Discharge And Home Healthcare Guidelines

To prevent bleeding episodes, the patient should avoid both physical activity that may lead to injury and medications that have anticoagulant properties. Instruct the patient or caregiver when to notify the physician and how to monitor for bleeding in the stool, urine, and sputum. Remind the patient or caregiver to notify any medical personnel of bleeding tendencies. If the patient is a school-age child, encourage the parents to notify the school of the diagnosis, treatment, and complications.

Explain all discharge medications, including dosage, route, action, adverse effects, and need for routine laboratory monitoring. If the patient is being discharged on a tapering corticosteroid dosage, be sure the patient or caregiver understands the schedule. If the patient had a central line placed for IV therapy, be sure the patient or caregiver has been properly trained in care, dressing changes, and sterile techniques. Teach the patient that antacids and oral drugs taken with meals can reduce gastric irritation. Weight gain, anxiety, and mood alterations are frequent side effects of steroid therapy. Parents and families need to be encouraged to lift activity restrictions when the child's platelet count returns to a safe range.

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