Laparoscopic partial nephrectomy

'''Pathway Laparoscopic and Open partial nephrectomy '''

'''

'''

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: IV/epidural until tolerating toast and crackers, then convert to oral; usually oxycodone and tylenol.

--Cardiac: home meds BUT avoid ACE,ARBS, diuretics, until creatinine normalizes. Hold Aspirin/Plavix until approved by Attending/Chief

--Pulm: wean O2, early ambulation, chest PT if requiring oxygen on POD1

--GI: POD1 clears, POD2 clears toast/crackers then ADAT, sometimes Dulc supp is used for these patients.

--GU: HLIV when po intake >400cc unless elevated creatinine then ask Chief. D/C foley usually on POD 2 (6 hours after epidural d/c’d if on one). JP stays in after the foley comes out, watch the JP output after the foley is removed and check with chief prior to removing JP.

--Heme: ambulate POD1, TED hose, pneumoboots

--Labs: CBC, Basic metabolic panel with magnesium POD1 and POD2

--General: ambulate early on POD1

--Discharge home POD2-3 without services