Discharge planning for Normal Spontaneous Delivery (NSD)

Medication

 Ibuprofen 600 mg for pain as needed

 Micronutrient Supplementation: Iron 60 mg and Folate 400µg once a day for 3 months
 Micronutrient Supplementation: Vitamin A 200,000 IU within 4 weeks after delivery
 Colace or MiraLAX for constipation
 Preparation H for hemorrhoids
 For breast cracks: Lanolin ointment, Apply to nipple after breastfeeding.

Exercise

 Instruct clients to incorporate tasks with ample periods of rest.

 Inform the client that she can slowly increase her activity little by starting ambulating or
walking.
 Instruct the client about proper body mechanics to avoid muscle injury
 Encourage the client to do Diaphragmatic Breathing Exercise for healing and
strengthening the core as well as the pelvic floor.

Treatment

 Tell the client the importance of treatment to be done.

 Encourage the client to continue complying with diagnostic examination to ensure that
they do not have any complications.
 Monitor blood pressure at home
 Instruct the client on how to perform breast self-examination.
 Encourage the client to follow the Physician’ s advice.

Health Teaching
Uterus

 By the 9th or 10th day after delivery, the uterus will no longer palpable.
 If fundus is in lateral position, instruct the client to void every 2-3 hours.
 If uterus is boggy or soft, instruct the client to massage the fundus in a circular motion.
Lochia

 Educate the client regarding the duration of lochia and its characteristics

Lochia Rubra Bright red in color that last for 1-3 days
Lochia Serosa Pinkish brown in color that last for 4-10 days
Lochia Alba Yellow white in color for 10 days to 6 weeks after delivery
  Report any abnormal characteristics of lochia such as spurting of blood in vagina that is
not expected, saturated perineal pad in under 1 hour, lochia is malodorous or foul
smelling, and large blood clot to the primary provider.
Perineum

 Instruct the client to take stool softener if constipation occurs.

 Educate about perineal care’
 Advise to put ice packs (non-pharmacological pain reliever) for pain and swelling.
Breast

 Wash the breast daily during bathing time.

 Instruct the client not to wash the breast with soap because it may eliminate sebaceous
secretion in the breast.
 Wash or clean hands when feeding the infant.
 Advise the client to put clean cloth in the bra to absorb the moisture or breast discharge.
Bladder

 Explain to the client that frequent urination may occur due to excess fluid accumulated in
the body during pregnancy.
 Encourage the client to urinate for every 4 to 6 hours.
Sexual Activity

 Avoid sexual activity until incision from episiotomy are fully healed and lochia subside.

Out-Patient Follow up

 Call the primary care provider if any of these persist:

o Fever
o Dizziness and Fainting
o Nausea and Vomiting
o Shortness of breath or chest pain
o Bleeding
o Headache with blurred vision
o Calf pain, redness or swelling
o Swollen, red or tender breast nipples
o Problems in urination or leaking
o Increase pain in the perineum
o Developing foul smelling discharge in the perineum
o Redness, swelling, pain, or pus in the incision site
o Severe depression or suicidal behavior

Diet
 Advise the client to eat a higher quantity and choice of nutritious foods, such as, meat
(lean beef, fish (salmon, tuna, hito), nuts (pistachio, almond, peanuts), whole wheat oats,
beans (garbanzos, black peas, kidney beans soy beans), vegetables (spinach,
malunggay, broccoli) fruits (orange, banana, mango), and milk (low fat fresh milk,
almond milk, soya milk) to make her feel strong and well.
 Encourage the client to drink 8 glasses of water a day. Whenever the client sit down to
feed the infant, drink a full glass of water.