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Chapter: Medicine Study Notes : Surgical and Fluid Management

Post-Operative Care

Eg following a laparotomy, Know and watch for complications.

Post-Operative Care

 

·        Eg following a laparotomy

·        Know and watch for complications

·        Analgesia:

o   Epidural: watch for low blood pressure

o   PCA/PRN narcotic (but watch for constipation from morphine/codeine)

·        Wound care:

o   Check not too much blood from drain

o   Rough times to leave a drain in for:

§  Laproscopic cholecystectomy/vascular surgery: 1 day

§  Rectal surgery: 3 –4 days

§  Mastectomy: 4 – 7 days (can go home with it in)

§  T-tube for biliary surgery: if latex then 10 – 14 days, if silicon then 3 – 4 weeks

·        Anti-coagulant (eg Clexane)

·        Fluid balance: if elderly alternate normal saline and dextrose bags (+KCl)

·        NG tube:

o   If no aspirate after 24 hours then take it out

o   If aspirate is green, leave it in

·        Prophylactic antibiotics: for uncomplicated laparotomy usually one dose intraoperatively

·        Consider rehabilitation, support at home, work re-entry

·        Plan follow-up

 

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Medicine Study Notes : Surgical and Fluid Management : Post-Operative Care |


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