/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-98535-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 - Face - Adult - Postoperative [5216]

OP - Plastic Surgery - Face - Adult - Postoperative [5216] - Clinical Hub, UW Health Clinical Tool Search, UW Health Clinical Tool Search, Order Sets, Ambulatory, Plastics


OP - Plastic Surgery - Face - Adult - Postoperative [5216]
PostOp/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
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
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 15
Printed by BENNETT, SARA J [SJB008] at 12/8/2017 9:20:05 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 [142715]
Blepharoplasty [142244]
Activity - Blepharoplasty [NURACT0008] Routine
Discharge Activity:
-It is important that you stay quiet and do little talking
for the first 24 hours; excess movement may cause
bleeding.
-No strenuous activity for 1-2week(s).
-No lifting greater than 15 pounds for 1 week.
-No driving or operating heavy machinery for the
next 24 hours or while on narcotics., Phase II
Discharge
Page 2 of 15
Printed by BENNETT, SARA J [SJB008] at 12/8/2017 9:20:05 AM
Copyright © 2017 University of Wisconsin Hospitals and Clinics Authority
Contact: Lee Vermeulen, CCKM@uwhealth.org Last Revised:
 
12/2017CCKM@uwhealth.org

Diet - Blepharoplasty [NUT8888] Routine
General:
Diet Modifications:
Other Diet Modifications:
-You may resume your normal diet as tolerated.
-For the next 48 hours, do not have any alcoholic
drinks, beer and wine included. They do not mix
with the anesthesia and may make you sick.
Wound Care - Blepharoplasty [NURWND0015] Routine, -Use iced gauze pads to help reduce
swelling and discomfort. When you arrive home, put
gauze pads/ washcloth in a bowl of ice water. Place
a cold gauze pad on each eye, then place iced eye
compress over gauze pad. Change pads as needed
to keep them cold (about every 10 to 20 minutes).
Continue this until bedtime for 2 days.
-Apply ophthalmic ointment to incisions as
instructed.
-When you sleep, prop your head up on three or
more pillows (sleeping in a recliner works well too).
Keeping your head above your heart will help
decrease soreness and swelling.
-Once in the middle of your first night home, you or
someone else should check your incisions. Call your
doctor if you notice excess bleeding or swelling or
decreased vision in your eyes.
Medications at Home - Blepharoplasty
[NURCOM0071]
Please complete in PATIENT FRIENDLY terms.
This order will appear on the patient's After Hospital
Care Plan., Routine, -Take your medicine as
ordered. Do not take any aspirin or anti-
inflammatory products until your doctor approves it.
Brow Lift [146347]
Page 3 of 15
Printed by BENNETT, SARA J [SJB008] at 12/8/2017 9:20:05 AM
Copyright © 2017 University of Wisconsin Hospitals and Clinics Authority
Contact: Lee Vermeulen, CCKM@uwhealth.org Last Revised:
 
