Velez College College of Nursing: Bascon, Karl Niño D. Calunsag, Hazel Kate C. Lague, Inah Krizia O

VELEZ COLLEGE
COLLEGE OF NURSING
J.M, 79 years old, male, diagnosed with Stage 4 Lung Carcinoma and COPD
DISCHARGE PLAN
SUBMITTED BY:
Bascon, Karl Niño D.
Calunsag, Hazel Kate C.
Lague, Inah Krizia O.
GROUP 4
BSN 3D
SUBMITTED TO:
Kho, Ricardo L, Jr.
Clinical Instructor
DISCHARGE PLAN FOR STAGE 4 LUNG CARCINOMA
MEDICATIONS
 Provided the patient, and S.O with an accurate list of medications.

 Educated the patient and S.O prior to discharge, including
o proper storage and use of medications
o what to do if a dose is missed
o potential side effects
o when to call about any concerns
o refill information.
 Provided a written copy of all information that is given verbally.
 Ensured that the patient is able to follow medication instructions.
 Explained the medication, its purpose, importance and expected side effects such as mouth
sores, hair loss, loss of appetite or weight changes, nausea and vomiting, and diarrhea and
constipation.
 Explained that chemotherapeutic medication can cause immunosuppression and patient must
take measures to avoid infection.
 Educated patient on the importance of following prescribed medication regimen.
 Instructed patient to read the medication name and check the correct dosage before taking.
 Instructed patient to take medication at right time and right frequency.
 Instructed the patient not to take medications not prescribed by the physician.
ENVIRONMENT
 Explained the importance of promoting safety in the environment such as:

o Keeping the environment free from clutter
o Wearing slippers inside the house
o Keeping the room bright
o Keeping sharp objects
 Explained the importance of cleaning the house frequently to minimize dust accumulation.
 Advised that patient must avoid crowds.
 Instructed patient to minimize visitors at home.
 Explained to patient the importance of wearing masks when going out.
 Emphasized the importance of washing hands at all times to prevent infection.
TREATMENT
 Instructed patient to take their medicines exactly as prescribed.

 Instructed patient to eat healthy food. If he does not feel like eating, he can eat small portion of
food frequently or every 2-3 hours that has protein and extra calories.
 Instructed patient to follow activity restrictions, such as not driving or operating machinery, as
recommended by your healthcare provider or pharmacist, especially if you are taking pain
medicines.
 Instructed patient to make sure to go to all follow-up appointments, and to call doctor or
healthcare provider when experiencing problems.
HEALTH TEACHING
 Instructed patient to eat several small meals a day when experiencing nausea. Eating clear soups
and mild foods are helpful until all symptoms are gone for 12 to 48 hours.
 Advised patient to drink plenty of water or electrolyte water to prevent dehydration when
patient is vomiting.
 Instructed patient to refrain from smoking/ using any fire when using oxygen at home.
 Instructed patient to use soft-bristled brush and use mouthwash given as directed to prevent
mouth sores.
 Recommended physical activity which can help reduce fatigue, improve mood and maintain a
healthy weight.
 Informed patient about lung cancer support groups and suggested talking to a counselor or
other cancer patients.
 Recommended and informed about palliative care specialist and facility which focuses on the
management of side effects.
 Instructed patient to take steps to manage stress and suggested different relaxation techniques
such as meditation, deep breathing, or doing hobbies.
OBSERVABLE SIGNS & SYMPTOMS
 Instructed S.O and patient to call an emergency hotline when:

