/clinical/,/clinical/cckm-tools/,/clinical/cckm-tools/content/,/clinical/cckm-tools/content/order-sets/,/clinical/cckm-tools/content/order-sets/ambulatory/,/clinical/cckm-tools/content/order-sets/ambulatory/plastics/,

/clinical/cckm-tools/content/order-sets/ambulatory/plastics/name-98533-en.cckm

201712342

page

100

UWHC,UWMF,

Tools,

Clinical Hub,UW Health Clinical Tool Search,UW Health Clinical Tool Search,Order Sets,Ambulatory,Plastics

OP – Plastic Surgery – Body – Adult – Postoperative [5221]

OP – Plastic Surgery – Body – Adult – Postoperative [5221] - Clinical Hub, UW Health Clinical Tool Search, UW Health Clinical Tool Search, Order Sets, Ambulatory, Plastics


OP - Plastic Surgery - Body - Adult - Postoperative [5221]
Post Op/Phase II
Medications - Non-Opioid (Oral) PRN [200904]
acetaMINOPHEN (TYLENOL) tab [34149] 650 mg, Oral, ONCE PRN For 1 Doses, pain
See Pain Management Algorithm for the Selection of
As-Needed Analgesics
Post-Op/Phase II
Medications - Opioid (Oral) PRN (Single Response) [143579]
oxycodone-acetaMINOPHEN (PERCOCET)
5-325 MG per tab [40668]
1 tab, Oral, ONCE PRN For 1 Doses, pain
See Pain Management Algorirthm for the Selection of
As-Needed Analgesic
No more than 4 grams acetaminophen per 24 hours
for adults or 15mg/kg per dose for peds <40kg.
Post-Op/Phase II
hydrocodone-acetaMINOPHEN (NORCO) 5-325
MG per tab [71425]
1 tab, Oral, ONCE PRN For 1 Doses, pain
See Pain Management Algorirthm for the Selection of
As-Needed Analgesic
No more than 4 grams acetaminophen per 24 hours
for adults or 15mg/kg per dose for peds <40kg.
Post-Op/Phase II
oxycodone tab [45976] 5 mg, Oral, ONCE PRN For 1 Doses, pain
See Pain Management Algorirthm for the Selection of
As-Needed Analgesic
Post-Op/Phase II
Anti-emetics [200905]
ondansetron (ZOFRAN ODT) disintegrating tab
[64224]
4 mg, Oral, ONCE PRN For 1 Doses, nausea/vomiting
Use first line
Post-Op/Phase II
ondansetron (ZOFRAN) injection [800202] 4 mg, Intravenous, ONCE PRN For 1 Doses,
nausea/vomiting
Use first line if unable to take medications by mouth or
enteral tube OR if immediate effect is needed
Post-Op/Phase II
Patient Care Instructions [143585]
Vital Signs [NURMON0013] SEE COMMENTS, Routine
Temperature Measurement Method:
Temperature Measurement Restrictions:
BP Source:
BP Location:
BP Position:
BP Restrictions:
Every 1-2 hours until discharge, Post-Op/Phase II
Discharge IV When Tolerating By Mouth / Prior to
Discharge [NURTAD0046]
ONCE
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:
Prior to Discharge [143580]
Page 1 of 9
Printed by BENNETT, SARA J [SJB008] at 12/8/2017 9:21:12 AM
Copyright © 2017 University of Wisconsin Hospitals and Clinics Authority
Contact: Lee Vermeulen, CCKM@uwhealth.org Last Revised:
 
