Date Medical Management Rationale

November 28,2010
03:47pm  Monitor V/S  To have a base line data
 NPO  In preparation for the surgery
 D5 LR 1L x 8 ̊  A hypertonic solution which
aids in lost body fluids
 Cefuroxime 750mg IV q 8 ̊  Preoperative antibiotic have
the efficacy in decreasing
postoperative wound infection
 Paracetamol 300mg iv q 4 ̊ 
for temp. > 38 ̊c
 For appendectomy at  Surgical removal of the
10:00pm appendix. Performed as soon
as possible to decrease the
risk of perforation.
11:30pm  NPO 
 O2 inhalation 2-3Lper ml 
 To follow: 
-D5LR 1L@ 30gtts/min.  A hypertonic solution which
aids in lost body fluids
-D5NSS 1L x 8 ̊ 
 Meds:
-ketorolac 30ml IV q8 ̊  It has an anti inflammatory
and analgesic activity inhibits
prostaglandin and leukotriene
synthesis
-metronidazole 500mg IV q8 ̊  Treatment of prophylaxis
against aneorobic infection
-continue cefuroxime 750mg
IV q8 ̊  An antibiotic to reduce the risk
for infection

November 29,2010
9:50am  Continue IV antibiotic 
 Ambulate  Promotes normalization of
organ function, e.g.,
stimulates peristalsis and
passing of flatus, reducing
abdominal discomfort.
8:00pm  IVF to follow:
-D5LR 1L x 8 ̊  A hypertonic solution which
aids in lost body fluids
-D5NSS 1L x 8 ̊

November 30,2010
8:00am  IVF to follow:
-D5LR 1L x 8 ̊  A hypertonic solution which
aids in lost body fluids
-D5NSS 1L x 8 ̊

6:00pm  IVF to follow:
-D5LR 1L x 8 ̊
 A hypertonic solution which
-D5NSS 1L x 8 ̊ aids in lost body fluids

December 01,2010
10:45am  Soft diet 
 Continue IV 
 Change dressing 
 Ambulate  Promotes normalization of
organ function, e.g.,
stimulates peristalsis and
passing of flatus, reducing
9:30pm  IVF to follow: abdominal discomfort.
-D5LR 1L x 8 ̊  A hypertonic solution which
aids in lost body fluids
-D5NSS 1L x 8 ̊ 
 D/C Cefuroxime 
 Cefriaxone 1g q12 ̊  An antibiotic which inhibits
synthesis of bacterial cell wall,
causing cell death
December 02,2010
10:50am  IVF to follow:
-D5LR 1L x 8 ̊  A hypertonic solution which
aids in lost body fluids
-D5NSS 1L x 8 ̊ 

December 03,2010
10:30am  IVF to follow:
-D5LR 1L x 8 ̊  A hypertonic solution which
aids in lost body fluids
-D5NSS 1L x 8 ̊ 
 May have regular diet. 
11:00am
 Ambulate  Promotes normalization of
3:00pm
organ function, e.g.,
stimulates peristalsis and
passing of flatus, reducing
abdominal discomfort.
 Change dressing 

 Continue meds. 
10:25pm
 Increase fluid intake 