Form for myo Questions part 2/ideas to improve it?

[Guest guest]

It could be in surgical order:

1)Type of pre op proceedures required:

A)x-ray of lungs yes no

comments:____________

date,location and time if yes_____________

B)EKG yes no

Comments:____________

date,location and time if yes_____________

C)examinations

including Type fo Exam,Date, Location, Time,

other information

1__________________________________________________

2__________________________________________________

3__________________________________________________

4__________________________________________________

5 example: Pelvic exam, day before surgery,at

hospital clinic, with nurse practioner

D)Bowel

Prep:_______________________________________

E)Other:____________________________________________

2)Proceedures Surgical Day:

A)Arrival: how early before surgery

time____________

Calls to make before:____________________

B)Type of

Anestigi(sp):____________________________

(local or general or spinal block)

C)Drs

Names:________________________________________

or potential if they cannot name everyone

D)Type of

Incision:_________________________________

E)Procedure

Expected:_______________________________

How long will it

take:___________________________

How much blood

loss:_____________________________

What do they expect to find and do about it:

_________________________________________________

_________________________________________________

_________________________________________________

F)TELL THEM WHAT YOU WILL NOT ACCEPT IN WRITING

IF NECESSARY

G)Other:____________________________________________

3) POST OPERATIVE RECOVERY:

A)Where will you wake up?

B)What tubes or bandages or IVs may you have and

their effects?:

_________________________________________________

_________________________________________________

_________________________________________________

C)Pain Management

Procedures:______________________

_________________________________________________

_________________________________________________

D)When will tubes staples bandages be removed?:

_________________________________________________

_________________________________________________

_________________________________________________

_________________________________________________

E)What are you expected to do before you can go

home?:

(walk, pass gas, have a bowel movement)

_________________________________________________

_________________________________________________

_________________________________________________

F)Other:___________________________________________

4) RECOVERY

A)What to

expect:__________________________________

B)What to worry about:

____________________________

C)Who to call in case of an

emergency:_____________

D)What can I

eat:__________________________________

E)What can I carry and how

long:___________________

F)When can I

drive:________________________________

G)When do I follow up with the

Doctor:_____________

H)When can I have

sex:_____________________________

I)When can I try to get

pregnant:__________________

J)OTHER____________________________________________

this is a general form designed to offer a general

idea of questions presented and should no case be

used

as a complete reference to what questions to ask.

Each woman's bodies and needs are different and they

must therefor expand on this begining.