12/2017CCKM@uwhealth.org

Activity - Brow Lift [NURACT0008] Routine
Discharge Activity:
-Keep your head elevated for at least the first week.
This requires using pillows, etc., or actual elevation
of the head of the bed or mattress. (Sleeping in a
recliner also works well.) Do not engage in activities
where you bend over, making you head lower than
your heart. Bend at the knees and squat down
instead of bending over at the waist.
-Engage in only sedate activity for the first few days.
It is not necessary to stay in bed during this time. To
get out of bed, roll on your side first and push up with
your arms.
-No driving for 48 hours or while you are taking pain
medication.
-Do not fly for 1 week following surgery
-Do not lift more than 15 lbs for 2 weeks.
-Generally, there should be no rigorous exercise for
one month following surgery. Walking daily is
acceptable.
-No tub baths, swimming or whirlpool for 2 weeks.
-When we see you after surgery, we will tell you
when you can take a shower and shampoo your hair
with any mild shampoo, such as Johnson's Baby
Shampoo. There may be clotted blood in your hair,
most of which will come out with the first shower and
shampoo, but may require 2 or more shampoos. The
entire head can be shampooed, but it should be
done very gently in the area of the stitches and
staples. It is best to face away from the showerhead.
Use only the COOL setting on a hairdryer.
-You may wish to bring a scarf to cover your hair the
day the dressing is removed.
-You must not go into the sun for 2 weeks following
surgery.
-Do not apply any makeup or lotions to your face
during the first week., Phase II Discharge
Diet - Brow Lift [NUT8888] Routine
General:
Diet Modifications:
Other Diet Modifications:
-It is best to eat a soft diet for the first week, such as
things that don't require much chewing.
Wound Care - Brow Lift [NURWND0015] Routine, -Do not be alarmed by the swelling and
bruising of the face. This will increase for the first 48
hours and then very slowly decrease over the next
two weeks.
-It is normal for your face, neck or ears to feel weak
or numb after surgery. This will resolve over the
next few weeks.
-Cold compresses should be applied to your eyes for
the first 48 hours after surgery to help minimize the
bruising and swelling.
Page 4 of 15
Printed by BENNETT, SARA J [SJB008] at 12/8/2017 9:20:05 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 - Brow Lift [NURCOM0071] Please complete in PATIENT FRIENDLY terms.
This order will appear on the patient's After Hospital
Care Plan., Routine, -Take your pain medications as
scheduled for the first 48 hours. The medication can
then be used on an as needed basis.
-You may be prescribed a low-dose steroid to help
reduce swelling. Start taking this the day after
surgery as directed.
-If antibiotics have been prescribed, take them as
directed. These should start the day after surgery.
-You may resume taking your routine medications
when you arrive home unless you have been
instructed differently by your surgeon
Derm Abrasion [143602]
Activity - Dermabrasion [NURACT0008] Routine
Discharge Activity:
-It is not necessary to stay in bed.
-May shower in *** hours., Phase II Discharge
Diet - Dermabrasion [NUT8888] Routine
General:
Diet Modifications:
Other Diet Modifications:
-You may resume your normal diet as tolerated.
Wound Care - Dermabrasion [NURWND0015] Routine, -Oozing of clear, yellow or bloody drainage
is to be expected for the first 24 hours. This is
normal.
-You may use Bacitracin, or Neosporin antibiotic
ointment on dermabrasion area 4 times daily. Apply
the ointment well to cover all areas treated.
-After all areas are healed and oozing has stopped,
apply Lubriderm lotion. This should occur in about 7
to 10 days. Apply a thin film 4 times daily after
washing. You may continue with antibiotic ointment
at bedtime.
-If you have any unusual rash or skin irritation,
please discontinue all topical medications and
contact our office.
-After all skin areas are healed, normal washing of
your face should be followed by Vitamin E or Cocoa
Butter. Gently rub into skin.
Medications at Home - Dermabrasion
[NURCOM0071]
Please complete in PATIENT FRIENDLY terms.
This order will appear on the patient's After Hospital
Care Plan., Routine, -Take the Valtrex prescription
given to you.
Face Lift [143596]
Page 5 of 15
Printed by BENNETT, SARA J [SJB008] at 12/8/2017 9:20:05 AM
Copyright © 2017 University of Wisconsin Hospitals and Clinics Authority
Contact: Lee Vermeulen, CCKM@uwhealth.org Last Revised:
 
12/2017CCKM@uwhealth.org

Activity - Face Lift [NURACT0008] Routine
Discharge Activity:
-Keep your head elevated for at least the first week.
This requires using pillows, etc., or actual elevation
of the head of the bed or mattress. (Sleeping in a
recliner also works well.) Do not engage in activities
where you bend over, making you head lower than
your heart. Bend at the knees and squat down
instead of bending over at the waist.
-Do not lift more than 15 lbs for 2 weeks.
-Generally, there should be no heavy exercise for
one month following surgery.
-Engage in only sedate activity for the first few days.
It is not necessary to stay in bed during this time. To
get out of bed, roll on your side first and push up with
your arms.
-No driving or operating heavy machinery for the
next 24 hours or while on narcotics.
-You will be seen at the office for removal of
dressings, and possibly for drain removal.
-When we see you after surgery, we will tell you
when you can take a shower and shampoo your hair
with any mild shampoo, such as Johnson's Baby
Shampoo. There may be clotted blood in your hair,
most of which will come out with the first shower and
shampoo, but may require 2 or more shampoos. The
entire head can be shampooed, but it should be
done very gently in the area of the stitches and
staples. It is best to face away from the showerhead.
Use only the COOL setting on a hairdryer.
-You may wish to bring a scarf to cover your hair the
day the dressing is removed.
-You must not go into the sun for 2 weeks following
surgery.
-Do not apply any makeup or lotions to your face
during the first week., Phase II Discharge
Diet - Face Lift [NUT8888] Routine
General:
Diet Modifications:
Other Diet Modifications:
-It is best to eat a softer diet for the first week, such
as things that don't require heavy chewing.
Page 6 of 15
Printed by BENNETT, SARA J [SJB008] at 12/8/2017 9:20:05 AM
Copyright © 2017 University of Wisconsin Hospitals and Clinics Authority
Contact: Lee Vermeulen, CCKM@uwhealth.org Last Revised:
 