o arm or leg feels warm, tender, and painful. It may look swollen and red.
o chest pain when taking a deep breath or cough.
o suddenly feeling lightheaded or are short of breath.
o coughing up blood
 Instructed S.O and patient to contact healthcare provider or oncologist if experiencing:
o fever
o blood in your mucus or spit
o vomiting and cannot keep food or liquids down
 Instruct S.O and patient to seek immediate care when:
o lips or nails look blue or pale.
DIET
 Advised patient to maintain a healthy weight. He can eat enough calories to avoid weight loss.
 Explained the importance of having essential nutrients the body needs, such as carbohydrates,
vitamins, minerals and water.
 Instructed patient to avoid foods that make lung cancer treatment side effects worse. Certain
foods worsen diarrhea, constipation and mouth sores.
 Encouraged clear liquids and bland, mild and cold foods. Dry, crunchy foods such as crackers and
pretzels can also help to prevent weight loss.
 Encouraged eating small meals throughout the day.
 Advise to add healthy fats to diet like avocado, nut butters and olive oil.
SPIRITUAL
 Advise patient to verbalize feelings to S.O.

 Encourage to have time and privacy to engage in spiritual growth.
 Advise to refer to priest/ counselor for support and to help foster sense of connectedness.
DISCHARGE PLAN FOR COPD

MEDICATION
 Provided the patient, and S.O with an accurate list of medications.

 Educated the patient and S.O prior to discharge, including
o proper storage and use of medications – demonstrate where possible
o what to do if a dose is missed
o potential side effects
o when to call about any concerns
o refill information.
 Provided a written copy of all information that is given verbally.
 Ensured that the patient is able to follow medication instructions.
 Explained the medication, its purpose, importance and expected side effects:
o Bronchodilators: are the mainstay treatment for COPD. It keeps airways open and may
decrease the amount of mucus in the lungs. Possible side effects include tremors,
nervousness, heart palpitations, headaches, muscle cramps, nausea, dry mouth, oral
thrush and sore throat
o Corticosteroids: are anti-inflammatory agents that reduces inflammation in the lungs.
Side effects include puffiness of the face, weight gain, and swelling of the hands, feet
and ankles.
o Antibiotics: usually prescribed when acute flare-up of symptoms occur due to an
infection. Side effects include gastrointestinal distress, dizziness, nausea and vomiting.
o Anti-anxiety medication is given to people, usually with severe COPD who have become
anxious about the inability to breathe easily. Side effects include excessive sleepiness.
 Educated patient on the importance of following prescribed medication regimen.
 Instructed patient to assess contraindications before taking medication.
 Instructed patient to read the medication name first before taking.
 Instructed patient to take medication at right time and right frequency.
 Instructed the patient not to take medications not prescribed by the physician.
 Instructed patient not to stop taking their medication or change the dose without talking to
healthcare provider first.
ENVIRONMENT
 Instructed patient to avoid environmental exposure such as cigarette and tobacco smoking, and
occupational exposure to dust, vapor, gas, fumes which could exacerbate COPD symptoms.
 Emphasized the importance of cleaning surroundings frequently to avoid dust accumulation.
 Instructed patient to avoid sick people especially those have colds or flu.
 Emphasized the importance of washing hands frequently to avoid infections.
TREATMENT
 Instructed patient to take COPD medications as directed and prescribed.

 Emphasized the importance of exercising regularly.
 Instructed patient to healthy foods and to maintain proper weight.
 Instructed patient to have proper rest.
 Encouraged to drink plenty of non-caffeinated and non-alcoholic fluids to keep mucus in the
lungs from getting thick.
 Emphasized to follow healthcare provider's instructions for follow-up appointments. Keep
appointments for all routine testing needed.
HEALTH TEACHINGS
 Instructed patient to avoid exposure to secondhand smoke.

