Discharge And Home Healthcare Guidelines

Teach the patient the mechanics of disk function and how herniation occurs. Instruct the patient in proper body mechanics, and advise avoiding high-torsion activities, such as twisting and heavy lifting. Discuss an exercise program with the patient as a maintenance program, following the 6-week physical therapy regimen. Be sure the patient understands any medication prescribed, including dosage, route, action, and side effects. Advise the patient against driving or operating heavy machinery if the medications are likely to impair judgment.

Herpes Simplex DRG CategĀ°>r 283

Mean LOS: 4.8 days Virus Description: MEDICAL: Minor Skin Disorders with CC

There are two types of herpes simplex virus (HSV), type 1 and type 2. HSV-1 causes infection above the waist, such as "cold sores" that occur on the mouth. This type may occur in the genital area as a result of oral-genital sexual practices. After the initial infection, the virus is dormant, but the patient is a carrier and likely to have recurrent infections. Events that trigger recurrences are sun exposure, fever, menses, stress, or lack of sleep.

HSV-2 causes lesions in the genital area. In the primary episode, multiple, blister-like, painful vesicles erupt on the vulva, perineum, cervix, or perianal area within 3 to 5 days after the initial exposure. The virus then becomes dormant and resides in the nerve ganglia of the affected area. Repeated outbreaks can happen at any time, but most patients have less severe regular recurrences that are more likely to occur during menses, pregnancy, or times of illness and stress. The more severe the primary outbreak, the more frequent the recurring infections. In the United States, 22% of the adult population has HSV-2, and 1.7 million new cases are diagnosed each year.

Active HSV is associated with spontaneous abortion in the first trimester of pregnancy and an increased risk of preterm labor after 20 weeks' gestation. If a patient has active herpes around the time of the estimated date of delivery, cesarean section is the preferred method of delivery. Infected infants can develop the following signs and symptoms after an incubation period of 2 to 12 days: fever, hypothermia, jaundice, seizures, poor feeding, and vesicular skin lesions.

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