Discharge And Home Healthcare Guidelines

Thyroid Factor

The Natural Thyroid Diet

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Teach the patient to avoid medications and foods that lead to endemic or sporadic goiter. Patients with endemic goiter should use iodized salt to supply at least 300 ^g of iodine daily to prevent goiter. Be sure that the patient understands all medications, including the dosage, route, action, adverse effects, and the need for any laboratory monitoring of thyroid medications. Encourage the patient to take thyroid hormone supplements at the same time each day to maintain constant thyroid levels in the blood.

Have the patient immediately report to the physician any signs and symptons of thyrotoxic crisis; these include rapid heart rate and palpitations, perspiration, shakiness and tremors, difficulty breathing, and nausea and vomiting. Teach the patient to report any increased neck swelling, difficulty in swallowing, or weight loss.

If the patient had surgery, teach him or her to change any dressings, to inspect the incision for redness, swelling, and discharge, and notify the physician about changes that indicate infection.

Gonorrhea

DRG Category: 350

Mean LOS: 4.5 days

Description: MEDICAL: Inflammation of the Male

Reproductive System DRG Category: 368 Mean LOS: 5.6 days Description: MEDICAL: Infections, Female Reproductive System

GGonorrhea is one of the most common sexually transmitted infections (STIs) in the United States. The risk of developing the infection from intercourse with an infected partner is between 50% and 90% for females and is 20% for males. The risk for males increases three- to fourfold after four exposures. Two types of infection develop: local and systemic (disseminated). Local infection involves the mucosal surfaces of the genitourinary tract, rectum, pharynx, or eyes. Systemic infections occur because of bacteremia and can lead to multisystem involvement with connective tissues, the heart, and the brain.

If left untreated, gonorrhea will involve the fallopian tubes, ovaries, and peritoneum, resulting in gonococcal pelvic inflammatory disease (PID) in women. Systemic complications of untreated, or undertreated, infections are disseminated gonococcal infections that lead to acute arthritis, tenosynovitis, dermatitis, polyarthritis, endocarditis, and meningitis. With adequate treatment, most people recover fully, but reinfection is common. If gonorrhea is contracted during pregnancy, preterm premature rupture of membranes, preterm birth, and increased risk for neonatal morbidity and mortality exist.

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