Your SlideShare is downloading. ×
Osce  post op management for lscs
Upcoming SlideShare
Loading in...5
×

Thanks for flagging this SlideShare!

Oops! An error has occurred.

×
Saving this for later? Get the SlideShare app to save on your phone or tablet. Read anywhere, anytime – even offline.
Text the download link to your phone
Standard text messaging rates apply

Osce post op management for lscs

4,485
views

Published on

Published in: Health & Medicine, Business

0 Comments
0 Likes
Statistics
Notes
  • Be the first to comment

  • Be the first to like this

No Downloads
Views
Total Views
4,485
On Slideshare
0
From Embeds
0
Number of Embeds
0
Actions
Shares
0
Downloads
106
Comments
0
Likes
0
Embeds 0
No embeds

Report content
Flagged as inappropriate Flag as inappropriate
Flag as inappropriate

Select your reason for flagging this presentation as inappropriate.

Cancel
No notes for slide

Transcript

  • 1. OSCE: Post LSCS Management 24 years old Malay lady, G1P0 at 38 week of amenorrhea has been decided for elective lower segment caesarean section operation in view of oblique lie. As a houseman, outline your management to this lady post operatively. Answer 1) Transfer the patient to the post natal wards after patient stable post-operatively. 2) Close monitoring of vital sign; temperature, oxygen saturation and blood pressure. To inform the MO in charge if BP is high. 3) Keep patient in supine position for at least 4-6 hours. 4) Keep patient nil by mouth for 4-6 hours. If patient fully conscious, no headache and vomiting, then may allow with clear fluid first then followed by solid food. 5) Continue IV pitocin 40 unit in 500 cc normal saline. 6) Strict input/output chart. Aim for urine output 0.5 ml/kg/hour. Off CBD after 24 hours. 7) Put patient on fluid maintenance (3 pints of normal saline and 2 pints of dextrose 5% within 24 hours) 8) Look for any sign of complication - Intra abdominal bleeding - Aspiration pneumonia or respiratory distress. - Post partum hemorrhage - Hypovolumia - Other type of infection - Deep vein thrombosis 9) IV ampicillin 500 mg 6 hourly for three doses. 10) Adequate analgesia (eg; suppositories voltaren 50 mg t.d.s) if severe pain, may consider opiod based analgesic with anti emetic. (IM Pethidine or IV morphine with IV maxalon) 11) Stokinett and encourage early ambulation to prevent DVT. Consider heparin infusion in patient who is high risk to develop DVT. 12) Daily FBC (Hb and TWC level) and coagulation profile. 13) Wound inspection at day three. If no complication and wound healing well, then can discharge the patient. 14) Encourage breast feeding once patient fully conscious. 15) Advise on contraception. Patient should not be pregnant for at least 2 years. Patient should also be council regarding mode of delivery for the next pregnancy.