 Demonstrated to patient breathing techniques, such as pursed-lip breathing, that will help ease
breathing.
 Instructed patient to refrain from smoking/ using any fire when using oxygen at home.
 Demonstrated how to use inhaler and nebulizers.
 Demonstrated patient techniques how to bring up mucus
When mucus collects in the airways, it can make breathing difficult and can lead to infection.
Use the techniques after using your bronchodilator medicine.
o Deep coughing: take a deep breath and hold it for 3 seconds. Use your stomach muscles
to expel the air. Avoid a hacking cough or just clearing your throat.
o Huff coughing: take a breath that is slightly deeper than normal. Use the stomach
muscles to make a "ha, ha, ha" sound while exhaling. Follow this by diaphragmatic
breathing and a deep cough if you feel mucus moving.
 Instructed patient about breathing tips for people with COPD get fresh air, try to avoid other
things that can bother your lungs, too. Stay inside on days when you know pollution or pollen is
bad.
 Instructed patient to avoid heavy lifting, avoid breathing in quickly and deeply through mouth
after coughing, and avoid outdoors when it is too cold, hot, or humid which could complicate
COPD symptoms. High humidity might cause patient to become fatigued more quickly.
OBSERVABLE SIGNS & SYMPTOMS
 Instruct patient to call healthcare provider right away if experiencing any of the following:
o Shortness of breath, wheezing, or coughing

o More mucus
o Yellow, green, bloody, or smelly mucus
o Fever or chills
o Tightness in your chest that does not go away with rest or medicine
o An irregular heartbeat or a feeling that your heart is beating very fast
o Swollen ankles
DIET
 Instructed patient to limit simple carbohydrates, including table sugar, candy, cake and regular
soft drinks.
 Encouraged patient to eat 20 to 30 grams of fiber each day and to have a moderate amount of
protein source foods such as milk, eggs, cheese, meat, fish, poultry, nuts and dried beans or
peas at least twice a day to help maintain strong respiratory muscles.
 Advised patient to choose protein with a higher fat content, such as whole milk, whole milk
cheese and yogurt.
 Advised patient to choose mono- and poly-unsaturated fats, which do not contain cholesterol.
 Advised patient to limit foods that contain trans fats and saturated fat such as butter, lard, fat
and skin from meat, fried foods, pastries.
 Instructed to avoid foods that cause gas or bloating. They tend to make breathing more difficult.
 Encouraged to eat 4 to 6 small meals a day for the diaphragm to move freely and lets your lungs
fill with air and empty out more easily.
SPIRITUAL
 Advise patient to verbalize feelings to S.O.

 Encourage to have time and privacy to engage in spiritual growth.
 Advise to refer to priest/ counselor for support and to help foster sense of connectedness.
Sources:
HealthWise. (n.d.) Lung Cancer Care Instructions. Retrieved from

https://myhealth.alberta.ca/Health/aftercareinformation
American Lung Association. (2020, March 22). Nutrition and Lung Cancer Side-Effects. Retrieved from
https://www.lung.org/lung-health-diseases/lung-disease-lookup/lung-cancer/patients/treatment/stay-
healthy/side-effects
Pope, B.B MSN, RN. (n.d.). Lippincott Nursing Center. Patient Education: Chronic Obstructive Disease.
Retrieved from https://www.nursingcenter.com/journalarticle
(n.d). Managing COPD. Retrieved from https://www.nationaljewish.org/conditions/health-
information/living-with-copd/managing-
RelayHealth. (n.d.) Chronic Obstructive Pulmonary Disease (Copd) Discharge Information. Retrieved
from copd https://link.springer.com/article.

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Velez College College of Nursing: Bascon, Karl Niño D. Calunsag, Hazel Kate C. Lague, Inah Krizia O

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Bascon, Karl Niño D.

Calunsag, Hazel Kate C.

Lague, Inah Krizia O.

Kho, Ricardo L, Jr.

 Provided the patient, and S.O with an accurate list of medications.

 Explained the importance of promoting safety in the environment such as:

 Instructed patient to take their medicines exactly as prescribed.

OBSERVABLE SIGNS & SYMPTOMS

 Instructed S.O and patient to call an emergency hotline when:

 Advise patient to verbalize feelings to S.O.

DISCHARGE PLAN FOR COPD

 Provided the patient, and S.O with an accurate list of medications.

 Instructed patient to take COPD medications as directed and prescribed.

 Instructed patient to avoid exposure to secondhand smoke.

o Shortness of breath, wheezing, or coughing

 Advise patient to verbalize feelings to S.O.

HealthWise. (n.d.) Lung Cancer Care Instructions. Retrieved from

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