New RN to ortho

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I am starting my first nursing job next week as an RN on ortho. I am really excited, but very nervous about finally starting my career. I am just looking for some advice, insight, etc. I want to be as prepared as possible before I start, although I know I am going to learn SO much when I actually get on the floor!

What basic things should I know as an ortho nurse?

What are the top 20 meds given on an ortho floor?

Any info that you could give me would be great....

Thanks!

Kyle

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Specializes in Med-Surg.

Top 20 meds? You're not asking for much are you? Just kidding. Let's see.....morphine, percocet, morphine, percocet, morphine, percocet....Lots of pain control issues.

The main thing to remember is Circulation-Senstation-Movement distal to the injury/surgical site.

Good luck. You'll do fine.

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Tweety - Thanks for the info.... sorry, I guess 20 is a lot to ask! :) Fingers crossed that I get settled in quickly and that I work with some nice nurses!

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Specializes in Med-Surg.

I hope you do. Ortho can be tough, with tough ratios.

Seriously the meds you'll need to know are narcotics, antiemetics and antibiodics. Those are the biggies.

Good luck!

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Specializes in Orthopedics/Med-Surg, LDRP.

Good luck! Pain is often the biggest thing that we deal with. I liked the one that was Morphine, Percocet, Morphine, Percocet. You'll get an occassional Dilaudid or Darvocet here and there. Plus Reglan, Zofran, Phenergan (for vomiting/nausea). Ancef, Zosyn, Levaquin or Flagyl as antibiotics. Lovenox to prevent clots. Colace to prevent the constipation from the narcotics.

Most doctors do CBCs, CMP's for the first 3 days.

There's PT involved, CPM machines for knee replacements.

I's and O's. Shurtrans/Hemovac drains.

PCA pumps (goes with the Morphine). Neuro checks, circulation checks. Other than that I think that's the biggest part.

Good Luck!

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Specializes in ORTHO/TRAUMA, PACU.

Congrats Welcome to Nursing!

Like tweety said, Circulation, Sensation, Movement. Priority everytime. DTV prevent also very important in these patient's. So Keep an close eye on your Saturation level. Antibiotic therapy is very important with the high risks on infection. Watch your bllod counts in these patient's too. H&H's, PT/INR's very important. Know your protocol for how Hips and spines should be ambulation what is allowed and not allowed.

Common Meds:

IRON

VITAMIN C

Stool Softners

Antibiotics: Ancef, Cleomycin, Gentamycin

Narcotics: Morphine, Hydromorphone, Oxycodone, Percocet

Our ortho Surgeons that do joint replacements have been using infusing nerve blocks, and around the clock tyelnol and toradol.

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Specializes in orthopaedics.

To add to the med list:

Arixtra

Coumadin

Phenergan

;)

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Specializes in ORTHOPAEDICS-CERTIFIED SINCE 89.

In addition to knowing which lab tests, learn the norms and abnorms. When I first started ortho, everyone with a hgb of 10 got 2 units packed cells. Now they hardly ever do that unless the person's h drops precipitously and they are symptomatic.

Also the prothrombin time alone is no longer used. The INR is the gold standard now.

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Specializes in ICU. Med/Surg: Ortho, Neuro, & Cardiac.

My knowledge is limited because of my level of education, but most of the ortho patients on our floor that I deal with are joint replacement patients. Some of the things I've learned:

1. No pillows under the knee. Period!

2. Refill your EBI (some places call them Polarcare) coolers. Ortho docs get pissed if they make AM rounds and the ice has melted.

3. NEVER attempt to do anything on your own (ambulate, reposition, etc.) unless you are 100% comfortable

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Specializes in ORTHOPAEDICS-CERTIFIED SINCE 89.

Jared those are excellent tips. WHat I usually do is position the icechest of the ebi or prolarcare next to the lavatory (if it is at bedside that is) then approximate how much ice it takes. Then fill a Paper bag with the ice. That way you don't delay in taking it to the room, don't lay it down and forget it (messy), and you don't waste ice. You usually put water in to the line and fill the rest with ice. That way the hose doesn't get air in the line.

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Specializes in ICU. Med/Surg: Ortho, Neuro, & Cardiac.

That's pretty good advice.

At our facility we have one of those huge rolling ice chests on wheels and I'll go fill it with ice down in the morgue when my shift starts. 3-4 hours into the shift I will take the ice chest around to each room and refill the EBI coolers. I've found that if you completely empty all of the ice and all of the water and fill it back up that it can go up to four hours without melting, whereas if you just add more ice to the water like I see a lot of people do then you will be refilling about every 2 hours.

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Specializes in Tele.

this is all great advice.

I did not post the orginial posting.... but reading it, I feel exactly the same, as if I wrote it.

I am starting to work in 2 weeks and I am nervous but excited to be back in the working field as a new RN. I used to be a CNA at the hospital where I am gonna work at, but I hardly ever went to work at that floor. Last time I worked there it was before nursing school and I was paired up with a nurse who died (true story) a few years back.

so basically, pain management and circulation distal to the surgery site, prevent DVT's......... anything else??

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