Table 1. UNIVERSITY OF VIRGINIA HEALTH SYSTEM CLINICAL PATHWAY: OUTPATIENT LAPAROSCOPIC CHOLECYSTECTOMY

Post operative orders: 1) Vital signs: PACU routine 2) I&O/fluids: per PACU routine 3) Diet: Sips, may advance to clear liquids when fully awake 4) Activity: OOB ad lib when awake. 5) Dressings: Maintain operative dressing. May reinforce as needed. 6) Meds: a) Nausea: Droperidol 1.25 mg-2.5 mg Q1H prn nausea. b) Pain: MS 1–2 mg IV Q 30 min prn pain c) Oxycodone/Acetaminophen 1–2 tabs q 4–6 hours prn pain. d) Hydrocodone/Acetaminophen 1–2 tabs q 4–6 hours prn pain. 7) IV Fluids: Discontinue IV when awake and not requiring IV pain medication. 8) Treatments: DC Foley if present, on arrival to PACU; DC oxygen when awake. 9) Discharge to SAS then home. Discharge Instructions: 1) Activity: No lifting greater than 10 lbs. until follow-up visit. Work: may return to work based on ability to follow activity restrictions. 2) Driving: May resume when no longer taking pain medication. 3) Dressings: You should remove your dressings the day after your operation. The strips on your skin should stay on for one week. 4) Shower: May shower after dressings are removed, maintain steristrips for one week from surgery. May take bath after 5 days. 5) Diet: clear liquids, add solid food as tolerated. High fat foods may cause pain. Drink 8 - 8 oz glasses of water or liquid per day. 6) Pain medication: As pain subsides may switch to Ibuprofen or Tylenol. 7) Medication: Resume previous home medications. 8) Bowels: May take stool softeners (Colace) or laxatives as needed. 9) Call your doctors office for: a) redness, swelling, or drainage from your incisions b) fever or chills c) pain increased from your baseline at discharge d) nausea and vomiting e) prolonged constipation or diarrhea (greater than 3 days) f) inability to urinate (pass water) after 8 hours 10) Any questions or concerns about your condition 11) If a return appointment has not been given to you, call your surgeons office