Republic of the Philippines

UNIVERSITY OF NORTHERN PHILIPPINES

College of Nursing

PATIENT DISCHARGE INSTRUCTION SHEET

Name: Chesley Daria Age: 8 years old Room: Childrens ward, cubicle 6 Address: Bulihan Silang, Cavite City A. DIET Name of Diet: DAT Purpose: to enhance nutrition and avoid malnutrition DIET FOODS ALLOWED WITHOUT RESTRICTION All fruits containing skin and seed should be avoided. The fruits one is permitted to have are:

Civil Status: Child

Fruits Bananas, pineapples, high fibers Apple sauce Pureed berries (de-seeded, de-skinned and pureed) Chayote Carrot Upo Squash

Vegetables

Grains

In the grain category, cooked cereals are soft and easy to chew and swallow. The cooked grains one is permitted to have are:

Oatmeal Grits Cream of wheat Cooked pasta Macaroni Smooth peanut butter Rice cooked in milk Rice balls Rice pancakes Ground meat Tender cooked beef, lamb or veal Tender cooked liver

Meat

and

Republic of the Philippines

UNIVERSITY OF NORTHERN PHILIPPINES

College of Nursing

Eggs

Cooked tuna, fish without bones Broiled or stewed turkey or chicken Soft boiled or scrambled eggs Milk Strained lemonade Chocolate milk Fruit juices Vegetable juices Soups (creamed soups) Broth

Beverages

Dietary Instructions: Protein Intake To build new tissues that support bones damaged by tuberculosis, you need adequate amounts of protein, which contains amino acids, the building blocks that repair and replace tissues. In an animal study reported in the August 1996 "Proceedings of the National Academy of Sciences of the United States of America," correcting protein deficiency in mice with tuberculosis decreased the rapid death rate of mice from infection. Vitamin Intake People with tuberculosis might have lower-than-normal levels of vitamin D, according to a meta-analysis of studies conducted by the Department of Public Health and reported in the February 2008 "International Journal of Epidemiology." This study did not establish an effective dose of vitamin D supplementation to reduce the risk of tuberculosis. Vitamin D aids in calcium absorption. A Pakistani study published in the December 2006 issue of the "Professional Medical

Republic of the Philippines

UNIVERSITY OF NORTHERN PHILIPPINES

College of Nursing

Journal" assessed calcium levels in 33 patients with tuberculosis, 20 of whom had spinal tuberculosis. Researchers found that all had low calcium levels, leading them to report that calcium supplements, as well as vitamin D supplements, would benefit those with tuberculosis. Considerations Although tuberculosis of the spine can cause spinal fractures and vertebral collapse, similar to spinal fractures seen in osteoporosis, they have different causes. Pott's disease, unlike osteoporosis, is not a disease of low bone density. Rather, bacteria infiltrate the bone and form abscesses that destroy the bone. Rebuilding bone in Pott's disease, like rebuilding bone in osteoporosis, does require good nutrition and adequate vitamin and mineral intake, including vitamin D and calcium supplements if levels are low. No specific nutritional diet for Pott's disease exists.

B. ACTIVITIES AND REHABILITATION ALLOWED Recommended exercises for Pott's disease rehabilitation include stretching, balance training, gait training and a group of exercises involving the use of PNF -- or proprioceptive neuromuscular facilitation -- techniques. Isometric exercises, the goal of such exercises is to develop muscle strength through contractions without movement. This way, muscle strength is gradually built up while minimizing the risk of further damage. After gaining enough strength and dexterity with these non-movement exercises, you are ready MODIFIED Performing stretching exercises, as a general rule, only gentle stretching exercises are permissible Before implementing this stage of exercises, assisted passive movements should first be perfected. Gentle stretching of your extremities is introduced only once the physical therapist confirms that it is safe. It is also important to maintain spinal stability while performing these gentle stretching exercises.

Republic of the Philippines

UNIVERSITY OF NORTHERN PHILIPPINES

College of Nursing

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