Post Operative Care Of Gynecological Patients

The wound is dressed and sterile pad is applied to vulva.
It is checked if patient is given appropriate position- Trendelenberg, propped up or supine.
It is checked that anesthesia paper is attached and intraoperative input/output,    blood loss are charted.
It is checked if anesthetist has mentioned references/investigations to be done.
It is checked if Foley’s catheter is strapped to the thigh in traction-free manner.
It is checked if patient has adequate intravenous hydration.
It is checked that orders are followed by ward staff.
If the patient has a drain/Ryle’s tube in-situ, it is checked whether it is fixed properly and its output is charted .
It is checked that a measuring tape is kept to measure abdominal girth.
It is checked that vitals are monitored regularly.
If patient is diabetic, it is checked that-
IV fluids having only dextrose are not infused.
HGT(1 hourly) especially if the patient is on neutralizing insulin drip, urine sugars/ketones (4 hourly).
Random blood sugars are sent 4 hourly
Insulin infusion, if any, is titrated as per target glucose levels and adjustment suggested by endocrinologist.
It is checked that all medications which the patient had been taking for any medical condition are administered via appropriate route unless specifically omitted.
It is checked that timing of antibiotic administration is mentioned.
On starting oral intake
It is checked if patient has good peristalsis before starting oral intake.
It is checked that patient takes small sips initially and is gradually shifted to soft diet followed by full diet.
It is checked that a sample for urine analysis is sent on day 3.
It is checked that catheter is kept in situ in following cases-
Anterior colporrhaphy: 5 days
Bladder injury: 7-21 days
It is checked that drain is not blocked.
In patients undergoing vaginal procedures-
It is checked that cases having perineal sutures are given local application of antiseptic cream.
Moist Povidone-iodinedine pessary is kept vaginally day 3 onwards, if applicable.
Before discharging the patient, it is checked that discharge summary is filled correctly.