Plan: -Counseling/discussion at bedside with [select value="patient|partner|family member|support person"] re: treatment options, including non-pharmacological and pharmacological approaches, treatment recommendations, and intended outcomes of treatment. -Discussion included [checkbox value="recommendations for psychotherapy to address XXXXX|recommendations for trial of XXXXX for XXXX disorder|analysis of risks versus benefits to patient| and infant while breast-feeding|of treatment of psychiatric disorder with medication|consideration of psychological and physiological benefits of breast-feeding|possibility of foregoing or stopping treatment with medication while breastfeeding|consideration of potential adverse effects of untreated maternal mental illness to maternal-child bonding|higher risk of decompensation without pharmacological management| potential risks to cognitive and behavioral development of infant with exposure through breast milk| and acknowledgement of the uncertainty of possible risks and harms to infant due to lack of available evidence"]. [checkbox value="Strategies undertaken to minimize exposure and risks to infant including:"][checkbox value= "medication selection, lowest effective dose, and timing of dose|need for close outpatient follow-up for management of psychiatric medication|need for coordination with pediatrician and close monitoring of breastfeeding infant for potential side effects, including sedation and EPS"]. -[checklist value="Patient|partner|family member|support person"] demonstrated understanding and agreed to plan for [checkbox value="trial of medication|psychotherapy|follow-up and management with outpatient mental health|referral to outpatient mental health for further evaluation and formulation of treatment plan"] as outlined above.
There are 6 form elements.