DISCHARGE PLAN

MEDICATION
 Instruct and encourage the patient to continue medication as prescribed by the
doctors.

EXERCISE
Instruct the patient to:
 Instruct the patient to do early ambulatory and to have moderate exercise for fast
wound healing process.
 Moderate activities that might badly affect her condition.

TREATMENT
 Instruct the patient to rely always to the physician if any complications will occur.

HYGIENE
Instruct the patient to:
 To do perineal wash and maintain good personal hygiene
 Wash the breast with water daily for cleanliness; soap or alcohol should never be used
on the breast as they tend to dry and crack the nipples and cause sore nipples.
 Wash hands before and after every feeding and air-dry nipple after each feeding.
 If nipples are sore, apply a few drops of breast milk after a feeding and let air dry.
 If breast is engorged, apply warm packs and express milk.
 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.
 Patient must take a bath every day and have a good oral hygiene

OUT-PATIENT SCHEDULE
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Instruct the patient to:
 Have a check-up or to consult physician once a month to monitor patient's condition.
 List of medicines when leave the hospital.
 Know the medicines. Know what they look like, how much you should take each time,
how often you are to take them, and why you take each one.
 Take medicines exactly as your provider tells you to.
 Talk to your husband before you use any other medicines, including non-prescription
medicines.
 Try to get at least 7 to 9 hours of sleep each night.

DIET
Instruct the patient to:
 Eat healthy foods include fruits, vegetables, whole-grain breads, low-fat dairy products,
beans, lean meats, and fish. It may be easier for you to eat several small meals a day
rather than a few large meals.
 Small frequent feeds in encouraged.
 Continue taking prenatal iron and vitamin pills until the postpartum visit.
 It is important to eat well – balanced diet and drink plenty of fluids. Drink two quarts of
fluid per day if you are breastfeeding.

Uterine Changes
Instruct the patient that 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
Instruct the patient that 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: The period will resume in approximately six to eight weeks, unless
breastfeeding.

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

Emotional Changes
Inform the patient that she may get “baby blues” after delivery. She 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.

Activity
Instruct the patient to:
 Rest! Do not do heavy housework or heavy exercise for two weeks.
 Avoid driving for one to two weeks.
 Avoid sexual activity, douching or tampons until her postpartum visit.

Birth Control
Inform the patient that it is advisable as soon as they resume sexual intercourse. Foam
and condoms are safe and easy to use. Birth control methods will be discussed further
at her postpartum visit.

Postpartum Visit
Instruct the patient to:
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 Call obstetrician two to three days after discharge to make an appointment for six
weeks.
 When to call doctor/midwife:
 Fever greater than 101, 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.

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