COURSE IN THE WARD

DAY 1

Admitted to room of choice under the service of De Lara

Full DAT

VS q4, monitor i&o and recordTo monitor progress or deterioration.

For cbc, platelet, na, k, crea, bun ( normal lahat)Baseline lab results and to check any underlying symptoms

Monitor I & OTo check possible fluid imbalance

Schedule for External binding valvuloplasty and excision perforation vein Right lower extremity tomorrow at 9 am tom. 03-18- 2015Operation for varicose veins, widening the vein

Inform anes

Inform for changes in schedule

Refer accordingly

CP Clerance May undergo specied procedure with minimal risk of cardo pulmonary complicationSince disease is cardiovascular related CP clearance is required to check risk for complication during and post-op*patient >35 y/o CP clearance is required to foresee risk for complications

Anes:

Hook IV PNSS IL @ 30 gtss/ minFor hydration

Give Omeprazole 40 mg/tab midnightProton pump inhibitor, to prevent gastric irritation since patient will be on NPO

NPO starting MidnightPrevent aspiration during the surgery

Start Cefuroxime 750 mg/IV (-)ANST q8Prophylaxis, prevent infection

Antiobiotics on call to OR

Refer accordingly

DAY 2

PACU

To PACU

Vs q15To closely monitor patient

O2 mask at 2 lpmEncouraged deep breathingFacilitate breathing and as a pain management

Flat on bed one head pillow until 6 pm then low moderate backrest

Clear liquids until 4 pm, then progressive dietTo provide gentle way of introducing food back to the digestive system

IVF 30 gtss/min followed by D5NR1L same rateFor hydration

Post op medsParacetamol 600 mg/ SIVP for 3 dosesDolcet tab 1 tab 6 for painCefuroxime 750 mg/ IV q8

Post op medsParacetamol 600 mg/ SIVP for 3 dosesDolcet tab 1 tab 6 for painCefuroxime 750 mg/ IV q8

Mild analgesic for moderate to severe painMild analgesic for moderate to severe painProphylaxis, prevent infection

2 PM

May transfer to room

Continue post op orders and close monitoringStill on close monitoring since patient just undergone surgery

Refer accordingly

3: 00 PM

DAT

IVF to consume

Monitor I&O per shift and record

Watched out for bleedingOne of the common complication after operation

Refer accordingly

DAY 3

May go home

May ambulate

Watched out for bleeding

Take home meds: Dolcet tab 1 tab 6 for painCefuroxime 250 mg/tab twice a day for 7 daysFollow up with after 2 weeks at UST Doctors ClinicMild analgesic for moderate to severe painProphylaxis, prevent infection