302 POST-OP ADMISSION ORDERS – BREAST REDUCTION page 1
Dr. Luis Cuadros 505.243.7670
Pt name: ________________________________________ DOB: _______________
CSN: _______________________________
Date: _______________________________
Status: Bedded Outpatient
Dx: S/P Bilateral breast reduction
Diet: Advance to regular as tolerated
Activities: Ad Lib
IV: D5NS @ 50cc Hour
O2 via NP to keep O2 Sat > 95%
Straight Cath PRN
Sequential TEDS
Morphine PCA:
Loading dose 2mg, then PCA dose 1mg, lockout interval Q10 minutes.
If pain not controlled, increase PCA dose to 2mg Q10 minutes.
Morphine IV Bolus 2mg Q1 Hour PRN breakthrough pain
If unable to tolerate Morphine –> change to Dilaudid PCA
Dilaudid PCA (if unable to tolerate morphine):
Loading dose 0.2mg, then PCA dose 0.1mg, lockout interval Q10 minutes.
If pain not controlled, increase PCA dose to 0.2mg Q10 minutes.
Dilaudid IV bolus 0.1mg Q 1 hour PRN breakthrough pain
Medications:
Kefzol 1gm IV Q8hr
Restoril 15-30mg PO HS PRN sleep
Tylenol 650mg PO/PR Q4hr PRN T>101°F or PRN pain
Zofran 4mg IV Q8hr PRN Nausea
Phenergan 6.25-12.5mg IV Q8hr PRN Nausea
Phenergan 25mg PO/PR Q8hr PRN Nausea
Benadryl 25-50mg PO Q6hr PRN itching
Toradol 30mg IV Q8hr PRN pain
Percocet 5/325 1-2 PO Q6hr PRN pain
Bacitracin 1 oz tube at bedside for dressing change
POST-OP ADMISSION ORDERS – BREAST REDUCTION page 2
Protocol for JP Care:
JP drains checked Q4hr for bulb compression, quantity and quality of drainage
Mark as sanguineous, serous or sero-sanguineous.
Record Q4hrs as follows: 6PM, 10PM, 2AM and 6AM.
Call MD:
if JP drainage greater than 50cc Q4 hours, or if increased pain and swelling is noted
Please have at bedside in am for dressing change:
[2] Blue disposable Chux
4X4 gauze – one box
250cc Saline irrigation
[2] Large Kerlix
[2] 3X18" petrolatum gauze
[2] 6" Ace wraps
suture removal set
Resume Pre-op Medications as follows:
Other Orders: