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Pre- and Post-Operative Orders: Radical Retropubic Prostatectomy (RRP)

Pre-Operative Orders for RRP

Dx: Adenocarcinoma of the prostate

Planned surgery: radical retropubic prostatectomy with bilateral pelvic lymphadenectomy.

Allergies:

Labs: Type and Screen
CBC
Basic Metabolic Panel (Chem 9)

Xray: Chest Xray if needed by anesthesia or hospital policy

Cardiology: EKG

Diet: NPO after midnight except for AM medicines with a sip of water

Patient instructions: Fleet's enema the night before surgery.
Hold aspirin, Plavix for one week prior to surgery
IV per anesthesia (Ringer's Lactate at 100cc/hr if no anesthesia preference)

Consent: Radical Retropubic Prostatectomy with pelvic lymphadenectomy

Shave: above umbilicus to mid scrotum

DVT prophylaxis: Knee high TED hose and sequential compression device.

Meds:

Cefazolin (eg. Ancef) 1 mg IV in pre-op area
Lovenox 30mg S.C. in pre-op; alternatively, if not available or covered:
- Heparin 2,500 units S.C. in upper extremity in pre-op (do not give with Lovenox).

RRP Post Op Orders

Dx: prostate cancer post radical prostatectomy. Admit to med/surg, Dr. Lamm. VS and I&O q. shift
Ambulate with assistance in AM

TED hose, knee high. Sequential Compression Device while in bed. Instruct/encourage: Incentive Spirometry q 1 hour while awake. Foley to gravity drainage; hand irrigate with NS prn clots or failure to drain.

Labs: Hemoglobin and Chem 9 in AM

Diet: Clear liquids advancing to regular diet as tolerated in AM

IV: D51/2 NS with 20 mEq KCL/liter at 125cc/hr for 8 hours, then 100cc/hr.

Allergies:

Meds:

Cefazolin (Anceph) 1mg IV q 8 hours x6 doses
Ketorolac (Toradol) 15mg IV q 6 hours for 48 hours
Hydrocodone 5mg & acetaminophen 500mg (e.g Vicodin) 1-2 tabs q 4 hours prn mild pain
Morphine 2-4mg IV q 4 hours prn severe pain
Compazine 5mg IV q 6 hours prn nausea/vomiting
Ambien 5mg po qhs prn insomnia
B&O suppository 30-60mg per rectum prn bladder spasms
Peri-Colace 2 capsules PO daily.
Protonix 40mg PO or IV q AM

Anticipate discharge in two days.

Call (602) 493-6626 for T>102 or output less than 30cc/hour please.

Created: 3/15/2005

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