Discharge And Home Healthcare Guidelines

Be sure the patient understands any pain medication prescribed, including dosage, route, action, and side effects. Be sure the patient understands the need for adequate bladder and bowel elimination. Instruct the patient to notify the primary caregiver of any exacerbation or sudden worsening of the condition. If the patient has difficulty speaking or communicating, be sure that she or he has access to a telephone support network or some other means of calling for assistance when she or he is at home alone for any length of time. Be sure the patient understands that stress, fatigue, and being overheated stimulate exacerbations. Teach the patient how to avoid situations that produce these reactions. Be sure the patient knows how to contact community agencies such as the MS Society for use of such in-home equipment as beds and wheelchairs and home maintenance support. Determine whether a home care agency is needed to provide home supervision and ongoing physical therapy support.

DRG Category: 034 Mean LOS: 5.3 days Description: MEDICAL: Other Disorders of Nervous System with CC

M uscular dystrophy is not a disease but a term applied to a number of genetic disorders that are characterized by gradual progressive weakness and muscle fiber degeneration without neural

Muscular Dystrophy involvement. The most significant finding in muscular dystrophy is skeletal muscle deterioration. Cardiac and other smooth muscles may be involved as well, leading to serious complications and premature death. To date, there is no cure for any of the muscular dystrophies, but there have been significant research advances related to gene identification for Duchenne's muscular dystrophy (a pseudohypertrophic, progressive form that begins in childhood and is transmitted as a sex-linked recessive trait). The genetic abnormality causes an absence of dystrophia, a protein of muscle cells. This deficit prevents adequate cell functioning, which leads to necrosis of muscle fibers. As the muscle undergoes necrosis, fat and connective tissue replace the muscle fibers. Complications include disabilities, contractures, skeletal deformities, and thoracic muscle weakness. The patient is prone to pulmonary complications such as pneumonia and cardiac dysrhyth-mias and hypertrophy.

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