TSC - Plastic Surgery - Hand - Adult - Postoperative [4820] PostOp/Phase II Patient Care Instructions [131475] 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 Give patient sling [NURCOM0022] ONCE, Routine, Post-Op/Phase II Diet [128905] Advance Diet as Tolerated [NURDIE0013] ONCE, Post-Op/Phase II Activity [128909] Activity [NURACT0008] CONTINUOUS, Routine ACTIVITY: Modifications WT BEARING RESTRICTIONS: Lifting Restrictions: May Shower: RESTRICTIONS: MODIFICATION RESTRICTIONS: No Bedrest NO BEDREST: Ambulate AMBULATE: with assistance Post-Op/Phase II Outpatient Discharge Orders (Medications) Medications-Prescriptions-Non-Opioids (Oral) Scheduled [200906] acetaMINOPHEN (TYLENOL) 325 MG tab - 2t q6h x7d [34149] 650 mg, starting 11/20/19, No Print, Phase II Discharge naproxen (NAPROSYN) 500 MG tab - 1t 2x/d x7d [40052] 500 mg, 0, starting 11/20/19, No Print, Phase II Discharge ibuprofen (MOTRIN) 200 MG tab - 3t q6h x7d [38353] 600 mg, starting 11/20/19, No Print, 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 11/20/19, Normal, Phase II Discharge oxycodone 5 mg tab - 1t q4hprn #15 [45976] 5 mg, 15 tab, 0, starting 11/20/19, Normal, Phase II Discharge oxycodone 5 mg tab - 1t q4hprn #25 [45976] 5 mg, 25 tab, 0, starting 11/20/19, Normal, Phase II Discharge Medications - Prescriptions - Bowel Management [143582] Order if opioids are prescribed senna-docusate (SENOKOT-S) 8.6-50 mg per tab [60530] 2 tab, 30 tab, 0, starting 11/20/19, Normal, Phase II Discharge docusate sodium (COLACE) cap [36857] 100 mg, 30 cap, 0, starting 11/20/19, Normal, Phase II Discharge polyethylene glycol (MIRALAX) oral powder [61353] 17 g, starting 11/20/19, Normal, Phase II Discharge Medications - Prescriptions - Anti-infectives [143583] cephalexin (KEFLEX) 250 mg cap - 4x/d-7d [44594] 500 mg, 28 cap, 0, starting 11/20/19, Normal, Phase II Discharge amoxicillin-clavulanate (AUGMENTIN) 875-125 MG per tab - 2x/d x7d [70053] 1 tab, 14 tab, 0, starting 11/20/19, Normal, Phase II Discharge clindamycin (CLEOCIN) 300 MG cap - 3x/d x7d [44723] 300 mg, 21 cap, , starting 11/20/19, Normal, Phase II Discharge Page 1 of 5 Printed by LIND, JANNA S [JSL237] at 11/20/2019 10:11:26 AM Copyright © 2019 University of Wisconsin Hospitals and Clinics Authority. All Rights Reserved. Printed with Permission. Contact: Lee Vermeulen, CCKM@uwhealth.org Last Revised: 11/2019CCKM@uwhealth.org Medications - Prescriptions - Non-categorized [141907] methylprednisolone 4 MG tab pack [170928] 1 each, 0, starting 11/20/19, Normal, Phase II Discharge diazepam (VALIUM) 5 mg tab - q6-8hp #12 [36679] 5 mg, 12 tab, 0, starting 11/20/19, Normal, Phase II Discharge ondansetron (ZOFRAN) tab [45939] 4 mg, 10 tab, 0, starting 11/20/19, Normal, Phase II Discharge Outpatient Discharge Orders (Discharge Instructions) What to Expect [194175] What to Expect [NURCOM0071] Please complete in PATIENT FRIENDLY terms. This order will appear on the patient's After Hospital Care Plan., Routine, • Discomfort or pain will vary from person to person and will depend upon the type of surgery. • If you had a block performed around the time of surgery, it is normal for your hand to be asleep for several hours after surgery. The block will wear off overnight or tomorrow morning, at which time it is normal to have an increase in pain. At that time, ensure you are keeping your hand elevated to help with swelling, and make sure you are taking pain medications as instructed. Activity [129667] Activity [NURACT0008] Routine Discharge Activity: See Instructions • You should not drive for at least 24 hours; even though you may not feel tired, your judgment and reflexes may be impaired. Do not drive while taking opioid pain medications. • Rest today and resume your normal activity tomorrow. • Keep the hand that had surgery elevated above the level of your heart at all times to help with swelling. • Do not move fingers that are in a splint. *** For those fingers that are not in a splint, we encourage frequent finger range of motion to help with swelling and to prevent the fingers from becoming too stiff ***., Phase II Discharge Diet [129669] Page 2 of 5 Printed by LIND, JANNA S [JSL237] at 11/20/2019 10:11:26 AM Copyright © 2019 University of Wisconsin Hospitals and Clinics Authority. All Rights Reserved. Printed with Permission. Contact: Lee Vermeulen, CCKM@uwhealth.org Last Revised:   11/2019CCKM@uwhealth.org Diet [NUT8888] Routine General: General (No Modifications) Diet Modifications: Other Diet Modifications: - Solid Consistency: Liquid Consistency: Liquid: Esophagectomy: Fat Controlled: Fiber: Fluid Restriction: Heart Healthy: Metabolic: Renal: Sodium Controlled: NPO: Tube Feeding: • 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 [129668] Wound Care [NURWND0015] Routine, • You likely have a bulky dressing/splint and ace bandage; *** keep these clean dry and intact until your clinic appointment. • Pain and swelling