sir pa follow up sa mga
kinahanglan sa akoa og para sa akoang anak” as verbalized by the patient.

HEALTH TEACHING
Breastfeeding

-Wash your breasts with water daily for cleanliness.

-Air dry nipples after each feeding.

-If nipples are sore, apply a few drops of breast milk after a feeding and let air dry.

-If breasts are engorged, apply warm packs and express milk.

Non-breastfeeding

-Wear a well-fitting bra for support.

-Use ice packs to relieve discomfort from engorgement.

-Avoid handling your breasts and do not express milk.

-Non-breastfeeding engorgement will subside in 24-36 hours.

Uterine Changes

-After-pains, or cramping, are normal. This cramping means that the uterus is
contracting to return to its non-pregnant size. The uterus takes five to six weeks to
return to its non-pregnant size.

Vaginal Discharge

-Usually lasts about ten days to four weeks. The color will change from bright red to
brownish to tan and will become less in amount and finally disappear.

-Menstruation: your period will resume in approximately six to eight weeks, unless
breastfeeding.
Care of Episiotomy

Sitz Bath: sitting in a tub of warm water for 15 minutes, two to three times per day, will
help relieve the discomfort.

Local agents, such as Tucks, Witch Hazel and Lanacane, may be applied to the
stitches.

Stitches will dissolve in one to three weeks.

Pain Relief

-Use a mild analgesic (Tylenol or Advil) for breast engorgement, uterine cramping and
episiotomy discomfort.

Diet & Nutrition

-Continue taking your prenatal iron and vitamin pills until your postpartum visit.

-It is important to eat a well-balanced diet and drink plenty of fluids. Drink two quarts of
fluid per day if you are breastfeeding.

Emotional Changes

-You may get “baby blues” after delivery. You may feel let down, anxious and cry easily.
This is normal. These feelings can begin two to three days after delivery and usually
disappear in about a week or two. Prolonged sadness may indicate postpartum
depression. Help is available through the Women & Infants' Day Program.

Activity

-Rest! Do not do heavy housework or heavy exercise for two weeks. Avoid driving for
one to two weeks. Check with your doctor for limitations on activities if you have had a
c-section.

-Avoid sexual activity, douching or tampons until your postpartum visit.

Birth Control

-Is advisable as soon as you resume sexual intercourse. Foam and condoms are safe
and easy to use. Birth control methods will be discussed further at your postpartum visit.
When to call your doctor/midwife:

-Fever greater than 38.3, with or without chills.

-Foul-smelling or irritating vaginal discharge.

-Excessive vaginal bleeding.

-Recurrence of bright red vaginal bleeding after it has changed to a rust color.

-Swollen area, painful area on the leg that is red or hot to the touch.

-Burning sensation during urination or an inability to urinate.

-Pain in the vaginal or rectal area.

-Crying and periods of sadness beyond the two weeks.

-Cesarean incision that is red, draining or painful.