ORDERS - ADCVAANDIMLS

Total Knee Tips & Pearls From Dr. Adam Rosen (A Virtual Total Knee Fellowship Podcast)

Hopefully your system does not go down but when it does here is your cheat sheet.
1. ALWAYS DATE AND TIME
2. SIGN and print your name and/or doctor number, pager number, etc
3. Make sure the patients name and medical record number or DOB is on the page
A- Admit
D - Diagnosis
C - Condition and Code Status
V - Vitals
A - Allergies
A - Activity
N- Nursing
D - Diet
I - IVF
M - Medications
L - Labs and Tests
S - Special - PT, OT, Case Management
And DATE AND TIME IT
Common Meds after TKA - always check the medication, dose and frequency and the safety profile for the patient.
Abx - Ancef 1 gm q8 (occ Vanco or other)
VTE Prevention - Asa 81 mg BID (or 325mg or eliquis, xarelto, warfarin, enoxaparin, etc)
Scheduled Pain Meds
1. acetaminophen 1000 mg PO q8
2. celebrex 200 mg PO BID
3. sometimes: gabapentin 100 mg PO q8
Breakthru Pain Meds
1. Tramadol 50 mg PO q6 prn mild pain (level 1-5)
2. Oxycodone IR 5 mg PO q6 prn moderate pain (level 6-9)
3. Oxycodone IR 10 mg PO q6 prn severe pain (level 10)
4. sometimes: IV breakthru medications
Bowel - colace 100 mg PO BID
GI - pepcid 20 mg PO BID
Puritis - claritin 10 mg PO q day prn itching
Nausea - zofran 4 mg IV q 6 prn nausea
HOME MEDS!
if diabetic don't forget sliding scale insulin
and DATE AND TIME the orders
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