Post-op Lower-Transverse C/S
🃏 Order set for Post-op Oliguria (Explore Laparotomy)
- C/S indication: elective vs emergency; failed IOL, fetal distress, malpresentation, prior C/S (VBAC vs repeat)
- Anesthesia type: SAB (spinal) most common; GA ถ้า emergency/failed SAB — N/V, shivering common post-SAB
- Estimated blood loss: normal C/S 500-1000 mL; Hb pre-op vs post-op
- Post-op ileus — encourage early oral + mobilization; bowel sounds + flatus before solid food
- VTE risk: C/S has higher VTE risk than SVD → LMWH หลังออก 6h
- Breastfeeding + skin-to-skin — encourage หลัง recovery room ถ้า mother stable
🕐 One-Day Orders
🔬 Investigation
- Vital signs q15 min ×4 → q30 min ×2 → q1h until stable → q4h
- Observe uterine tone + lochia (bleeding per vagina)
- Retain Foley’s catheter; observe UO
- Record I/O as mL
💊 Medication
- Acetar 1,000 mL + Syntocinon 20 U IV rate 120 mL/hr ×2 → 5%DN/2 1,000 mL IV rate 120 mL/hr
- Retain Foley’s catheter; observe bleeding per vagina + wound
- Pain control ตาม Anesthesia order
- MO 3 mg IV prn q6h
- Plasil 10 mg IV prn q8h
- จิบน้ำเย็น → soft diet เช้าวันถัดไป; IV หมด off พร้อม off Foley
🔁 Continuous Orders
🔬 Investigation
- Record V/S, I/O as mL; wound check daily; observe uterine tone + lochia
💊 Medication
- Ceftriaxone 2 g IV OD + Metronidazole 500 mg IV q8h
- **Paracetamol (500) 1 tab PO prn q4–6h 20
- **Ibuprofen (400) 1×3 PO pc 20
- **AirX (simethicone 80) 1×3 PO ac 20
- **Triferdine 1×1 PO pc 60
- **CaCO3 1×1 PO pc 60
- Promote breastfeeding + ambulation; observe uterine tone, B/V
- Discharge: ครบ 72 ชม. + น้ำนม 3 ดาว → F/U PP Clinic 6 wk + FP; HM ยาเดิม