You will be given additional postoperative instructions specific to your procedure on the day of surgery.  Please make sure that your caregiver/responsible adult is accompanying you to hear these instructions from the recovery room nurse. 

After arriving home, if you have questions and are unable to reach the center, please call your physician office.  If you feel that you need care and are unable to reach your physician, please go to the nearest emergency room or call 911.

• It can take more than 24 hours for the drugs given during anesthesia to be completely cleared from your body. You may experience light-headedness, dizziness and sleepiness following surgery. THEREFORE, A RESPONSIBLE ADULT MUST DRIVE YOU HOME AND STAY WITH YOU FOR THE FIRST 24 HOURS FOLLOWING YOUR PROCEDURE.
• Do not drive or operate hazardous machinery, equipment, or power tools for the next 24 hours. If a child, no bicycle riding, skateboards, etc. Do not make any important or critical decisions.
• DO NOT drink alcoholic beverages next 24 hours. Alcohol enhances the effects of anesthesia and sedatives.

 Your next appointment with your physician will be in/on ___________________.

 You should call the doctor’s office today to schedule an appointment to see him/her on _________.

PHYSICAL ACTIVITY		MEDICATIONS
Rest for the first 24 hours. Move slowly when walking, standing and getting out of bed. In case of dizziness, have someone with you when walking or standing.  Weight bearing as tolerated.		 Prescriptions sent home with patient: Drug Name _____________ Dose ________ Drug Name _____________ Dose ________ Time of last pain medication given at the surgery center: ________
INCISION CARE		 Yes  No Resume all mediations as previously prescribed by your physician.
 Report to doctor any unusual discomfort, drainage, or bleeding. If you have excessive bleeding, apply pressure to the area, elevate it if possible, and contact your physician.  Apply ice to operative site and keep elevated for __________________________.  Do not change dressing until after first post-operative visit. Keep site clean and dry.  You may remove dressing in ____ days. Wash hands thoroughly before changing dressing.  Observe the operative area for signs of infection: increased pain, redness, fever, discharge, swelling and/or foul odor. These signs and symptoms usually become apparent 36-48 hours. If present call your physician.__________________________ BATHING:  Sponge bath until after first post-operative visit.  Shower  ____________________________________
		 You have received an antibiotic used to treat or prevent infections caused by bacteria. Side effects include: mild diarrhea; skin rash/ itching/ redness or swelling; sore mouth or tongue; stomach cramps or upset stomach.
		 You have received an antihistamine to prevent or relieve allergic symptoms, nausea, vomiting, hyperacidity and dizziness. Side effects include: drowsiness, thickening of mucous, sore throat and fever; unusual bleeding or bruising (uncommon with one dose); unusual tiredness or weakness.
		 You have received an antiemetic to treat or prevent nausea and/or vomiting and to produce sedation. Side effects include: drowsiness; dry mouth; sensitivity of skin to sun; nightmares; sore throat and fever; unusual excitement; nervousness; diarrhea, constipation, restless irritability.
DIET		Physician’s Homecare Instruction Sheet given?
Progress slowly to a regular diet. If your stomach feels uneasy or you have not appetite, begin with sips of clear liquids (tea, ginger ale, broth), then light foods (soup or Jello, etc.) until you can tolerate, gradually progressing to solid foods.  Change of your diet to _________________.		 Yes  N/A
		Additional Instructions

Report the following signs and symptoms to your physician immediately: difficulty in breathing, continued nausea or vomiting, excessive swelling on or around the incision area, redness, increased pain, temperature of 100 degrees F or above. In case of emergency, call your doctor at __________ or dial 911.

By signing this form, I hereby acknowledge that these instructions have been discussed with me and that a copy was given to me for my review.

________________________________ (Responsible Adult)

________________________________ (Patient) PATIENT LABEL

________________________________ (Nurse)