Discharge And Home Healthcare Guidelines

Advise the patient that recurrence is greater than 50% with noncompliance. Reinforce the need to avoid the following: aspirin products and NSAIDs, alcohol intake, caffeine products, and smoking. Review signs and symptoms that should be reported—those that may indicate recurrence or complications, including pain, nausea, vomiting, black tarry stools, fatigue, and frank bleeding. Stress the importance of eating three meals at approximately the same time each day.

Postoperatively, tell the patient what to expect if infection occurs so she or he can tell the healthcare provider when the first signs occurred. The symptoms include pain, redness, swelling, and drainage at the incisional site. After a Billroth II surgical procedure, the patient may develop symptoms of the dumping syndrome. Explain the reason and timing of the symptoms that may occur, noting that the episodes will subside in 6 to 12 months. Teach the patient how to control the problems with the following suggestions: (1) Take fluids only between meals, none with meals; (2) Eat smaller amounts more frequently in a semirecumbent position; (3) Eat a low-carbohydrate diet, concentrating on high-protein and moderate-fat foods; and (4) Avoid refined sugars (sweets); (5) Lie down after meals for 30 minutes; (6) Take anticholinergic drugs 30 minutes before meals as prescribed; and (7) Reinforce the need to stop smoking to promote healing and prevent recurrence.

Pericarditis DRG Category: 144

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