12/2017CCKM@uwhealth.org

Wound Care - Face Lift [NURWND0015] Routine, -Do not be alarmed by the swelling and
bruising of the face. This will increase for the first 36
hours and then very slowly decrease in the next two
weeks.
-It is normal for your face, neck or ears to feel weak
or numb after surgery. This will resolve over the
next few weeks.
-Cold compresses should be applied to your face
and neck for the first 48 hours after surgery to help
minimize the bruising and swelling.
-You will be provided with a Velcro removable
dressing that I would like you to wear for 1 week
(day and night). After that it can worn if comfortable
but is not required.
-When the drain is removed you should apply the
anti-biotic ointment to the incision lines around your
ears and under your chin. This should be done for 7
days.
-You may wish to bring a scarf to cover your hair the
day the dressing is removed.
-Avoid direct sun exposure for 2 weeks following
surgery.
-Do not apply any makeup or lotions to your face
during the first week.
-If you have a drain you will be instructed on how to
care for it by the nursing staff.
-If the drain stops functioning please call the OR and
they will instruct you on how to milk the drain.
Medications at Home - Face Lift [NURCOM0071] Please complete in PATIENT FRIENDLY terms.
This order will appear on the patient's After Hospital
Care Plan., Routine, -Take your pain medications as
scheduled for the first 48 hours. The medication can
then be used on an as needed basis.
-You may be prescribed a low-dose steroid to help
reduce swelling. This medication should be started
the day after surgery.
-If antibiotics have been prescribed, take them as
directed. These should start the day after your
surgery.
-You may resume taking your routine medications
when you arrive home unless you have been
instructed differently by your surgeon.
Otoplasty [143608]
Page 7 of 15
Printed by BENNETT, SARA J [SJB008] at 12/8/2017 9:20:05 AM
Copyright © 2017 University of Wisconsin Hospitals and Clinics Authority
Contact: Lee Vermeulen, CCKM@uwhealth.org Last Revised:
 
12/2017CCKM@uwhealth.org

Activity - Otoplasty [NURACT0008] Routine
Discharge Activity:
-Do not pull on your ears.
-No driving or operating heavy machinery for the
next 24 hours or while on narcotics.
-Sleep with your head elevated for 2-3 weeks.
-For 4-6 weeks, wear a stocking cap or headband to
protect your ears.
-Be careful when pulling clothing over your head.
You may prefer to wear shirts and blouses that
button up the front.
-Do not wear earrings for 3 weeks after surgery.
-Glasses should be placed with care. Do not let your
glasses rest on the suture line. Try to place them so
they rest in the hairline.
-You may return to work within 2-3 days if you feel
strong enough., Phase II Discharge
Diet - Otoplasty [NUT8888] Routine
General:
Diet Modifications:
Other Diet Modifications:
-You may resume your normal diet as tolerated
-Do not drink alcoholic beverages. They do not mix
well with the medication you have received and
could make you very sick.
Wound Care - Otoplasty [NURWND0015] Routine, -A bulky bandage will be wrapped around
your head to cover your ears. Leave the bandage on
until your clinic visit. Do not shower or get this
bandage wet. If the bandage is very loose or very
tight, call the doctor.
-When the bandage is first removed, the ears may
seem to be overcorrected or too close to the head.
This is normal. The ears will begin to take their new
position within a few days to weeks.
-There may be some drainage from the suture lines
for 2-3 days. Nondissolvable sutures will be removed
10-12 days following surgery.
-After your sutures are removed, you may shampoo
your hair as usual. If you normally use a hair dryer,
be sure it is on the cool setting.
Medications at Home - Otoplasty
[NURCOM0071]
Please complete in PATIENT FRIENDLY terms.
This order will appear on the patient's After Hospital
Care Plan., Routine, -The amount of discomfort you
may feel varies from person to person. Pain
medication may be ordered for you to take at home.
Facial Flaps and Grafts [143609]
Page 8 of 15
Printed by BENNETT, SARA J [SJB008] at 12/8/2017 9:20:05 AM
Copyright © 2017 University of Wisconsin Hospitals and Clinics Authority
Contact: Lee Vermeulen, CCKM@uwhealth.org Last Revised:
 
