Discharge Plan

West Visayas State University

COLLEGE OF NURSING
La Paz,
Iloilo City

DISCHARGE PLAN

M=Medications
Take antinausea medicine as directed
Rationale: This medicine may be given to calm your stomach and prevent
vomiting.
Reference: Breast Cancer in Women (Discharge Care) - What You Need to
Know. (n.d.). Drugs.com. Retrieved November 27, 2020, from
https://www.drugs.com/cg/breast-cancer-in-women-discharge-care.html
‌Take prescription pain medicine as directed.
Rationale: Post-surgical pain control helps speed your recovery and reduces

chances of complications, such as pneumonia and blood clots. Medications like
ibuprofen also help reduce inflammation and swelling.
Reference: Post-Op Pain: Management & Recovery After an Operation - Made
for This Moment. (n.d.). Made For This Moment | Anesthesia, Pain
Management & Surgery. Retrieved November 27, 2020, from
https://www.asahq.org/madeforthismoment/pain-management/types-of-
pain/post-op/
E= Exercises
Advised to do exercises (Wand exercise, elbow winging, shoulder blade stretch)
gradually that are approved by the physician and introduced the general
guidelines from the American Cancer Society for the exercises.
General guidelines for these exercises
 Patient might feel some tightness in the chest and armpit after surgery.
This is normal, and the tightness should decrease as the patient does her
exercises. If it doesn't, call your doctor.
 Many women have burning, tingling, numbness, or soreness on the back
of the arm and/or on the chest wall. This is because the surgery can
irritate some of the nerves. These feelings might increase a few weeks
after surgery. It may be helpful to exercise after a warm shower when
muscles are warm and relaxed.
 Wear comfortable, loose clothing when doing the exercises.
 Do the exercises slowly until feeling a gentle stretch. Hold each stretch at
the end of the motion and slowly count to 5. It’s normal to feel some
pulling when stretching the skin that has been shortened because of the
surgery. Do not bounce or make any jerky movements when doing any of
the exercises. The patient should not feel pain, only gentle stretching.
 Do each exercise 5 to 7 times. Try to do each exercise correctly.
 Do the exercises twice a day until the patient get back to her normal
flexibility. Continuing to do some exercises during the months after
surgery can help her keep good mobility.
 Be sure to take deep breaths, in and out, while doing each exercise.
 The exercises are set up so that you start them lying down, move to
sitting, and finish them standing up.
Rationale: Exercises help improve aerobic (heart-lung) capacity especially for

women who have had breast cancer. There’s evidence that fitness and weight
loss may even help lower the risk that some types of cancer will come back after
treatment. (American Cancer Society)
T= Treatment
Advised to take temperature each day for 7 days after the surgery.

Rationale: Monitoring and maintaining body temperature during the
perioperative period has a significant impact on the risk of myocardial
ischemia, cardiac morbidity, wound infection, surgical bleeding, and patient
discomfort. (Frank, et al., 1999)
Advised to take adequate rest.

Rationale: When the patient gets home from the hospital, she will probably be
fatigued from the experience. She must allow herself to get extra rest in the first
few weeks after surgery.
Reference: What to Expect During and After Mastectomy Surgery. (2019,
February 27). Breastcancer.org.
https://www.breastcancer.org/treatment/surgery/mastectomy/expectations
#:~:text=At-home%20recovery%20from%20mastectomy.%201%20Rest.
%20When%20you
H=Health Teachings
Advised to check incisions daily for signs of infection. These include redness,
swelling, and drainage. They also include the edges of an incision opening up.
Rationale: All surgery has risk, but in fact, most women do not develop post-
mastectomy infections. Skin is the body’s natural barrier to infection; anytime it’s
opened, infection has an opportunity to sneak in.
Reference: Infection After Mastectomy: Why Does It Happen? (n.d.). BREAST
RECONSTRUCTION: YOUR RIGHT. YOUR CHOICE. Retrieved
November 27, 2020, from http://www.breastrecon.com/blog/infection-after-
mastectomy-why-does-it-happen
Advised to keep incisions clean and dry.
Rationale: Keeping the incision area dry, which may mean delaying your shower
for 24 to 72 hours after your surgery, is thought to help prevent infection and
promote healing.
Instructed to follow her instructions about bathing or showering.
Rationale: Showering and keeping the areas clean is the best thing for the
patient. After the surgery, she will typically be in the hospital for two to three
days. But before the patient leaves, the nurse will assist her in taking
a shower and show some ways on how to do it at home.
Reference: Showering After Breast Reconstruction Surgery. (2020, July 14).

PRMA. https://prma-enhance.com/breast-reconstruction-blog/showering-
after-breast-reconstruction-surgery/
O= Out patient follow-up

Advised the patient to make a follow-up appointment and comply with the
schedule ordered by the physician.
Rationale: The patient usually has a follow up appointments every few
months to check and see whether the patient has any problems or worries. The
appointments also gives her the chance to raise any concerns she has about her
progress.
Reference: Follow up appointments | Breast cancer | Cancer Research UK.
(n.d.). Www.Cancerresearchuk.org. Retrieved November 27, 2020, from
https://www.cancerresearchuk.org/about-cancer/breast-
cancer/treatment/follow-up
D=Diet
Encouraged to eat normal meals as soon as she feels able and stick to a healthy,
well-balanced diet. Add protein powder or dry milk to meals. Add grated cheese
to vegetables, potatoes, rice, and salads. Eat high-protein snacks such
as almonds, peanuts, and cheese.
Rationale: Without an adequate amount of protein in our diet, our body has
trouble forming collagen which is a main component for healing. For this reason,
a high protein diet is essential for a quick and healthy recovery after surgery. The
best way to get enough protein is to eat a nutritious diet.
Reference: The Importance of a High Protein Diet After Breast Reconstruction
Surgery. (2020, July 17). PRMA. https://prma-enhance.com/breast-
reconstruction-blog/the-importance-of-a-high-protein-diet-after-breast-
reconstruction-surgery/
S= Spirituality
Encouraged the patient to continue to her normal spiritual routine such as
praying and meditation.
Rationale: Asking breast cancer survivors about the role of spirituality in their
lives might be a useful marker to predict their ability to cope with stress and their
quality of life. Spirituality and prayers have been known to be important for both
physical and emotional well-being .

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West Visayas State University

‌Take prescription pain medicine as directed.

Rationale: Post-surgical pain control helps speed your recovery and reduces

Rationale: Exercises help improve aerobic (heart-lung) capacity especially for

Advised to take temperature each day for 7 days after the surgery.

Advised to take adequate rest.

Advised to keep incisions clean and dry.

Reference: Showering After Breast Reconstruction Surgery. (2020, July 14).

O= Out patient follow-up

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