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Clinical Pathway – Bowel Resection Pre-Admission Consult • Anesthetist Tests • Blood test • Electrocardiogram if required • Chest X-ray if required Day of Admission Post-op on day of admission • Blood test if required • Antibiotic • Patient Controlled Analgesia (IV PCA) or Epidural infustion for pain management • Antibiotic (prevent infection) • Anti-nausea medications • Anticoagulant (blood thinner) • Patient’s own medications if required • Intravenous • TED stockings Assessment & Treatment • Vital signs (Blood Pressure, Heart & Respiratory Rate, Temperature, Bowel & Breath Sounds) • Oxygen if needed • Intravenous • Abdominal incisions • Drain/drainage • TED stockings Activity • Sit at side of bed Medication • Measure legs for support stockings (TEDs) Nutrition • Urinary catheter Elimination Patient Teaching/ • Pre-op instructions • Bowel preparation • Skin preparation Discharge Planning • Plan for a hospitalization of 5 days including day of surgery • Pre-op instructions • Deep breathing and coughing exercises • Ankle exercises ©The Ottawa Hospital – L’Hôpital d’Ottawa Clinical Pathway – Bowel Resection Post-op Day 1 Post-op Day 2 Consult Tests • Blood test • Blood test Medication • IV PCA or Epidural infusion for pain management • Antibiotic • Anti-nausea medication • Anticoagulant • Patient’s own medications if required • IV PCA discontinued and oral pain medication started • Anti-nausea medication • Anticoagulant • Patient’s own medications if required • Vital signs • Oxygen if needed • Intravenous • Abdominal dressing • Drain/ drainage • TED stockings • Vital signs • Oxygen if needed • Intravenous discontinued if drinking well • Abdominal dressing removed and left open to air • Drain removed (if present) • TED stockings Activity • Sit in chair 2 times • Walk in hall 3 times at least Nutrition • Surgery diet • Eat what you feel you can manage • Surgery diet • Urinary catheter • Urinary catheter removed (if present) • Up to bathroom • Deep breathing and coughing exercises • Ankle exercises • Pain management • Activity • Deep breathing and coughing exercises • Ankle exercises • Pain management • Activity Assessment & Treatment Elimination Patient Teaching/ Discharge Planning ©The Ottawa Hospital – L’Hôpital d’Ottawa Clinical Pathway – Bowel Resection Post-op Day 4 Discharge Day Post-op Day 3 Consult Tests • Blood test if required Medication • Oral pain medication • Anti-nausea medication • Patient’s own medications if required • Oral pain medication • Anti-nausea medication • Patient’s own medications if required Assessment & Treatment • Vital signs • Oxygen if needed • Abdominal incision • TED stockings • Vital signs Activity • Walk in hall 3 times at least • Activity as tolerated Nutrition • Surgery diet • Surgery diet Elimination • Passing gas per rectum Patient Teaching/ Discharge Planning • Deep breathing and coughing exercises • Ankle exercises • Pain management • Activity Review post-op instructions with the nurse: • Activity • Medications • Wound care • Diet • When to cal the doctor • Follow-up visit • Discharge tomorrow by 10:00 a.m. ©The Ottawa Hospital – L’Hôpital d’Ottawa