12/2017CCKM@uwhealth.org

Patient Must Be Seen by Attending Prior to
Discharge [NURMON0083]
ONCE, Starting today For 1 Occurrences, Routine,
Post-Op/Phase II
Patient Must Be Seen by Resident Prior to
Discharge [NURMON0082]
ONCE, Starting today For 1 Occurrences, Routine,
Post-Op/Phase II
Patient Must Void Prior to Discharge
[NURMON0081]
ONCE, Starting today For 1 Occurrences, Routine,
Post-Op/Phase II
Outpatient Discharge Orders
Medications-Prescriptions-Non-Opioids (Oral) Scheduled [200906]
acetaMINOPHEN (TYLENOL) 325 MG tab - 2t
q6h x7d [34149]
650 mg, starting 12/8/17 until 12/15/17, Normal,
Phase II Discharge
naproxen (NAPROSYN) 500 MG tab - 1t 2x/d x7d
[40052]
500 mg, 0, starting 12/8/17 until 12/15/17, Normal,
Phase II Discharge
Medications - Prescriptions - Opioid (Oral) PRN (Single Response) [143581]
oxycodone 5 MG tab - 1t q4hprn #5 [45976] 5 mg, 5 tab, 0, starting 12/8/17, Normal, Phase II
Discharge
oxycodone 5 mg tab - 1-2t q4hprn #15 [45976] 5-10 mg, 15 tab, 0, starting 12/8/17, Normal, Phase II
Discharge
oxycodone 5 mg tab - 1-2t q4hprn #25 [45976] 5-10 mg, 25 tab, 0, starting 12/8/17, Normal, Phase II
Discharge
Medications - Prescriptions - Bowel Management [143582]
senna-docusate (SENOKOT-S) 8.6-50 mg per tab
[60530]
2 tab, 30 tab, 0, starting 12/8/17, Normal, Phase II
Discharge
docusate sodium (COLACE) cap [36857] 100 mg, 30 cap, 0, starting 12/8/17, Normal, Phase II
Discharge
polyethylene glycol (MIRALAX) oral powder
[61353]
17 g, starting 12/8/17, Normal, Phase II Discharge
Medications - Prescriptions - Anti-infectives [143583]
cephalexin (KEFLEX) 250 mg cap - 4x/d-7d
[44594]
500 mg, 28 cap, 0, starting 12/8/17 until 12/15/17,
Normal, Phase II Discharge
amoxicillin-clavulanate (AUGMENTIN) 875-125
MG per tab - 2x/d x7d [70053]
1 tab, 0, starting 12/8/17 until 12/15/17, Normal,
Phase II Discharge
clindamycin (CLEOCIN) 300 MG cap - 3x/d x7d
[44723]
300 mg, starting 12/8/17 until 12/15/17, Normal,
Phase II Discharge
Medications - Prescriptions - Non-categorized [141907]
methylprednisolone 4 MG tab pack [170928] 1 each, 0, starting 12/8/17, Normal, Phase II
Discharge
diazepam (VALIUM) 5 mg tab - q6-8hp #12
[36679]
5 mg, 12 tab, 0, starting 12/8/17, Normal, Phase II
Discharge
ondansetron (ZOFRAN) tab [45939] 4 mg, 10 tab, 0, starting 12/8/17, Normal, Phase II
Discharge
Discharge Instructions - Procedure Specific [143573]
Abdominoplasty [143586]
Page 2 of 9
Printed by BENNETT, SARA J [SJB008] at 12/8/2017 9:21:12 AM
Copyright © 2017 University of Wisconsin Hospitals and Clinics Authority
Contact: Lee Vermeulen, CCKM@uwhealth.org Last Revised:
 
12/2017CCKM@uwhealth.org

Activity - Abdominoplasty [NURACT0008] Routine
Discharge Activity:
• Wear the abdominal binder (or girdle) for 2 weeks
or until instructed differently by your surgeon. You
may remove the binder only to shower.
• You may experience some dizziness the first time
you take the garment off. You need to have
someone with you. Take the garment off slowly while
sitting down.
• You should have someone help you when you get
out of bed the first few times.
• You may be walking slowly and bent over at the
waist to start with, this is very common. You will
slowly begin to walk more upright over the next
week.
• You may find that you tire quickly. You should walk
around your house and have planned rest periods.
• No heavy lifting (>15lbs.), sports or strenuous
activity for 2-3 weeks.
• No driving or operating heavy machinery for the
next 24 hours or while on narcotics.
• Wear loose fitting clothing for a few days.
• Do not tub bath, swim or whirlpool for 2 weeks.
• Pain/Discomfort is common after this surgery and
will last up to a week. You may also have some
numbness and tingling in your hands and fingers for
the next few days., Phase II Discharge
Diet - Abdominoplasty [NUT8888] Routine
General:
Diet Modifications:
Other Diet Modifications:
Eat small well balanced meals, and drink plenty of
fluids. DO NOT drink alcoholic beverages for the first
2 days, or while taking pain medication.
Wound Care - Abdominoplasty [NURWND0015] Routine, - You may have “drains” or tubes placed
during surgery to drain away excess fluid from your
abdomen. The fluid will collect in a bulb attached to
the tube. This drain will stay in for a short while.
Record the amount of drainage from the drains and
bring the results with you to your clinic visit. You
MAY shower with the tubes in.
- You may shower in 24 hours.
- Remove dressings in 24 hours before showering. If
you notice a large steri-strip over the incision, leave
this in place until this falls off on its own. Put a thin
layer of bacitracin over the incision twice daily for
one week. You may need to use gauze bandages
over the incisions for a few days until the incisions
stop weeping. Once incisions are dry, you do not
need to use bandages.
Page 3 of 9
Printed by BENNETT, SARA J [SJB008] at 12/8/2017 9:21:12 AM
Copyright © 2017 University of Wisconsin Hospitals and Clinics Authority
Contact: Lee Vermeulen, CCKM@uwhealth.org Last Revised:
 
