Admission and Discharge Instructions
- Patient's Name: ____________________________________
- Diagnosis: Your child's diagnosis is ____________________________
- Discharge Instructions:
- For pain or fever over 102°F (39°C) give
____________________________
____ mg of acetaminophen every 4 to 6 hours OR
____ mg of ibuprofen every 6 to 8 hours
- ______________________________________________________________
- ______________________________________________________________
- For pain or fever over 102°F (39°C) give
____________________________
- Additional Instructions:
- _______________________________________________________
- _______________________________________________________
- _______________________________________________________
- Follow-up Appointment after Discharge
___ Your child needs to be rechecked and has an appointment on _____________ at _______ with _________________________.
___ Your child needs to be rechecked in ________ days. Call your child's doctor to make an appointment.
___ A follow-up appointment is not necessary. Call your doctor if you have any concerns.
- Call your doctor if any of the following occur (phone
number: ___________)
- _______________________________________________________
- _______________________________________________________
- _______________________________________________________
- Caregiver's name __________________________ Date___________
Written by B.D. Schmitt, M.D., and Robert Brayden, M.D.
Published by McKesson Health Solutions LLC.
This content is reviewed periodically and is subject to
change as new health information becomes available. The
information is intended to inform and educate and is not a
replacement for medical evaluation, advice, diagnosis or
treatment by a healthcare professional.
Copyright © 2003 McKesson Health Solutions LLC. All rights reserved.
