Condition

4. Vital signs: q shift

5. Activity: No weight bearing on infected joint. Up in chair as tolerated. Bedside commode with assistance.

6. Nursing: Warm compresses prn, keep joint immobilized. Passive range of motion exercises of the affected joint bid; otherwise, keep knee in resting splint.

7. Diet: Regular diet.

8. IV Fluids: Heparin lock

9. Special Medications:

Empiric Therapy for Adults without Gonorrhea Contact:

-Nafcillin or oxacillin 2 gm IV q4h AND Ceftizoxime (Cefizox) 1 gm IV q8h or ceftazidime 1 gm IV q8h or ciprofloxacin 400 mg IV q12h if Gram stain indicates presence of Gram negative organisms.

Empiric Therapy for Adults with Gonorrhea: -Ceftriaxone (Rocephin) 1 gm IV q12h OR -Ceftizoxime (Cefizox) 1 gm IV q8h OR -Ciprofloxacin (Cipro) 400 mg IV q12h.

-May complete course of therapy with cefuroxime axetil (Ceftin) 400 mg PO bid.

10. Symptomatic Medications:

-Acetaminophen and codeine (Tylenol 3) 1-2 PO q4-6h prn pain. -Heparin 5000 U SQ bid.

11. Extras: X-ray views of joint (AP and lateral), CXR. Synovial fluid culture. Physical therapy consult for exercise program.

12. Labs: CBC, SMA 7&12, blood C&S x 2, VDRL, UA. Gonorrhea cultures of urethra, cervix, urine, throat, sputum, skin, rectum. Antibiotic levels. Blood cultures x 2 for gonorrhea.

Synovial fluid:

Tube 1 - Glucose, protein, lactate, pH. Tube 2 - Gram stain, C&S. Tube 3 - Cell count.

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