12/2017CCKM@uwhealth.org

Activity - Reconstructive Facial Flaps and Grafts
[NURACT0008]
Routine
Discharge Activity:
-Keep your head elevated for at least the first week.
This requires using pillows, etc., or actual elevation
of the head of the bed or mattress. (Sleeping in a
recliner also works well.) Do not engage in activities
where you bend over, making you head lower than
your heart. Bend at the knees and squat down
instead of bending over at the waist.
-Do not lift more than 10 lbs for 2 weeks.
-Generally, there should be no exercise for one
month following surgery.
-Engage in only sedate activity for the first few days.
It is not necessary to stay in bed during this time. To
get out of bed, roll on your side first and push up with
your arms.
-It is normal for your flap or graft to feel weak or
numb after surgery. This will resolve over the next
few weeks.
-No driving or operating heavy machinery for the
next 24 hours or while on narcotics.
-Please refrain from tobacco and nicotine
replacement for at least 2 weeks before and after
surgery.
-You will be seen at the office for removal of
dressings, and possibly for drain removal.
-When we see you after surgery, we will tell you
when you can take a shower and shampoo your hair
with any mild shampoo, such as Johnson's Baby
Shampoo. There may be clotted blood in your hair,
most of which will come out with the first shower and
shampoo, but may require 2 or more shampoos. The
entire head can be shampooed, but it should be
done very gently in the area of the stitches and
staples. It is best to face away from the showerhead.
Use only the COOL setting on a hairdryer if your flap
or graft is near the hairline.
-Do not apply any makeup or lotions to your face
during the first week.
-Avoid sun exposure to your flap/ graft site for at
least 3 months., Phase II Discharge
Diet - Reconstructive Facial Flaps and Grafts
[NUT8888]
Routine
General:
Diet Modifications:
Other Diet Modifications:
-It is best to eat a soft diet for the first week, such as
things that don't require much chewing. Avoid spicy
or thermal hot foods which can cause flushing.
Wound Care - Reconstructive Facial Flaps and
Grafts [NURWND0015]
Routine, -Your flap or graft may appear pink,
purplish or dusky. There may be some exposed
tissue covered by Vaseline or other moist dressing.
-Keep area clean and dry. Change dressing as
directed by your surgeon.
Page 9 of 15
Printed by BENNETT, SARA J [SJB008] at 12/8/2017 9:20:05 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 - Reconstructive Facial
Flaps and Grafts [NURCOM0071]
Please complete in PATIENT FRIENDLY terms.
This order will appear on the patient's After Hospital
Care Plan., Routine, -Take your pain medications as
scheduled for the first 48 hours. The medication can
then be used on an as needed basis.
-You may be prescribed a low-dose steroid to help
reduce swelling. This medication should be started
the day after surgery.
-If antibiotics have been prescribed, take them as
directed. These should start the day after your
surgery.
-You may resume taking your routine medications
when you arrive home unless you have been
instructed differently by your surgeon.
Rhinoplasty [143610]
Page 10 of 15
Printed by BENNETT, SARA J [SJB008] at 12/8/2017 9:20:05 AM
Copyright © 2017 University of Wisconsin Hospitals and Clinics Authority
Contact: Lee Vermeulen, CCKM@uwhealth.org Last Revised:
 
