Open Prostatectomy

'''Pathway Open Radical Prostatectomy '''

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Always check with Chief first: ''these are “guidelines” only. Orders must be approved by Chief prior to implementing. May change with time/patient/ attending and Chief.''

--N: PCA until tolerating house diet usually at noon on POD1, then convert to oral; usually oxycodone and tylenol. Toradol is often written for these patients but is sometimes held if bloody case or elevated creatinine. The resident who performs the surgery will be the one to write for this.

--Cardiac: home meds. Hold Aspirin/Plavix until approved by Attending/Chief

--Pulm: wean O2, early ambulation night of surgery preferred, chest PT if requiring oxygen on POD1

--GI: POD1 clears in am, House diet at noon. ''Nothing per rectum. ''

--GU: HLIV when po intake >400cc. ''Foley stays in!!! Never deflate balloon or reposition foley. Foley should always be attached to cath secure. '' Check with Chief prior to flushing these foleys (sometimes these patients can have clot retention and may require gentle flushing). JP drain is removed POD2 if output is less than 60cc since midnight (always check with Chief first).

--Heme: pneumoboots, TED hose, ambulate on POD0, SQH for Dr. Doyle patients

--Labs: CBC, Basic metabolic panel with magnesium, POD 0 and POD1

--Discharge home POD2 around 10am, without services.