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Chapter-28 Postoperative Rounds

BOOK TITLE: Ward Rounds in Obstetrics and Gynecology

Author
1. Srinivas K
ISBN
9789352702398
DOI
10.5005/jp/books/18053_31
Edition
1/e
Publishing Year
2018
Pages
11
Author Affiliations
1. Bangalore Medical College and Research Institute, Bengaluru, Karnataka, India
Chapter keywords
Fluid requirement, intraoperative fluid therapy, postoperative fluid, mobilization, blood transfusion, relaparotomy, physiotherapy, thromboprophylaxis, incisional hernia

Abstract

This chapter compromises of three cases which present a brief discussion on postoperative rounds. These cases are discussed in question and answer format. Crisp and to the point answers of the questions have been given in this chapter. A person weighing 70 kg with good health normally requires about 2–3 L of fluid per day. Urinary loss is 1–2 L, perspiration amounts to about 500 mL which varies with temperature of the surroundings. Other losses could be from lungs and stools. Mobilization needs to be done as early as possible. Once the anesthetic effect weans off the patient should start limb movements. By 6–8 hours the catheter may be disconnected and the patient may be encouraged to move to the toilet. Pain relief is a very important component of postoperative management. Initiation of oral liquids can be started as early as 4–6 hours once the bowel sounds are established and there is no postoperative nausea and vomiting (PONV). Physiotherapy is a very important intervention in the postoperative period. This starts with limb movements and respiratory exercises in the form of deep breathing in the immediate postoperative period to early ambulation, sitting up, moving around, etc.

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