Admission Diagnosis: Post-Operative Radical Prostatectomy

IN PACU:

CBC with diff, Electrolytes, Creatinine

Diet

On Admission:

Sips to Clear FluidsOR Energy controlled Clear Fluids

When passing flatus:

Regular DietOR Energy controlled Diet

Activity

 Activity as toleratedOut of bed day of surgery Ambulate TID Post-Op Day 1

Vital Signs

 VS + O2 sats Q4H x 24 hours, QID x 24 hours then BID when stable

Notify Authorized Provider:

  • for temp greater than 38.5° C
  • systolic blood pressure less than 90 mmHg or greater than 160 mmHg
  • diastolic blood pressure greater than 100 mmHg
  • pulse less than 50 bpm or greater than 120 bpm
  • True Urine output less than 120 mL in 4 hours
  • O2 sats less than 92%

Patient Care

Tubes/Drains

Urinary catheter to straight drainage. Manual irrigation PRN

Catheter traction overnight. Discontinue catheter traction Post-Op Day 1

NS bladder irrigation at a rate of 125 mL/h Or at a rate to maintain catheter patency

Adjust rate to keepurine clear or light pink

Intake and Output Q4H x 24 hours, then QSHIFT and PRN

Snyder drain to suction. Empty and record volumeQSHIFT and PRN

Incision/Wound Care

 Change Dressing 24 hours Post-Op, then PRN

POC

POC Capillary Glucose: BID before meals or TID before meals orTID AC and QHS

If POC ordered – Authorized Provider to reassess after 72 hours

Laboratory

CBC with diff, Electrolytes, CreatinineDay 1 Post-Op Day 1 and Day 2 Post-Op

IV Solutions

IV Fluid:Ringers Lactate 125 mL/h With 20 mEq KCl per L of IV fluid

2/3 1/3 With 40 mEq KCl per L of IV fluid

NS Rate ______mL/h

Salinelock IV when drinking well

Medications

 Belladonna and Opium suppository Rectally Q6H PRN(Not to be discontinued when Spinal/Epidural Analgesia Post-Operative Order Set is used)

bisaCODYL suppositories 10 mg Daily Rectally, starting Post-Op Day 1, until flatus

DocusateSodium 100 mg po bid

HyoscineButylbromide 20 mg IV or Subcutaneous Q4H PRN

Home medications as per Medication Reconciliation History sheet when signed by Authorized Provider

Antibiotic Prophylaxis

Cephalexin 500 mg PO BID

Nitrofurantoin SR 100 mg PO Daily

Diabetes Management

HypoglycemiaClinical Protocol greater than or equal to 18 years

Subcutaneous Insulin Order Set

Nicotine Replacement Therapy

Nicotine Replacement Therapy (NRT) Order Set

VTE Prophylaxis Management

Patient has been assessed for VTE Prophylaxis Management: Bleeding Risk LOS less than 48 hours

VTE Prophylaxis Order Setif indicated to be signed by Authorized Provider

Admission/Discharge/Transfer

Plan for Post-Op Day 1 – 3 discharge

 Follow up in 2 weeks for catheter removal after cystogram

Consults

 CCAC for catheter care, wound care and supplies

Physiotherapy

Other

Order Set Orderable – (Automatic order for statistical reports)

GBHN/Radical Prostatectomy Post op/MD/06-15/v6 Copyright © 2007-2015 Grey Bruce Health Network

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