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2. Exercise/ Activity and Home Environment

Procedure: Deep Breathing Exercises
Steps: a. Take big, deep breathes through your nose
b. Hold your breath for 3-5 seconds
c. Exhale in a purse lip manner
d. Continue for 10-20 minutes until you feel relaxed
Procedure: Coughing exercises
Steps: a. Take a deep breath – hold for three seconds then huff out three times.
b. On the third huff, cough deeply from the lungs, not the throat.
b. Complete 5 cycles
Procedure: Brisk walking for 20 minutes
Steps: a. Walk a little initially and then gradually increase the time.
b. Warm up and cool down with a slow, gentle walk to ease you up.
c. Take light, easy steps and make sure your heel touches down before your toes
d. Walk on grass rather than concrete to help absorb the impact if possible.
Procedure: Swimming
Steps: a. Relax and keep your head above the water.
b. Do strokes and time yourself for 10 to 20 minutes.
Restrictions:
a. Avoid hazardous or strenuous activities such as heavy lifting.
b. Avoid smoking or second hand smoke
c. Avoid skin pricks, cracks and cuts.
d. Avoid tight-fitiing shoes
Home Environmental Hazards:
a. Slipping or accident hazards
b. Exposure to second hand smoke
c. Knife cuts and burns during cooking

3. Treatment & Therapies

a. Physical therapy. Exercises may help the patient’s strength and mobility such as
walking.
b. Recreational therapy. Patient may benefit from recreational therapies, such as
swimming or listening to music.
c. Hydrotherapy pool/sea exercises. Exercises or swimming in apool or in a sea offers
relief for back pain, arthritis and stressn addition, you should know that very few
studies have looked at whether over-the-counter cough medicines lessen coughing
caused by pneumonia. If you want to try a

1. Health Teaching/Education
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a. Eat a low fat diet such as leafy green vegetables, fruits, sweet potatoes, legumes and etc. to
prevent heartburn, improve cholesterol level and to cut weight. Read food labels to make sure the
food you are choosing are low in fat
b. Take maintenance and home medications religiously. Don’t skip doses.
c. Call your health care provider if severe pain in the upper belly, shoulder or back, fever, nausea and
vomiting or jaundice occurs
d. Take regular exercises, have a proper diet and adequate rest periods.
e. Avoid stress; listen to relaxing music, have a regular walk or do deep breathing exercises.
f. Reduce sodium intake; avoid canned and processed foods, dried fish and etc.
g. Lose some weight; eat high fiber foods and do exercises
h. Have a regular check or record on your blood pressure.
i. Avoid caffeinated drinks and exposure to second hand smoke
j. Moisturize skin to prevent cracks. Avoid cuts and pricks.
k. Wear non slippery shoes or slippers and avoid tight-fitting shoes
l. Have a regular foot care; cleaning and trimming of toes nails with even tops, inspecting in between
toe nails for corns, calluses, redness, swelling, bruises, blisters or breaks in the skin, applying
moisturizers or mild lotions to feet.
m. Avoid too much sweet or sugar intake.
n. Increase fluid intake upto 1500-2500 ml per day
o. Elevate head by putting pillows under if difficulty of breathing occurs
p. Follow up with your health care provider as advised.

2. OPD Visit
Clinic Appointment Schedule: March 8, 2019; 9 AM
Follow-up Diagnostic or Laboratory Exam: NONE
Referrals: NONE

3. Diet
a. Encouraged client to increase intake of fiber to avoid constipation.
b. Instructed to increase fluid intake upto 6-8 glasses daily or as tolerated
c. Instructed to increase intake of nutritious foods such as fruits and green leafy vegetables such as
kangkong, malunggay, broccoli and etc. Eat foods rich in Vitamin C such as lemon, sweet
potatoes, vegetables and etc.
d. Decrease cholesterol, fat, sugar and sodium intake

3-day sample menu

Day 1 Day 2 Day 3

Breakfast 2 glasses of water 2 glasses of water 2 glasses of water
1 cup of rice with 1 cup of rice with 1 cup of rice with fried
vegetable soup ginisang ampalaya fish
1 piece of orange 1 banana 1 apple
Lunch 2 glasses of water 2 glasses of water 2 glasses of water
1 cup of rice with chop 1 cup rice with squash
suey and malunggay soup
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1 sweet potatoe 1 cup of rice with 1 cup of calamansi

2 small slices of boiled okra and juice
watermelon tomatoe
2 sweet potatoes
1 cup of orange juice
Dinner 2 glasses of water 2 glasses of water 2 glasses of water
1 cup of rice with fried 1 cup of rice with 1 cup of rice with fried
fish vegetable lumpia fish
1 cup of calamansi 1 piece of orange 1 small bowl of
juice steamed broccoli with
garlic

4. Spiritual Care and Psychological or Sexual Needs (Give special consideration to religious and
cultural practices)

 Encouraged to continue praying to God and to attend mass every Sundays and other days

 Encouraged to put pillows bedside the patient on the bed to avoid injury or falls

 Advised not to leave patient alone and to keep watch at all times

 Instructed to keep sharp objects away from the patient

C.DISCHARGE DETAILS
a. Date and Time of Discharge: January 27, 2019
b. Accompanied by: Sister
c. Mode of Transportation: Ambulation
d. General Condition upon Discharge: Discharged with improved condition, still with pain at surgical
wound area.

I have read and understood the discharge instructions given to me.

_____________________________
CLIENT/SIGNIFICANT OTHER
(Signature over Printed Name)

Instructed By: Approved By:

____________________________ ________________________________
STUDENT NURSE CLINICAL INSTRUCTOR
(Signature over Printed Name) (Signature over Printed Name)
 56

REFERENCES

1. Brunner & Suddarth’s. (2014). Medical- Surgical Nursing (13th edition). Quezon City, Philippines: C&E

publishing, Inc.

2. Doenges, M. & Moorhouse, M. F. & Murr, A. (2012). Nurse’s Pocket Guide: Diagnosis, Prioritized,

Interventions and Rationales. Philadelphia, Pennsylvania: F.A DAVIS COMPANY

3. Dwyer-Schull, P. (2008). Nursing Spectrum Drug Handbook: McGraw–Hill Companies, Inc.

4. Ladwig, G. B., Ackley, B. J., et. al. (2016). Nursing Diagnosis Handbook - E-Book: An Evidence-Based

Guide to Planning Care. Elsevier Health Sciences.

5. Lucangelo, U., Pelosi, P., Zin, A. W., et. al. (2008). Respiratory System and Artificial Ventilation.

Springer Science & Business Media.

6. Tortora, G. & Derrickson, B. (2011). Principles of Anatomy and Physiology (13th edition, vol. 1):

Organization, Support and movement, and Control Systems of the Human Body. Quezon city, Philippines:

C&E Publishing, Inc.

7. Myers, G. (2007). Nursing Care Plans (6th edition): Nursing Diagnosis and Intervention. Singapore:

ELSEVIER, INC.

8. Marieb, E. N. (2011) Essentials of Human Anatomy & Physiology (8th edition): Quezon city, Philippines:

C&E Publishing, Inc.

9. Berkow, R. & Fletcher, A. (2000). The Merck Manual (16th edition, vol. 1): General Medicine. U.S.A:

Merch & Co, Inc.

10. Wheeler, D. S., Wong, H. R., Shanley, T. P. (2008).The Respiratory Tract in Pediatric Critical Illness and

Injury. Springer Science & Business Media.

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