Mr. Stevens has been admitted for a right knee replacement due to osteoarthritis. He is 76 years old, and has been a Type 2 Diabetic for the past 10 years. You are receiving Mr. Stevens to the surgical unit from the PACU. The client is on a PCA pump, which was programmed in the PCAU. It is now 1630 hours. The post-operative orders are: Metformin 500 mgs po bid Novolin Toronto insulin per sliding scale (6 – 9 give 0 units; 9.1 – 12.0 give 2 units; 12.1 – 14.0 give 4 units; 14.1 – 20.0 give 6 units) (below 4 and above 20, notify physician) Acetaminophen 650 mg po q6h for the next 48 hours Lovenox 40 mg s/c at 2200 hours tonight Gravol 25 – 50 mg po/IM q4h prn Fluids to diabetic 1800 kcal diet IV Normal Saline at 125 mL/hr IV Ciprofloxacin 400 mg bid Change dressing tomorrow D/C Foley catheter in AM O2 via nasal prongs PRN The Acetaminophen 650 mg is due for 1800 hours. You ask the client whether he has any pain and he states, “No, I have not had to use the pump. I don’t think I need the Acetaminophen now”.
