ID: BM is an 8 day old male born to a mom with high-risk behaviour (=amphetamine use, ethanol use, no prenatal care, cigarette smoker) requiring HIV prophylaxis
On discharge BM was picked up by the Ministry of Child and Family Development (MCFD) social worker to be placed with a foster family. Thus at discharge it was pertinent for me to explain the medications thoroughly and be sure that the social worker was able to replicate the instructions to BM’s foster family.
BM was to be discharged on:
- Lamivudine 6 mg PO Q12H x 6 days (total of 2 weeks)
- Zidovudine 10mg PO Q12H x 32 days (total of 6 weeks) (=4mg/kg/dose).
The social worker representing MCFD was counselled on the administration (=using oral syringes as well as cleaning instructions), indication and side effects of both medication. She was also counselled on the dates of finishing each therapy, and the days where the baby has to go for blood work (HIV PCR, as well as CBC, lytes, LFTs).
This was one of my first counselling on discharge during residency, which presented a challenge but was a great learning experience. This was also the first time I ever counselled someone who likely was not going to be involved in the care of the baby. Thus during the counselling the social worker wrote down all of the information I gave her (as well as took the information sheets provided). This served as a strong reminder to be cognizant of ensuring that there was no miscommunication and that I explained everything succinctly but thoroughly.
The Oak Tree Clinic website was HUGELY helpful for this counselling. See links for their resources for lamivudine and zidovudine that were provided to MCFD as well.