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MSC – Ankle/Foot – Adult – Postoperative [4959]

MSC – Ankle/Foot – Adult – Postoperative [4959] - Clinical Hub, UW Health Clinical Tool Search, UW Health Clinical Tool Search, Order Sets, Ambulatory, Madison Surgery Center


MSC - Ankle/Foot - Adult - Postoperative [4959]
PostOp/Phase II
Do NOT order phase II medications for cases involving anesthesia.
Vital Signs [132836]
Vital Signs [NURMON0013] EVERY 30 MINUTES, Routine
Temperature Measurement Method:
Temperature Measurement Restrictions:
BP Source:
BP Location:
BP Position:
BP Restrictions:
Post-Op/Phase II
Activity [134250]
Activity [NURACT0008] CONTINUOUS, Routine
AD LIB:
AMBULATE: with assistance
CHAIR:
DANGLE:
BEDREST:
RESTRICTIONS:
UPPER LEFT EXTREMITY WEIGHT BEARING:
UPPER RIGHT EXTREMITY WEIGHT BEARING:
LOWER LEFT EXTREMITY WEIGHT BEARING:
LOWER RIGHT EXTREMITY WEIGHT BEARING:
Post-Op/Phase II
Patient Care Instructions [143828]
Please use patient's own Durable Medical Equipment
from home [NURCOM0022]
ONCE, Please use the following durable medical equipment
that the patient brought from home: ***, Post-Op/Phase II
Patient to be discharged to home when deemed stable per MSC Discharge from Phase II Recovery to Home Policy
[135357]
Patient to be discharged to home when deemed stable
per MSC Discharge from Phase II Recovery to Home
Policy [NURCOM0022]
ONCE, Phase II Discharge
Outpatient Discharge Orders (Medications)
Medications - Prescriptions - Analgesics (Opioids) (Single Response) [132532]
hydrocodone-acetaMINOPHEN (NORCO) 5-325 MG per
tab [71425]
50 tab, , starting 1/14/16, Normal
oxycodone-acetaMINOPHEN (PERCOCET) 5-325 MG
per tab [40668]
50 tab, , starting 1/14/16, Normal
oxycodone 5 MG tab [45976] 50 tab, , starting 1/14/16, Normal
Medications - Prescriptions - Antiemetics [132533]
ondansetron (ZOFRAN) 4 MG tab [45939] 30 tab, 0, starting 1/14/16, Normal
Medications - Prescriptions - Bowel Management [195665]
senna-docusate (SENOKOT S) 8.6-50 MG per tab -
NOTE: order if opioids are prescribed [60530]
starting 1/14/16, Normal
Medication Instructions [138575]
You may take ibuprofen (Motrin, advil, etc).
[NURCOM0022]
Routine, Some patients benefit from ibuprofen (Motrin, Advil)
600 mg (three 200 mg tablets) three times a day with food.
This drug can be taken WITH or INSTEAD OF your narcotic
medication, if there is no history of stomach/ulcer problems or
allergies to aspirin or ibuprofen. Please discuss with your
Medical Doctor if this is appropriate for you to take.
DO NOT take ibuprofen (motrin, advil, etc.).
[NURCOM0022]
Routine, Do not take ibuprofen without discussing with your
surgeon first.
No more than 4 grams of acetaminophen should be
taken in any 24 hour period [NURCOM0022]
Routine, No more than 4 grams of acetaminophen should be
taken in any 24 hour period
Page 1 of 4
Printed by GUETZLAFF, SCOTT F [SFG091] at 1/14/2016 1:58:34 PM

Copyright © 2015 University of Wisconsin Hospital and Clinics Authority, University of Wisconsin Medical Foundation, Inc, UW-Madison
Contact: Lee Vermeulen, CCKM@uwhealth.org Last Revised:



















 
01/2016Lee Vermeulen, CCKM@uwhealth.org

You may take aspirin for VTE prophylaxis
[NURCOM0022]
Routine, You may take aspirin to prevent deep vein
thrombosis. Take on 325mg aspirin, twice daily for *** weeks.
DO NOT take acetaminophen [NURCOM0022] Routine, Do not take acetaminophen without discussing with
your surgeon first.
Outpatient Discharge Orders (Discharge Instructions)
Discharge Instructions - Activity Status [134254]
Activity - Left Leg [132865]
Non-Weight Bearing [NURCOM0022] Routine
You Should Use Crutches/Walker:
You May Move Your Ankle:
You May Move Your Toes:
Weight Bear as Tolerated [NURCOM0022] Routine
You Should Use Crutches/Walker:
You May Move Your Ankle:
You May Move Your Toes:
Partial Weight Bearing, Heel Only [NURCOM0022] Routine
You Should Use Crutches/Walker:
You May Move Your Ankle:
You May Move Your Toes:
Activity - Right Leg [132865]
Non-Weight Bearing [NURCOM0022] Routine
You Should Use Crutches/Walker:
You May Move Your Ankle:
You May Move Your Toes:
Weight Bear as Tolerated [NURCOM0022] Routine
You Should Use Crutches/Walker:
You May Move Your Ankle:
You May Move Your Toes:
Partial Weight Bearing, Heel Only [NURCOM0022] Routine
You Should Use Crutches/Walker:
You May Move Your Ankle:
You May Move Your Toes:
Discharge Instructions [132846]
Activity [NURACT0008] Routine
Discharge Activity: See Instructions
• You should NOT drive if you are taking narcotics and you
should get clearance from your doctor before driving.
• Do deep calf massage and range of motion to ankle six
times daily on operative side
Diet [NURDIE0013] Routine, • You may resume your normal diet as tolerated.
• Attempt to eat small, light meals frequently throughout the
day while recovering from surgery.
• NAUSEA May be a side effect from anesthesia. Definitely a
side effect from narcotic medication taken without food!
• Do NOT drink alcohol for 24 hours after your surgery or
while taking narcotics.
Wound Care [NURWND0015] Routine, • Bleeding is normal after surgery, and can be
minimized by keeping the foot elevated. It is normal to expect
some bleeding into the bandages, and this may even soak
through to the outer layers. Reinforce dressing as needed.
DO NOT CHANGE the bandage for bleeding. If you have
excessive bleeding (dressing soaked or dripping), call the
office and ask to speak to one of the physicians. (After hours
use paging service).
• KEEP YOUR DRESSING DRY!!! If your dressing gets wet
post-operatively, you need to be seen that day or the
following morning to have it changed. You may shower only if
you can keep the dressing absolutely dry. Tape on a plastic
bag and keep it out of the direct stream of water in the
Page 2 of 4
Printed by GUETZLAFF, SCOTT F [SFG091] at 1/14/2016 1:58:34 PM

