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Discussion

Starting PO after c/s

When do you start giving your patients ice, sips, clear liquids after a csection? Our docs put in orders to "progress diet as tolerated", but that's a standard order that doesn't have much bearing on what the nurses on our unit and on the MBU actually do. (Most of our patients have spinals with either morphine PCA or Duramorph afterwards.) I just read in the latest AJN (I think) that auscultating bowel sounds is pretty much useless as an assessment of meaningful bowel function.

What do you do?

Altalorraine

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once PAR recovery is over, we start on ice chips and advance as tolerated. Generally works out JUST FINE. We also ambulate early, too. VERY important.

You know, they are going to have their family members sneak in whatever they want anyways :uhoh3: :uhoh3: :uhoh3: :uhoh3: .

You know, they are going to have their family members sneak in whatever they want anyways :uhoh3: :uhoh3: :uhoh3: :uhoh3: .

Our patients are compliant for the most part. I'm sure it has to do with our population.

Our C/S pts get duramorphs. They have sips/clears ordered for 24 hours. Most start on ice after 2h if no N/V. Some RNs advance to regular if the pt passes gas. I follow orders, clears for 24h.

At my current hospital, pts are started on ice chips pretty much immediately (in post-op recovery) and advance to clear fluids soon after if there is no nausea/vomiting. Diet is advanced to full diet (encouraging them to start slow with soft/bland foods at first) when they are passing gas (usually within 8 hours of delivery)

At my last hospital, we were a little less focused on flatus; once they had adequate bowel sounds we would advance the diet. AM sections would often eat a lite lunch, and a full dinner.

We also start on ice chips as long as BP and N/V are under control in the PACU. Pt gets a clear liquid diet until they are passing flatus.

When I had my c section, as soon as I was moved into my own room my mom asked what and when I could eat, the nurse told her "anything she wants starting now." I didn't feel like anything though.

I remember the next morning when they made me walk it felt like TORTURE I thought I would never walk normal ever again!

I like to start them on clear liquids and then introduce food gradually as long as there is no nausea and vomiting. BUT - there's always the mom's who are munching down on hamburgers or pizza that family members have brought in!

My dear husband brought me a cheeseburger basket when I was assigned a room after my emergency c/s....thinking he was fulfilling my original request of a nasty, greasy cheeseburger after I delivered. Both of us were sadly disappointed to find that I was not allowed to have it until the next day (Delivery was at 12:22 p.m.):( It was the thought that counts, right???

As far as ambulation...my nurse told me that I should take it easy for the first day and begin ambulating the next morning. Having had someone close pass away b/c of blood clots after surgery, I forced myself to begin walking as much as I could (which wasn't much) the night I delivered . Seemed like the more I walked, the less and less sore it got. It certainly surprised the nurses that I was walking the hall 8 hours post c/s!!

I still remember the disappointment on my husband's face when he realized that I couldn't have the fat, nasty cheeseburger he remembered to bring for me.....

I still remember the disappointment on my husband's face when he realized that I couldn't have the fat, nasty cheeseburger he remembered to bring for me.....

But it was incredibly sweet that he remembered. :) He was trying to keep your birth plan as intact as possible and he probably didn't know that a greasy cheeseburger, as good as it may sound after a long labor, wasn't the best thing to give a mom who had her insides rearranged. :p

Our Doctors all pretty much have the same orders. Ice chips once in the room, clears after that if no n/v and doing well. Then progress to a soft diet & then a regular diet with the passing of gas. It would usually go, C/S @ 8am....ice chips once in room...clears for lunch and maybe dinner..depending on mom it sometimes is a soft diet. Ambulate patient after 8pm in room only. In Am Ambulate patient in hall and breakfast is a soft diet. Lunch is usualy a regular diet for sure. :twocents:

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We do the bowel sounds thing . . . .. ice chips first, then clear liquid and full liquid and regular . . .

The men who have surgery are quicker to want to eat "real food" than the women, in my experience. And they always want a big greasy burger . . . .. . .yeah, that is soooo pretty coming right back up. :rolleyes:

I guess I don't understand the need to eat so soon - I didn't feel like eating food for days. Not nausea . . just not hungry.

steph

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