12/2017CCKM@uwhealth.org

Activity - Rhinoplasty [NURACT0008] Routine
Discharge Activity:
-Do NOT hit or move any portions of your nose or
packing.
-Do NOT use a straw. This can create suction in the
back of your throat, which could cause a higher risk
of bleeding or swelling.
-You will be breathing through your mouth until the
swelling is resolved. This may cause some dryness
and irritation in your mouth and throat. Use a
humidifier or vaporizer along with brushing your
teeth may make you feel more comfortable.
-DO NOT BLOW YOUR NOSE.
-Do not hold back a sneeze. Sneeze with your mouth
open.
-Expect nasal stuffiness. This is caused by post-op
swelling that will decrease over the next few weeks.
Also, it is normal to have numbness over your nose.
-Keep your head elevated at least 30 degrees (Use 2
pillows or sleep in a recliner) for the next few weeks.
This helps to keep swelling to a minimum.
-Only light activity after your surgery for one week.
-You may wear your lightest weight glasses lightly
resting on your nasal cast, or taped to your forehead.
You may insert your contact lenses two days after
surgery. After removal of your nasal splint, you
should limit the time that glasses are worn. If your
glasses have small "feet", you may wish to ask your
optician to install larger or softer "feet". You may
have tenderness on the sides of your nose after
wearing glasses for a prolonged period of time.
Remove your glasses for an hour or two for relief.
This is normal, and should resolve in 3-4 months.
-No aerobics, jogging or swimming for 2-3 weeks, or
until ok with your Surgeon.
-No tub baths, swimming or whirlpools for 1-2 weeks.
-You may drive only if you are not taking pain
medication.
-No lifting over 10 pounds for 1 week.
LONG TERM CARE:
-Swelling and Bruising of your nose and the
surrounding area is a normal result of nasal surgery.
The swelling will gradually resolve over time.
-You may have swelling under your upper lip and at
the bottom of your nose. This mild tenderness and
swelling should be gone within two weeks.
-Numbness over your nose is also very common and
will resolve in about 3 months.
-Breathing through your nose will gradually improve
after we clean your nose several days after surgery.
By the week after surgery your breathing should be
much improved.
-No sun exposure to the nose/ face for 3 months
following surgery. Sun exposure can cause swelling
and slow the healing process. You should wear a
Page 11 of 15
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Copyright © 2017 University of Wisconsin Hospitals and Clinics Authority
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12/2017CCKM@uwhealth.org

sunscreen with at least SPF 15 and a brimmed hat
when outdoors., Phase II Discharge
Diet - Rhinoplasty [NUT8888] Routine
General:
Diet Modifications:
Other Diet Modifications:
-Resume normal diet as tolerated.
Wound Care - Rhinoplasty [NURWND0015] Routine, -Expect nasal drainage for the first 2-3
days.
-You will need to change the small gauze dressing
under your nose when it becomes soiled. The first
day the drainage will be bloody. It will change to
pink-yellow color after the first day or so.
-Expect crusting in the nose for 3-6 weeks while the
incision is healing.
-Do not pick the inside of your nose.
-An ice pack can be applied to the incision site once
per hour for 10 minutes each time to help reduce
swelling and discomfort. Place the ice pack
diagonally across the eyes of the nasal bridge.
-For the first week after surgery, cleanse the nose
and ear incisions with a Q-tip saturated with
hydrogen peroxide. Use a rolling motion along the
length of the incision and allow drying. Roll a thin
layer of antibiotic ointment over the incision. Do this
3 times a day.
-Directly after surgery, you may feel sick to your
stomach due to the drainage that you have
swallowed during the surgery. If you vomit, it is not
unusual for it to be bloody.
Medications at Home - Rhinoplasty
[NURCOM0071]
Please complete in PATIENT FRIENDLY terms.
This order will appear on the patient's After Hospital
Care Plan., Routine, -Discomfort following surgery
varies from person to person. You have been given
a prescription for pain medication. These pills
contain a mild narcotic that might make you
lightheaded or even nauseated. Pain medication
works best if taken at the onset of pain.
-Do not use decongestants or antihistamines unless
your Surgeon has recommended them.
-You may resume your regular medications after
your surgery.
-If you have been given prescriptions for an
ANTIBIOTIC and/or a STEROID, BEGIN taking both
of these medications the day after surgery. Please
follow the directions as printed on the package of
this medication. Both medications are important for
proper healing; they decrease the risk of infection
and minimize swelling.
-DO NOT take aspirin or Ibuprofen, for 7 days before
and after your surgery, as it may cause bleeding.
-Start using the Deep Sea Nasal Spray that is in your
take home supplies 4 times a day starting the day
after surgery.
Septoplasty [143612]
Page 12 of 15
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12/2017CCKM@uwhealth.org

