Doctor’s Order

Preoperative & Postoperative

 PREOPERATIVE
• Please admit to OB Ward under the service of Dr. Dela Peña/PACU Dr. Pardo
• Secure consent for admission
• NPO
• Monitor VS q1
• 2nd IVF of D5LR 1L x 8hrs
• Labs: CBC, HbsAg, blood typing, urinalysis
• Meds: Clindamycin 900g IVq8 ANST, Gentamycin 240g IVOD ANST
• For pelvic lap
• Secure consent to procedure
• Secure 2 units PRBC properly typed and cross matched for possible BT
• Refer to OR/AROD
• Abdominal prep
• Insert foley catheter
 Postoperative
• To PACU, moderate high back rest, O2 via nasal cannula @ 3L/pm
• Monitor VS q 15mins. Until stable
• NPO
• IVF
• Right- PNSS 1L x KVO while on BT
• Left-Regulate 3rd Gelofusine 500mL x 8 hrs
• TF: D5LR 1L x 8hrs
• TF:PNSS1L x 8hrs
• Meds:
1. Cont. Antibiotics
2. Tranexamic Acid 500mg IVq8
3. Vit. K amp. TID x 2 days
4. Dexamethasone 1 amp IV BID x 2 days
5. Omeprazole 40mg IV OD stat @ 12nn
6. Ketorolac 30mg IV q4 RTC ANST x 6 doses then q6 x 2days
7. Tramadol chip 300mg , Tramadol in 500mL PNSS x 24 hrs x 2 cycles, start in PACU
8. Furosemide 20mg IV q6 x 3 doses, 2nd dose at 9am as long as BP > 90/40
• Transfuse 2nd unit of blood, fast drip then transfuse 3rd unit of FWB to run x 4hrs
• Repeat CBC w/ APAPTT, serum Na, K, Cl at 6 hrs. Post BT of 3rd unit
• Prepare another 2 units of PRBC, properly typed and cross matched for possible
additional BT
• Encouraged deep breathing
• Monitor UO q4 x 24 hrs. and record, Keep UO >30cc/hr
• Refer accordingly