peterncarrine

I was not on same unit with pt - on a telemetry unit; just knew student, who was tech on our unit. Anyway....apparently docs gave first dose Vit k (5 mg) ~ 40 hrs p admission, then another dose (10 ng) 24 hrs p that. Pro x's/INR were 27.0/2.6 on admit; 32.6/3.1 next day; 34.3/3.2 at 38 hrs; 27.9/2.6 p 1st dose Vit K; 17.4/1.6 p 2nd dose - students take great notes about labs :).......Dilaudid 1mg then 2 mg q3h for pain (but student could not remember any comments about muscle spasms, only external rotation as cause.... Pt ended up with big sacral decub 4 days p admit - found in OR - so your point is well taken about value of Vit K earlier --> OR earlier. And post op care (in surg ICU bcse of cardiac hx) which included frequent T&P to pt's benefit

Yes - they handled the coagulation problem fine (finally had to give her Vit K to get her INR and pro times WNL. It was just the skin care issue that concerned me. I am not an ortho nurse so after I said "Of course" to the student, I backed off and said "Let's check" just in case preventing adduction etc was not adequate. The patient was not in traction and was on a regular mattress. She developed a sacral decub, which is why the issue came up. Thanks for the info

Hi - Recently a student nurse asked me about turning a patient with a fx hip before her ORIF - an 81 yo woman with some cardiac instability needing resolution and on Coumadin so had to wait for INR to come down. She was on a med-surg unit for 3-4 days before going to OR. Do you turn these pts (back to unaffected side)? Do you put them on air mattress? Thanks