Post-operative Orders Hip Fracture

  1. Admit to Racca/McKinley2-West
  2. Consult ______
  3. Diagnosis s/p R or L ORIF Hip
  4. Condition: Stable Vitals q routine
  5. Allergies: ______
  6. Activities: With Assistance, OOB TID
  7. Nursing q routine total joint protocol.
  8. Foley to Gravity,
  9. O2 to keep sats > 96%
  10. Bilateral SCD’s
  11. Strict I’s and O’s.
  12. Thigh-high Ted hose on both lower extremities unless dressing on operated leg precludes.
  13. Reinforce Dressing prn.
  14. Ice packs to operative site for twenty minutes q one hour for 48 hours.
  15. IS q one hour when awake, instruct patient to use and keep at bedside, cough and deep breathing q 4 hours.
  16. Overhead frame on inpatient bed.
  17. Assist patient up in chair or dangle at bedside tonight if no motor block present, then TID. Get patient up on unaffected side.
  18. PT in AM per total joint protocol if Hgb> 9 and INR< 3.0
  19. WBAT B LE or TDWB ______LE

9. OT Consult for ADLs and dressing change.

11. Diet Regular advance as tolerated or ______ADA Diet

12. IVF D51/2 NS w/ 20 meq ______cc/hr. HL IVF tol po intake.

13. D/C planner consult for acute rehab vs home pt for gentle rom and gait training vs Skilled Nursing.

14. Home health care for pt/ptt/inr draws 2x per week if pt discharged home, Lovelace Coumadin Clinic Referral

15. Meds

a. Ancef one gram IVPB q 8 hours for 48 hours.

b. Coumadin 5(five) mg at 2100 or Lovenox ______

  1. FeSO4 325 mg po qd WM.
  2. MVI one tablet po qd.
  3. Tylenol one gram po/pr q 4 hours prn headache, or temperature > 101 degrees Fahrenheit.
  4. Laxative of choice
  5. Pepcid 20 mg po BID

Post-operative Hip Fracture Orders Cont.

  1. Flexeril 10 mg tablets, one po q 8 hours prn muscle spasms.
  2. Colace 100 mg po q d and prn q 12 hours.
  3. Phenergan 12.5-25 mg IM/IV/PO/PR q 6 hours prn
  4. Percocet 5mg/325mg one to two tablets po every 3-6 hours prn
  5. Morphine Sulphate per PCA
  6. Meds______
  1. Labs
  2. H/H in PACU
  3. H/H in AM q d x 3 days
  4. PT/INR q am if patient on Coumadin.
  5. PLT Count POD #3 if on Lovenox
  6. X-ray Low AP Pelvis to include entire stemor fracture fixation device and acetabulum, and Lateral L / R Hip in PACU.
  7. Discharge planning consult.