PLACE LABEL HERE
ADJUSTABLE GASTRIC BANDING
POST-OP ORDERS
The following orders will be implemented. Orders with a “q” are choices and are NOT implemented unless checked.
Initial all handwritten order modifications and the bottom of each page when indicated (multipage).
DIAGNOSIS: ______
1. Diagnostics: 4 hrs post op, Bariatric Upper GI Series with Omnipaque (iohexol), Dose no more than 30 ml at a time. Frequency per Radiologist. Call results to Surgeon.
2. Vital signs per per unit routine
3. Elevate: q HOB elevated at least 45 degrees
4. Dressings: q Reinforce as needed q Change ______q Other: ______
5. Activity: Continue SCDs until ambulatory then ambulate with assistance q Other: ______
6. Dietitian to Assess and Manage prior to discharge. Reason: Education Post Bariatric Surgery.
7. Diet: May have ice chips (30 ml/hr) if no nausea.
When patient returns from UGI progress to Bariatric Sugar Free liquid diet: Water, broth, unsweetened gelatin, sugar-free popsicles, caffeine free tea or coffee.
Absolutely NO other foods or beverages.
No juice or saccharin (Sweet‘N Low) products. May have Equal or aspartame.
Encourage warm liquids for patient with hiccups or frothy sputum.
No carbonation or straws.
8. Provide patient/family discharge instructions on Adjustable Gastric Banding. Refer to Bariatric Owner's Manual for physician specific instructions.
9. Continuous Pulse ox with telemetry until patient goes for UGI
MEDICATIONS See policy 520-06 for range orders and pain intensity guidelines.
10. VTE Prophylaxis: q Heparin 5,000 units SQ STAT x 1 dose in PACU (given in thighs only)
OR
q Lovenox (enoxaparin) 40 mg SQ STAT x 1 dose in PACU. If CrCl < 30, give 30 mg SQ (given in thighs only)
11. Pain: q Roxicet elixir (oxyCODONE 5 mg/acetaminophen 325 mg/5 ml) 5-10 ml po q 4 hrs prn. DC if Hycet ordered.
or q Hycet elixir (HYDROcodone/acetaminophen 7.5/325 mg/15 ml) 15 ml po q 4 hrs prn. DC if Roxicet ordered.
and/or q Toradol (ketorolac) 30 mg IV (or IM if no IV access) q 6 hrs prn (15 mg if CrCl 31-50, > 65 y/o or < 50 kg) x 5 days max. DC if CrCl < 30.
12. Nausea/Vomiting q Reglan (metoclopramide) 10 mg IVor po q 6 hrs prn (5 mg if > 65 y/o)
q If persistent nausea, give Zofran (ondansetron) 4 mg IV or po q 6 hrs prn
______
Date Time Physician Signature PID Number
*1-27809* FORM 1-27809 REV. 12/2015 WHITE: Medical Record CANARY: Pharmacy Page 1 of 1