| Pain Management |
- Oral Analgesia
- Start:
- Continue:
- Acetaminophen PO q4hr PRN for mild pain
- Oxycodone PO q4hr PRN for moderate pain
- Diazepam PO q6hr PRN for muscle spasticity
- IV Analgesia
- Continue:
- Hydromorphone IV q3hr PRN for breakthrough pain
- Nalbuphine IV q4hr PRN for itching
- Ondansetron IV q8hr PRN for nausea/vomiting
- Complete:
- Hydromorphone PCA discontinued if not done on POD 1
- Ketorolac IV q 6hr, max 8 doses
|
| Activity/PT |
- Toe touch weight bearing on affected extremity with hip ROM precautions
- PT and OT daily
- Ambulate and OOB to chair TID
- Use CPM 0-50° on 2 hrs, off 2 hrs while awake when indicated
- Stair training and adaptive equipment education for lower body dressing
- Attempt walking to bathroom to use toilet
- PT/OT Discharge Criteria
|
| GI |
Continue famotidine and bowel regimen as ordered
|
| Nutrition |
Regular diet as tolerated |
| Tubes/Drains |
Hemovac removal by Ortho APP |
| Respiratory |
Incentive spirometry q2hrs while awake
|
| Other Medications |
- Continue:
- Aspirin 325 mg daily for DVT prophylaxis
- Cholecalciferol 50 mcg daily for bone health
- Initiate:
- Indomethacin PO 25 mg TID, if indicated for heterotopic ossification
|
| Discharge Planning |
- Ensure home health needs and transportation are available if required
- Provide prescriptions to family
- First incision dressing change as determined by Orthopedics
- Discharge to home when goals are met
|