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Hip fracture

  • Admission orders

    • Admit: Medical or Orthopedics Floor
    • Diagnosis: Hip Fracture
    • Condition: Guarded
    • Vital Signs: q 4 hours
    • Allergies:
    • Nursing:
      • Foley catheter
      • monitor I/Os
      • oxygen at 2 L via NC if sat < 92%
      • SCDs
      • delirium prevention
    • Diet: NPO for OR in AM
    • Activity: Bedrest
    • Labs:
      • CBC with platelets
      • Chem 7
      • coags: PT/INR, PTT
      • EKG
      • type and cross for 2 units packed RBCs
      • hip xray
    • IV: D5 1/2 Normal Saline at 100 mL/h
    • Special: surgical consult, goal to operate within 24-48 hours
    • Medications:
      • Warfarin 5 mg PO tonight
      • Acetaminophen 650 mg PO q 6 hours prn
      • Morphine 1-2 mg IV q 2 hours prn pain
      • Colace 250 mg PO qd
      • Senna 1 tablet PO bid
      • Calcium carbonate 2 tablets PO bid
      • Vitamin D 400 IU PO qd
      • Metoprolol 25 mg PO q 12 hours - hold for HR < 50, SBP < 100
      • Cefazolin 1 g IV to accompany patient to the OR
  • Discharge

    • skilled nursing facility placement
    • anticoagulation (enoxaparin or warfarin) 1 month postop
    • Calcium, vit D

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