NURS308 Lecture 5: Diabetes
12 Jul 2018
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Gd is a 71 yo male seen in the orthopedic clinic for left knee pain, severe enough to limit his usual activities of skiing and playing tennis. Synvisc and non-steroidal therapy were not successful and he is scheduled for a total knee athroplasty. Pre-operatively he is cleared by his primary care physician, having no other significant medical problems. He has a dental cleaning, attends a pre-op education class and has labs done. Lab results include: aptt 24. 9, inr 0. 98, na 138, cl 104, bun 12, glucose 91, k 4. 9, creatinine 0. 9, wbc 6. 7, hct. Vancomycin was given and a prosthesis placed via a midline incision. Post-op care included: 24 hours of vancomycin and cefazolin, pca analgesia with hydormorphone (wean to po hydrocodone w/acetaminophen pod#2), docusate sodium, is 10x/hr wa, warfarin daily starting pod#1, teds/scds, pt/ot, cpm. A ble duplex ultrasound was ordered and revealed a thrombus in the operative leg. Labs from pod#1 included inr 1. 09, h/h 13/37.
