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Total Knee Replacement – Day 2

         blood draw: A blood drawing technician will draw your blood at 6 AM (will test for your red blood cell level
         - hematocrit - and possibly chemitry level).  Ask your nurse about your hematocrit (should be above 30 and if
         the hematocrit is below 26 we may recommend a transfusion)

         vitals and monitoring: The nurse or aid will measure your vitals (temperature, pulse, blood pressure, and
         respirations, as well as noting the oxygen saturation rate).  It is normal to have an elevated temperature for
         2-3 days after surgery.  Remember that the pulse oximeter machine will measure a continuous heart rate and
         blood oxygen level.  The pulse should be below 100 and the oxygen saturation should be above 95% (or you will need oxygen) 

         bath: the nursing staff will give you a sponge bath.

         breakfast: Try to restart a normal diet.  You really should be out of bed on day 2.  This makes eating easier and lets the nursing staff
         clean your linen.Try to restart a normal diet.

         tubes: The bladder catheter is removed unless you are having trouble mobilizing. The nasal oxygen will be removed once your O2
         saturation level is greater than 92-94%.  The IV fluids will be discontinued once you are drinking fluids well.

         physical therapy: The physical therapy service will pick up where they left off on day one.  This is a good day to walk down the hall.
         They will probably leave you in a chair for at least 2 hours.
         CPM  The therapists will show you how to increase the range of motion about 10-20 deg a day.  On day 2, you should get the COM
         up to 70-80 deg. When in bed, the patient should keep the CPM for at least 50% of the time.  If the machine helps you sleep, feel
         free to keep this running during the night.
          
         blood clots:  The nurse will give you a shot in the abdominal fat to prevent blood clots (Lovenox).   Ask her to teach you how to
         give these shots as they are often given for a week or two at home.  You are encouraged to move your feet back and forth for two
         minutes every 30 min (2 min during each TV commercial).   This will also help prevent blood clots.

         hospitalist: The hospitalist will continue to see you on a daily basis.  He may change around some of your home medications.

         wound dressing: Typically, the wound dressing is left alone for several days unless there is bleeding.

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Original Text by Clifford R. Wheeless, III, MD.

Last updated by Daren Sipes, MS on Monday, December 17, 2007 12:14 pm