DISCHARGE PLAN

A. OBJECTIVES
1. Demonstrate effective teaching strategies for patients
2. Explain how to educate clients who have special needs or difficulty with self-management
3. Identify the factors that an educator would evaluate to determine if a client is able to manage her/his
respiratory illness.
4. Identify the methods of administration of the medication

1. Exercise/Activity and Home Environment

Type of Activity Allowed/To be continued: Deep breathing exercises
Procedure or Steps:
a. Breathe in deeply and slowly through your nose, expanding your lower rib cage, and letting your abdomen
move forward.

b. Hold for a count of 3-5

c. Breathe out slowly and completely through pursed lips. Don’t force your breath out

d. Rest and repeat 10 times every hour. Rest longer if you become dizzy or lightheaded

Type of Activity Allowed/To be continued: Coughing exercises

Procedure or Steps:
a. If you’re lying on your back, bend your knees (if your surgeon says you can) and rest your feet on the bed
b. Support your incision firmly and your hands or a small pillow before you try to cough
c. Breathe in deeply and cough firmly. If you cough up some mucous, clear it into a tissue. Repeat the coughing
until there isn’t any more mucous. If you have a lot of mucous, you may need to take break so you don’t get too
tired

Type of Activity Allowed/To be continued: Foot and Leg exercises

Procedure or steps:
a. Ankle lump
 Pump your ankles up and down for 1 minute
 Relax both feet
 Repeat 5 times then relax
b. Ankle circles
 Circle both ankles; first to the right, and then to the left
 Repeat 5 times then relax
c. bend each knee one at a time, sliding your foot up along the bed and then back down
d. repeat 5 times then relax

Type of Activity Allowed/To be continued: Breathing using an incentive spirometer

Procedure or steps
a. Sit up and hold the device
b. Place the mouthpiece spirometer in your mouth. Make sure you make a good seal over the mouthpiece with
your lips
c. breathe out normaly and breathe in slowly
d. Try to get tis piece to rise as high as you can
e. Take 10 to 15 breaths with your spirometer every 1 to 2 hours, or as often as instructed by the nurse or doctor.

Use of Equipment (if any): spirometer

Restrictions:
a. Avoid strenuous activities
b. Do not smoke
c. Do not climb high altitudes after a pneumothorax
d. Avoid compression on the chest

Home Environmental Hazards:

a. chemicals (such as fragrances and pesticides)
b. Dust mites
c. Mold/Moisture/Damp environments
d. Pests (especially cockroaches and mice)
e. Pet Dander
f. Second hand smoke
g. Wood Smoke

2. Treatments/Therapies

 Hydration should be maintained

 Inhalation of humidified air may facilitate removal of airway secretions.
 Expectorants are sometimes used with the intention of liquefying these secretions.
 Antitusive agent are indicated to relieve the discomfort associated with non-productive coughing but are
contraindicated when secretion of airway mucus is excessive
 Bronchodilators may be indicated in animals with asthma like conditions and chronic respiratory disease
 Broad-spectrum antibiotics should be used if specific bacteria cannot be identified, and once begun, a
full course of therapy should be completed
 Apply chest physiotherapy

3. Health Teaching/Education (e.g., asthma)

Health Prevention/Promotion
 Have adequate rest and sleep to decreases stress and may enhance the immune system.
 Don’t skip meals and maintain proper diet such as foods high in B-vitamins and iron, such as whole grains (If no
allergy), dark leafy greens. Also eat antioxidant-rich foods, including fruits (such as blueberries, cherries, and
tomatoes) and vegetables (such as squash and bell pepper).
 Avoid caffeine and other stimulants, alcohol, and tobacco.
 Exercise lightly
 Maintain also medications that are being prescribed by the physician.

4. OPD Visit

Have a follow up check up schedule to visit physician to assess extent of treatment and further
assessment.
Obtain drugs that may be administered at home for further treatment.

5. Diet
 A balanced diet. A balanced diet with a high intake of fruit, vegetables and fish reduces the risk of
developing lung diseases, especially asthma and COPD.
 Eat 20-30 grams of fiber each day, from items such as bread, pasta, nuts, seeds, fruits and vegetables.
 Eat a good source of protein at least twice a day to help maintain strong respiratory musles.
 Good choice include milk, egg, cheese, meat, fish, poultry, nuts and dried beans or peas
 Avoid caffeine and other stimulants, alcohol, and tobacco.
 Use healthy cooking oils such as coconut oil. Avoid cooking oils at high temperatures, as carcinogens
may form.
 Reduce or eliminate trans-fatty acids, found in such commercially-baked goods as cookies, crackers,
cakes, French fries, onion rings, donuts, processed foods, and margarine.

3- Day Sample Menu

Day 1 Day 2 Day 3
Breakfast Breakfast Breakfast
I cup of rice I cup of rice I cup of rice
1 bananas Scrambled eggs Orange
Ginisang upo and kalabasa I glass of milk Seared okra and Tomato
Recipe
Lunch Lunch Lunch
 1 cup of rice 1 cup of rice 1 cup of rice
Watermelon Adobong sitaw Tinolang isda
Kangkong with squid balls Orange
Dinner Dinner Dinner
1 cup of rice 1 cup of rice 1 cup of rice
Chicken breast Ginisang upo Scrambled eggs
Orange Bananas Avocados

6. Spiritual Care and Psychological or Sexual Needs (Give special consideration to religious and
cultural practices)
Spiritual and Psychological Needs
(✓ ) Spiritual Counseling
(✓) Grief Work
( ) Anger Management
( ) Confession
( ) Family Therapy
( ) Reconciliation of Conflicted Relationships
(✓ ) Supportive Counseling
( ) Join Church Organizations/Activities
(✓) Prayer
(✓ ) Meditation, Reflection, and Spiritual Devotion
(✓) Religious Rituals
(✓ ) Religious/Spiritual Materials

Sexual Needs
( ) Marriage Counseling
( ) Sex Therapy
( ) Sexual Violence
( ) Referral to Appropriate Agencies

 Encourage patient to have daily prayer and have relationship with God.
 Encouraged to continue to have a positive outlook in life.
 Encourage also to read Quran or any inspiring books.

C.DISCHARGE DETAILS
a. Date and Time of Discharge: ___________________________________________________
b. Accompanied by: _____________________________________________________________
c. Mode of Transportation: _______________________________________________________
d. General Condition upon Discharge: _____________________________________________