12/2017CCKM@uwhealth.org

Medications at Home - Abdominoplasty
[NURCOM0071]
Please complete in PATIENT FRIENDLY terms.
This order will appear on the patient's After Hospital
Care Plan., Routine, • You may resume your routine
medications unless instructed differently by your
surgeon.
• You have been given a prescription for pain
medication. Usually the first 1 or 2 days are the most
uncomfortable; we suggest taking the pain
medication as ordered. ALSO, remember that you
must not drive while you are taking this medication.
• Most narcotic pain medications may cause
constipation. We recommend that you take a daily
stool softener (ie. Docusate sodium) while taking the
pain medication. If you continue to have problems
with constipation you may also try a dulcolax
suppository or Miralax daily until you are able to
move your bowels. All of these medications may be
purchased without a prescription at your local
pharmacy. Increasing your fluid intake and activity
level may also help.
Arm Lift [143587]
Activity - Arm Lift [NURACT0008] Routine
Discharge Activity:
• You need to rest for the next 48 hours. Keep your
arms elevated above your heart as much as
possible. Most people feel more comfortable to have
someone stay with them the first few days after
surgery.
• No driving or operating heavy machinery for the
next 24 hours or while on narcotics.
• Avoid strenuous activity. At the end of the first
week you may begin to gradually increase your
activity. Avoid lifting more than 10 lbs for 3-4 weeks.
No sports or strenuous activities for 3-4 weeks.
• Pain/Discomfort is common after this surgery and
will last up to a week. You may also have some
numbness and tingling in your hands and fingers for
the next few days., Phase II Discharge
Diet - Arm Lift [NUT8888] Routine
General:
Diet Modifications:
Other Diet Modifications:
It is recommended that you eat a balanced diet and
drink plenty of fluids.
Page 4 of 9
Printed by BENNETT, SARA J [SJB008] at 12/8/2017 9:21:12 AM
Copyright © 2017 University of Wisconsin Hospitals and Clinics Authority
Contact: Lee Vermeulen, CCKM@uwhealth.org Last Revised:
 
12/2017CCKM@uwhealth.org

Medications at Home - Arm Lift [NURCOM0071] Please complete in PATIENT FRIENDLY terms.
This order will appear on the patient's After Hospital
Care Plan., Routine, • You may resume your routine
medications unless instructed differently by your
surgeon.
• You have been given a prescription for pain
medication. Usually the first 1 or 2 days are the most
uncomfortable; we suggest taking the pain
medication as ordered. ALSO, remember that you
must not drive while you are taking this medication.
• Most narcotic pain medications may cause
constipation. We recommend that you take a daily
stool softener (ie. Docusate sodium) while taking the
pain medication. If you continue to have problems
with constipation you may also try a dulcolax
suppository or Miralax daily until you are able to
move your bowels. All of these medications may be
purchased without a prescription at your local
pharmacy. Increasing your fluid intake and activity
level may also help.
Wound Care - Arm Lift [NURWND0015] Routine, • Remove dressings in 24 hours before
showering. If you notice a large steri-strip over the
incision leave this in place until this falls off on its
own. Put a thin layer of bacitracin or vaseline over
the incision twice daily for one week. You may need
to use gauze bandages over the incisions for a few
days until the incisions stop weeping. Once incisions
are dry you do not need to use gauze bandages.
• You must not soak in the bathtub, whirlpool, or
swimming pool for the next 2-3 weeks or until the
incisions have completely healed.
• You will wear the arm compression wraps for 2
weeks to keep the swelling and bruising to a
minimum. You may take compression wraps off
during a shower and reapply afterward, but do not
wrap too tight. If you notice swelling, numbness,
tingling or an increase in pain, take the wrap off and
call the number listed on your Discharge Instructions
• Your scar will be long and may be slow to heal: it is
not unusual to have scabbing along the scar for
several weeks and fluid under the skin.
• Your arms will be swollen for about 3-4 weeks.
Your final result will not be totally complete for 3-6
months.
• An ice pack can be applied to the incision site once
per hour for 10 minutes each time to help reduce
swelling and discomfort.
• You may have drain tubes placed during surgery to
drain away excess fluid from the arms. Record the
amount of drainage and bring the results with you to
the clinic on the day drains are removed.
Liposuction [143588]
Page 5 of 9
Printed by BENNETT, SARA J [SJB008] at 12/8/2017 9:21:12 AM
Copyright © 2017 University of Wisconsin Hospitals and Clinics Authority
Contact: Lee Vermeulen, CCKM@uwhealth.org Last Revised:
 
