Discharge And Home Healthcare Guidelines

Encourage the patient to follow a recommended moderate exercise program. Suggest the use of a firm mattress or bed board to minimize spinal deformities. Emphasize the importance of attending physical therapy sessions and routine follow-up visits with the physician. Stress the importance of assessing the home environment for safety. Teach the patient to maintain adequate lighting, remove scatter rugs, and keep the home uncluttered. Instruct the patient to avoid abrupt movements and to report any increases in bone pain. Teach the patient to use assistive devices for ambulation.

Be sure the patient understands the dosage, route, action, and side effects of all prescribed medications. Instruct the patient in proper self-injection techniques for calcitonin. Educate the patient about side effects, such as nausea, vomiting, itchy hands, fever, inflammation of the injection site, and facial flushing, as well as the signs and symptoms of hypercalcemia. Teach the patient to take ethane hydroxydiphosphate (EHDP) medication with fruit juice on an empty stomach at least 2 hours before meals. Tell the patient to call the physician if he or she experiences stomach cramps, diarrhea, or new bone pain. Educate the patient who is taking plicamycin about the signs and symptoms of infection. Tell the patient to report any easy bruising, bleeding, nausea, or anorexia. Provide information about the Paget's Disease Foundation (165 Cadman Plaza East, Brooklyn, NY 11201).

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