Whipple
POD#0
Post op orders -> check labs (CBC, BMP, Mg, Phos, iCal, INR)
if Cr ok and LFTs not elevated then start tylenol (975mg q8H down NJ), gabapentin (100-300 TID),
celebrex (200 BID)
q4 SSI high dose
incentive spirometer
protonix 40mg q12hr
LR @150cc/hr
Ancef q8h and diflucan 400mg x48hr post op
dPCA
lovenox PM dose 40mg
POD#1
limited CLD (250cc per shift, no carbonated beverages, no straws), should be bari-clears so they are in medicine cups
clamp trial (usually 6-8 hours). If passes, then remove NG while patient takes sips to not dislodge NJ
start Tube feeds at 10cc/hr via NJ
POD#2
Unlimited CLD
TF @ 20cc/hr
POD#3
FLD
TF @ 30cc/hr
JP drain studies (amylase, lipase, TG, ?cultures if needed) -> eval for milky fluid after meals
POD#4
Remove JP if studies and cultures are negative
soft diet