can be relieved by taking your medication and by elevating your arm above the level of your heart. Ice packs may be used to decrease swelling and pain for 1-2 days following surgery. • Keep the dressing and/or elastic wrapping dry. The elastic bandage may be rewrapped as necessary if it becomes too loose or too tight. • Monitor the circulation of the hand and fingers that are visible outside the dressing or splint. Do this by looking at the skin color and feeling the temperature. The skin color should be the same as your other hand and should feel warm to the touch. • Make sure there is feeling in the fingers. Be alert to any numbness, tingling or "pins and needles" sensation. IV Site [NURCOM0071] Please complete in PATIENT FRIENDLY terms. This order will appear on the patient's After Hospital Care Plan., 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. Medications at Home [129670] Page 3 of 5 Printed by LIND, JANNA S [JSL237] at 11/20/2019 10:11:26 AM Copyright © 2019 University of Wisconsin Hospitals and Clinics Authority. All Rights Reserved. Printed with Permission. Contact: Lee Vermeulen, CCKM@uwhealth.org Last Revised:   11/2019CCKM@uwhealth.org Medications at Home [NURCOM0071] Please complete in PATIENT FRIENDLY terms. This order will appear on the patient's After Hospital Care Plan., Routine, • You may resume taking your routine medications. • In order to reduce the amount of opioid pain medications you need, we recommend taking acetaminophen and ibuprofen (or naproxen) on a regular schedule if you do not have any allergies or problems with these medications. You may take 1000mg acetaminophen by mouth three times a day, and 600mg ibuprofen three times a day. It is safe to combine these medications with oxycodone. If you were given an opioid pain medication with acetaminophen in it, make sure your total dose of acetaminophen does not exceed 4000 mg/day. When to Call Your Surgeon [129666] When to Call Your Surgeon [NURCOM0071] Please complete in PATIENT FRIENDLY terms. This order will appear on the patient's After Hospital Care Plan., Routine, • Fingers are cold to the touch or blue in color. • Tingling, numbness and/or increasing pain in the fingers occurs. • Loss of motion to the fingers is experienced (for fingers that are not in a splint). • Excess swelling is not relieved with elevation and/or ice. • Excessive bleeding. • Persistent nausea and vomiting. • Pain not relieved with pain medication. • Fever over 100° F (by mouth) for two readings taken four hours apart during the first 3 days. • 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. Other Discharge Instructions [129018] Other Discharge Patient Care Instructions [NURCOM0071] Please complete in PATIENT FRIENDLY terms. This order will appear on the patient's After Hospital Care Plan., Routine 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. Contact Information [129298] Page 4 of 5 Printed by LIND, JANNA S [JSL237] at 11/20/2019 10:11:26 AM Copyright © 2019 University of Wisconsin Hospitals and Clinics Authority. All Rights Reserved. Printed with Permission. Contact: Lee Vermeulen, CCKM@uwhealth.org Last Revised:   11/2019CCKM@uwhealth.org Contact Information [NURCOM0071] Please complete in PATIENT FRIENDLY terms. This order will appear on the patient's After Hospital Care Plan., Routine, For any questions or concerns after your surgery, please call: 608-836-9990 or Toll Free 1-866-477-9990, Monday through Friday from 8 a.m. to 5 p.m. to speak with a nurse or have a call returned to you. After hours, weekends or holidays, please call the same number and give the operator your name, surgeon's name and your phone number including area code. A physician will return your call. Follow-Up Appointments [128913] Schedule Appointment at Transformations [NURCOM0056] Routine Purpose: With whom: For when: Transformations Clinic 2349 Deming Way Madison, WI (608) 836-9990 Schedule Appointment at UW Health - University Hospital [NURCOM0056] Routine Purpose: With whom: For when: UW Health - University Hospital 600 Highland Avenue Madison, WI (608) 263-7502 Schedule Appointment at UW Health - 1 S. Park Clinic [NURCOM0056] Routine Purpose: With whom: For when: UW Health Clinic 1 S. Park St. Madison, WI 53715 Phone: (608) 287-2000 Schedule Appointment at UW Health - 20 S. Park Clinic [NURCOM0056] Routine Purpose: With whom: For when: UW Health - 20 S. Park Clinic 20 S. Park St. Madison, WI 53715 (608) 720-5200 Schedule Appointment at UW Health at the American Center [NURCOM0056] Routine Purpose: With whom: For when: UW Health at The American Center 4602 Eastpark Blvd. Madison, WI 53718 (608) 440-6700 Page 5 of 5 Printed by LIND, JANNA S [JSL237] at 11/20/2019 10:11:26 AM Copyright © 2019 University of Wisconsin Hospitals and Clinics Authority. All Rights Reserved. Printed with Permission. Contact: Lee Vermeulen, CCKM@uwhealth.org Last Revised:   11/2019CCKM@uwhealth.org