12/2017CCKM@uwhealth.org

Activity - Liposuction [NURACT0008] Routine
Discharge Activity:
• No driving or operating heavy machinery for the
next 24 hours or while on narcotics.
• Plan to be off work for about 1 week after surgery.
• Plan activities that do not require a lot of standing
or lifting.
• You will have bruising and swelling that may last for
1-2 months.
• No tub baths, swimming or whirlpools for 7 days.
• An ice pack can be applied to the incision site once
per hour for 10 minutes each time to help reduce
swelling and discomfort.
• Plan rest periods throughout the day for the first
couple of weeks.
• Do not do strenuous activities/ exercise for 2-3
weeks or until approved by you doctor. (Usually
about 3 weeks)
• Limit lifting to less than 15 pounds for 2 weeks.
• Do not cross your legs or sit for more than 1 hour in
the same position.
• Do not fly for 10 days.
Pressure Garment (Girdle, Binder):
• You must wear your pressure garment for two
weeks after surgery.
• You may remove the garment to shower. Wear the
garment again after your shower.
• The garment has special openings for elimination.
• You may feel dizzy the first time you take your
garment off. Have someone with you. Take the
pressure garment off slowly while sitting. After
removal, wear loose comfortable clothing., Phase II
Discharge
Wound Care - Liposuction [NURWND0015] Routine, • It is not uncommon to see a large amount
of pinkish watery drainage from your incisions. If it
becomes a more concentrated red drainage, you
should call the doctor.
The suctioned areas will be swollen and bruised, and
you may feel some burning. The bruises may get
worse for 1-2 days and last for several weeks. The
swelling may last for 3 months. This is NORMAL.
Please be patient as it may take 3 months to see
your final results.
Diet - Liposuction [NUT8888] Routine
General:
Diet Modifications:
Other Diet Modifications:
• Do not drink alcohol for 24 hours after your surgery
or while taking narcotics.
• You may resume your normal diet as tolerated. Be
sure to drink 8- 10 glasses (8 oz.) of fluid daily to
promote healing.
Page 6 of 9
Printed by BENNETT, SARA J [SJB008] at 12/8/2017 9:21:12 AM
Copyright © 2017 University of Wisconsin Hospitals and Clinics Authority
Contact: Lee Vermeulen, CCKM@uwhealth.org Last Revised:
 
