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Standards for Female and Male Sterilization Services - STATE ...

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62<strong>St<strong>and</strong>ards</strong> <strong>for</strong> female <strong>and</strong> male <strong>Sterilization</strong> services9. Vital signs: monitoring chart (<strong>for</strong> female sterilization)Event Time Sedation* Pulse BloodPressureRespiratoryRateBleedingComments(Treatment)Preoperative (every 15in after premedication)Intra-operative(continuous)Post-operative1.2.Every 15 min <strong>for</strong>first hour <strong>and</strong> longerif the patient is notstable/awakeEvery 1 hour until 4hours after surgery15 min30 min45 min1 hr2 hrs3 hrs4 hrs*Sedation: 0–Alert 1–Drowsy 2–Sleeping/arousable 3–Not arousableName <strong>and</strong> signature of the attending staff nurse10. Post-operative in<strong>for</strong>mationPassed urineYes............................................................ No...............................................................Abdominal distension Yes............................................................ No...............................................................Patient feeling wellYes............................................................ No...............................................................If no, please specify ...........................................................................................................................................................................................................................................................................................................................................................................................................................

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