Activity - Septoplasty [NURACT0008] Routine
Discharge Activity:
-Do not hit or move any portions of your nose or
packing.
-Do not use a straw to drink fluids. This can create
suction in the back of your throat, which could cause
a higher risk of bleeding or swelling.
-You will be breathing through your mouth until the
swelling is resolved. This may cause some dryness
and irritation in your mouth and throat. Use a
humidifier or vaporizer along with brushing your
teeth may make you feel more comfortable.
-Do not hold back a sneeze. Sneeze with your mouth
open.
-Keep your head thirty degrees above your heart for
the next few weeks. Do not lie flat in bed. Sleep with
extra pillows under your head.
-Expect nasal stuffiness. This is caused by post-
operative swelling that will decrease over the next
few weeks.
-Do not pick the inside of your nose.
-Expect crusting in the nose for 3 to 6 weeks while
the incision is healing.
-For one week after surgery, you may engage in light
activity only, and then you may resume normal
activity as tolerated.
-You may wear your lightest weight glasses and
lightly rest them on your nasal cast, or taped to your
forehead. You may insert your contact lenses two
days after surgery. After removal of your nasal
splint, you should limit the time that glasses are
worn.
-No aerobics, jogging or swimming for 2-3 weeks.
-No driving or operating heavy machinery for the
next 24 hours or while on narcotics.
-No lifting greater than 10 pounds for 1 week.
-Avoid stressful activities and situations., Phase II
Discharge
Diet - Septoplasty [NUT8888] Routine
General:
Diet Modifications:
Other Diet Modifications:
-Resume normal diet as tolerated.
Page 13 of 15
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Copyright © 2017 University of Wisconsin Hospitals and Clinics Authority
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12/2017CCKM@uwhealth.org

Wound Care - Septoplasty [NURWND0015] Routine, -Expect to have some nasal bleeding after
your surgery.
-You will need to change the small gauze dressing
under your nose when it becomes soiled. Your nurse
will show you how to do this before you go home.
Heavy bleeding (soaking more that one pad per
hour) should be reported to your physician.
-Change the dressings as needed. You may stop
using the dressings when the drainage has stopped.
-At first, nasal drainage will be bloody. It will
gradually change to a pink-yellow color by the
following day.
-An ice pack can be applied to the incision site once
per hour for 10 minutes each time to help reduce
swelling and discomfort.
-For the first week after surgery, cleanse the nasal
and ear incisions with a Q-tip saturated with
hydrogen peroxide. Use a rolling motion along the
length of the incision and allow drying. Roll a thin
layer of antibiotic ointment over the incision. Start
this the day after surgery and cleanse 3 times a day.
-Directly after surgery, you may feel sick to your
stomach. This is due to the drainage that you
swallow during surgery. This drainage is irritating to
the stomach and may cause you to vomit. If you
vomit, it may be bloody.
Medications at Home - Septoplasty
[NURCOM0071]
Please complete in PATIENT FRIENDLY terms.
This order will appear on the patient's After Hospital
Care Plan., Routine, -Discomfort following varies
from person to person. You have been given a
prescription for pain medication. These pills contain
a mild narcotic and may make you lightheaded or
even nauseated. Remember, pain medication works
best if taken at the onset of pain.
-Your doctor may prescribe a nasal saline spray to
loosen crusting and make you more comfortable.
-Do not use decongestants or antihistamines unless
your doctor recommends them.
-You may resume your regular medications after
your surgery.
- If you have been given prescriptions for an
ANTIBIOTIC and/or a STEROID, BEGIN taking both
of these medications the day after your surgery.
Both are important for proper healing, to decrease
the risk of infection and to minimize swelling.
-Do not take aspirin, ibuprofen, naproxen or any
other non-steroidal anti-inflammatory drugs before or
after surgery, as it can cause bleeding.
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.
Page 14 of 15
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Contact: Lee Vermeulen, CCKM@uwhealth.org Last Revised:
 
12/2017CCKM@uwhealth.org

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 [142238]
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.
- Incision 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 15 of 15
Printed by BENNETT, SARA J [SJB008] at 12/8/2017 9:20:05 AM
Copyright © 2017 University of Wisconsin Hospitals and Clinics Authority
Contact: Lee Vermeulen, CCKM@uwhealth.org Last Revised:
 
12/2017CCKM@uwhealth.org