Copyright © 2015 University of Wisconsin Hospital and Clinics Authority, University of Wisconsin Medical Foundation, Inc, UW-Madison
Contact: Lee Vermeulen, CCKM@uwhealth.org Last Revised:



















 
01/2016Lee Vermeulen, CCKM@uwhealth.org

shower. Do not immerse it, even in a bag.
• If the ACE bandage is too tight, unwrap it and re-apply it
loosely. Start at the toes and wrap upward. If the dressing is
still too tight call your doctor.
• Ice and elevate your foot or ankle as much as possible for
the next 2-3 days.
• Check the circulation of your toes. (If dressing not covering
the toes.) You can check circulation by pressing your toenail
bed, which should briefly turn white when squeezed and
released, then quickly (<2 seconds) turn pink again. The toes
and foot should be warm.
• Your foot/leg may be completely numb following the surgery
if you had a nerve block. The length of time is variable. (6-24
hours) Begin taking pain medications when sensation begins
to return to the foot.
Medications at Home [NURCOM0071] Please complete in PATIENT FRIENDLY terms. This order
will appear on the patient's After Hospital Care Plan., Routine,
• Pain will vary from person to person and will depend upon
the type of surgery done.
• Pain Medications: You may receive a prescription for pain
medication upon discharge from the surgery center. Take as
directed.
IV Site [NURWND0015] Routine, • Sometimes redness, warmth, or soreness occurs at
the (IV) Intravenous site. This can be relieved by putting a
warm, wet washcloth on the site 4 times a day. Call your
Doctor/Nurse if this does not get better in 1-2 days or if gets
worse.
When to Call Your Surgeon [NURCOM0079] Please complete in PATIENT FRIENDLY terms. This order
will appear on the patient's After Hospital Care Plan.
You should include specific instructions on when and who to
call.
You should include actual provider names (i.e. not 'PCP').
You should NOT include the discharging unit as a contact.,
Routine, • Foot and/or toes are cool, blue or white in color
• Excessive swelling extending up the leg not relieved by
elevation and ice.
• Persistent pain not controlled with prescribed medications.
• Excessive, continual drainage through dressing despite ACE
wrap, ice and elevation.
• Fever over 101.5º F (by mouth) for two readings taken four
hours apart.
• Problems urinating or emptying your bladder.
Contact Information [135666]
Contact Information [NURCOM0071] Please complete in PATIENT FRIENDLY terms. This order
will appear on the patient's After Hospital Care Plan., Routine,
Your Surgeon's name is @ATTPROV@ and can be reached
at @ATTENDPH@, Monday - Friday between 8:00am and
4:30pm. After 4:30pm or on weekends please call the after
hours clinic at 262-2122.
Follow-Up Appointments [132845]
Schedule Appointment at UW Health Podiatry Clinic
[NURCOM0056]
Routine
Purpose:
With whom:
For when:
UW Health Podiatry Clinic
20 South Park
Madison, WI
(608) 287-2200
Page 3 of 4
Printed by GUETZLAFF, SCOTT F [SFG091] at 1/14/2016 1:58:34 PM

Copyright © 2015 University of Wisconsin Hospital and Clinics Authority, University of Wisconsin Medical Foundation, Inc, UW-Madison
Contact: Lee Vermeulen, CCKM@uwhealth.org Last Revised:



















 
01/2016Lee Vermeulen, CCKM@uwhealth.org

Schedule Appointment at 1 South Park - Foot and Ankle
[NURCOM0056]
Routine
Purpose:
With whom:
For when:
1 South Park
Madison, WI
(608) 287-2700
Schedule Appointment - Other [NURCOM0056] Routine
Purpose:
With whom:
For when:
Follow-up Appointment Established [NURCOM0022] Routine
Page 4 of 4
Printed by GUETZLAFF, SCOTT F [SFG091] at 1/14/2016 1:58:34 PM

Copyright © 2015 University of Wisconsin Hospital and Clinics Authority, University of Wisconsin Medical Foundation, Inc, UW-Madison
Contact: Lee Vermeulen, CCKM@uwhealth.org Last Revised:



















 
01/2016Lee Vermeulen, CCKM@uwhealth.org