Physician’s Orders
Wake Tech Community College
Simulation Suite
Date
Phase 1
Hour
Chart Copy of Order
Hip Fracture: Pre-op
Patient Status: Acute Inpatient
Patient Location: Surgical Unit
Date of Surgery: tomorrow
Informed Consent to be obtained by MD. Place form on
clipboard.
Allergies: NKDA, strawberries- hives
Consults: anesthesia consult pre-op
Activity: Bedrest
Vital Signs: Every 4 hours per unit protocol with neurovascular
checks
Pulse Oximetry: Every 4 hours
Nutrition: NPO after midnight
IV: Medlock
Nursing: Intake and output every 8 hours. Notify MD if urinary
output is less than 240 ml in 8 hours.
Foley: placed in ED
Labs: CMP, type and screen, PT, aPTT, INR, Albumin, Proteindone in ED
Diagnostic Tests:
Left hip x-ray- done in ED
DVT prophylaxis: Send TED hose and SCD’s to OR with patient
Medications:
Oxycodone 5 mg PO every 4-6 hours PRN pain
Resume Home Medications (on MAR)
Patient Name: Sara Tompkins
Medication Record Number: 1231230
Physician’s Orders
Wake Tech Community College
Simulation Suite
Date
Phase 1
Second
Order Set
Hour
Chart Copy of Order
Discontinue Diazepam and Naproxen.
Institute Falls Precautions.
Initiate K Protocol.
Ondansetron (Zofran) 10 mg IV every four hours x 2 doses PRN
for nausea/vomiting.
Ketorolac (Toradol) 15 mg IV every 6 hours PRN pain.
Percocet 1-2 tablets every 6 hours PRN pain.
Patient Name: Sara Tompkins
Medication Record Number: 1231230
Physician’s Orders
Wake Tech Community College
Simulation Suite
Date
Phase 2
Hour
Chart Copy of Order
Hip Surgery: Post-Op Orders
Patient Status: Acute Inpatient
Patient Location: Surgical Unit
Diagnosis: Left Hip Repair
Allergies: NKDA, strawberries-hives
Vital Signs: every 4 hours with neurovascular checks
Pulse oximetry every 4 hours
IV of LR at 100 ml/hour. Medlock on POD #1 in evening.
Consults: PT, OT, Rehab
Nursing:
Intake and Output every 8 hours. Call MD if urinary output is less than 240
ml in 8 hours.
Discontinue foley on POD #2 at 0600. If patient unable to void after foley
discontinued, scan bladder and reinsert foley if residual is greater than 500
ml.
Dressing: Reinforce dressing PRN for saturation.
Nutrition: Ice chips and meds allowed day of surgery.
Then advance diet as tolerated on POD #1.
Activity:
Safety and Falls Precautions.
Turn and position every 2 hours off affected extremity.
Cough and deep breathe every two hours while awake.
Basic post-op exercises per PT routine.
Labs:
CBC with diff daily x 3.
BMP daily X3. IF K is less than or equal to 3.6 initiate Adult K Protocol.
Medications:
Morphine 1-2 mg IV every 2 hours PRN severe pain.
Percocet 1-2 tablets PO every 6 hours PRN pain.
Ondansetron (Zofran) 10 mg IV every 4 hours x 2 doses.
Zolpidem (Ambien) 5 mg PO at bedtime PRN insomnia.
Bisocodyl (Dulcolax) 10 mg supp PR daily PRN constipation start POD #2.
Patient Name: Sara Tompkins
Medication Record Number: 1231230
Physician’s Orders
Wake Tech Community College
Simulation Suite
Date
Skip to
Phase 4
Hour
Chart Copy of Order
Assign sitter to be with patient at all times until delirium clears.
Discontinue Ambien.
Discontinue Oxybutynin.
Check blood glucose every 6 hours.
IVF: D5 NS at 100 ml/hour
Obtain Nutrition consult
Keep sats greater than 92%.
CBC now
Obtain urine C&S and then d/c foley.
Levofloxacin (Levaquin) 500 mg PO once a day for 14 days.
Patient Name: Sara Tompkins
Medication Record Number: 1231230