12/2017CCKM@uwhealth.org

Medications at Home - Liposuction
[NURCOM0071]
Please complete in PATIENT FRIENDLY terms.
This order will appear on the patient's After Hospital
Care Plan., Routine, • You may resume your routine
medications unless instructed differently by your
surgeon.
• You will have pain medicine ordered by your
doctor. Take as directed by your pharmacist.
Remember: do not drive while taking narcotic pain
medication.
• Most narcotic pain medications may cause
constipation. We recommend that you take a daily
stool softener (i.e., Docusate sodium) while taking
the pain medication. If you continue to have
problems with constipation, you may also try a
dulcolax suppository or Miralax daily until you are
able to move your bowels. All of these medications
may be purchased without a prescription at your
local pharmacy. Increasing your fluid intake and
activity level may also help.
Thighplasty [142424]
Activity - Thighplasty [NURACT0008] Routine
Discharge Activity:
• You need to rest for the next 24-48 hours. Keep
your legs elevated as much as possible. Most people
feel more comfortable to have someone stay with
them the first few days after surgery.
• An ice pack can be applied to the incision site once
per hour for 10 minutes each time to help reduce
swelling and discomfort.
• No driving or operating heavy machinery for the
next 24 hours or while on narcotics.
• You may have some numbness and tingling in your
legs and feet for the next few days. This is normal.
• Avoid strenuous activity. At the end of the first
week you may gradually increase your activity. After
about 2 weeks you may increase your activity but
you must not do any heavy lifting (anything more that
10 pounds.) or vigorous activity until instructed by
your surgeon (usually 3-4 weeks).
• Your legs will be swollen for about 3-4 weeks. Your
final result will not be totally complete for 3-6
months., Phase II Discharge
Diet - Thighplasty [NUT8888] Routine
General:
Diet Modifications:
Other Diet Modifications:
It is recommended that you eat a balanced diet and
drink plenty of fluids.
Wound Care - Thighplasty [NURWND0015] Routine, - You may shower in 48 hours. You must
not soak in the bathtub, whirlpool, or swimming pool
for the next 3-4 weeks and at least until incisions are
completely healed and dry.
- Your scar will be long and it may be slow to heal; it
is not unusual to have scabbing along the scar for
several weeks and fluid under the skin.
Page 7 of 9
Printed by BENNETT, SARA J [SJB008] at 12/8/2017 9:21:12 AM
Copyright © 2017 University of Wisconsin Hospitals and Clinics Authority
Contact: Lee Vermeulen, CCKM@uwhealth.org Last Revised:
 
12/2017CCKM@uwhealth.org

Medications at Home - Thighplasty
[NURCOM0071]
Please complete in PATIENT FRIENDLY terms.
This order will appear on the patient's After Hospital
Care Plan., Routine, • You have been given a
prescription for pain medication. You will have some
pain and discomfort for a few days. Please take the
pain medication as directed for comfort.
• Most narcotic pain medications may cause
constipation. We recommend that you take a daily
stool softener (i.e., Docusate sodium) while taking
the pain medication. If you continue to have
problems with constipation, you may also try a
dulcolax suppository or Miralax daily until you are
able to move your bowels. All of these medications
may be purchased without a prescription at your
local pharmacy. Increasing your fluid intake and
activity level may also help.
Other Wound Care Instructions [143589]
J-P Drain Instructions [NURWND0080] Routine
IV Site Care [NURWND0015] Routine, Sometimes redness, warmth, or soreness
occurs at the Intravenous (IV) 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 it gets worse.
Discharge - Suture Line Care [DC0021] Routine, Patient has (select all that apply): {Select
type(s):4001480}
Leave original surgical dressing on for: *** or until MD
follow-up.
Keep incision completely dry (shower only with
waterproof covering) for *** or until MD follow-up.
Other: ***
Other Patient Care Instructions [143592]
Surgery and Smoking [NURCOM0071] Please complete in PATIENT FRIENDLY terms. This
order will appear on the patient's After Hospital Care
Plan., Routine, Research and experience with
smoking patients have shown the supply of blood to
small capillaries in the tissue is reduced, so the risk of
bad healing, failure to heal, or even death of some
tissue, increased scarring or other complication
increases.
When to Call Your Doctor [143593]
Page 8 of 9
Printed by BENNETT, SARA J [SJB008] at 12/8/2017 9:21:12 AM
Copyright © 2017 University of Wisconsin Hospitals and Clinics Authority
Contact: Lee Vermeulen, CCKM@uwhealth.org Last Revised:
 
12/2017CCKM@uwhealth.org

When to Call Your Doctor [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, -Excessive bleeding.
- Persistent nausea and vomiting.
- Pain not relieved with pain medication.
- Fever over 100.5º F (by mouth) for two readings
taken four hours apart.
- Problems urinating or emptying your bladder.
- Incisions or drain sites become more painful,
swollen, red and/or feel warmer than usual.
- Severe Chest Pain or Shortness of Breath - Call 911.
Contact Information [143584]
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 hours, please call the same
number listed above and you will be directed to the
paging operater who will contact the Resident on call.
Follow Up Appointments [142234]
Patient to Schedule Appointment [NURCOM0056] Routine
Purpose:
With whom:
For when:
Page 9 of 9
Printed by BENNETT, SARA J [SJB008] at 12/8/2017 9:21:12 AM
Copyright © 2017 University of Wisconsin Hospitals and Clinics Authority
Contact: Lee Vermeulen, CCKM@uwhealth.org Last Revised:
 
12/2017CCKM@uwhealth.org