PPALM VFB CC (possibly the worst acronym of all time): PO, pain, ambulation, lochia (= menses?) · Void, flatus, bottle or breast feeding? · Contraception and circumcision (consented?).
Vitals / Objective:
- •BP: isolated mild range, gestational HTN, preeclampsia ± SF, hypotension, shock?
- •Temperature: >100.4 = febrile. Think about timing in relation to delivery for IAI vs. endometritis. DDx: UTI, mastitis, URI, bacteremia, etc.
- •HR: tachycardia — what was their baseline? Total EBL? Consider CBC / transfusion. Tolerating PO? Consider fluid bolus.
Physical Exam:
- •What is a fundus? Who knows — sometimes habitus is an issue.
- •When do I pull the dressing? POD#2, use spray!
- •HTN: headache, vision changes, dyspnea, RUQ, epigastric pain, edema.
- •Anemia: dizzy, lightheaded, SOB.
Postpartum Huddle:
- •Occurs at 9:15 AM with nursing, lactation, social work, peds on 5300.
- •Discuss early discharges or other concerns.
- •If floor person is in a delivery, the other intern can cover.