Bariatric Surgery Post Op Plan PACU Phase
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- Benedict Vernon Houston
- 6 years ago
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1 Bariatric Surgery Post Op Plan PACU Phase PHYSICIAN S Weight Allergies Admit/Discharge/Transfer Patient Status Pt Status: Inpatient (LOS > 2 midnights) Pt Status: Observation (LOS < 2 midnights) Code Status Code Status: Full Code Code Status: DNI Do Not Intubate Code Status: DNR Do Not Resuscitate Code Status: Partial Resuscitative Effort Admitting Diagnosis/Reason for Visit Bariatric Surgery Post Op Laboratory CBC STAT, Comment: Patient is in PACU Basic Metabolic Panel STAT, Comment: Patient is in PACU Comprehensive Metabolic Panel STAT, Comment: Patient is in PACU Order Taken by Signature: Page: 1 Bariatric Surgery Post Op Plan Version: 3 Effective on: 12/18/13 **
2 Arrives to Room PHYSICIAN S Patient Care Patient Activity Out of Bed Assist as Needed, Bed Position: HOB >/= 30 degrees, Pt MUST visit Bathroom. HOB elevated 30 degrees at all times. Post Op Day 1 MANDATORY Out of Bed q4hrs Apply Elastic Stockings Apply to: Bilateral Lower Extremities, Length: Knee High, IF appropriate size available Apply Pedal Pump Apply to Bilateral Feet, Remove after first visit to bathroom Insert Urinary Catheter (Insert Foley) Foley, Straight cath if no void by 8hr post op. Strict Intake and Output Per Unit Standards, Pt to void into commode chair in bathroom, not in bed. Notify Provider (Misc) Notify Dr. Syn Office: Pager: Cell: , Reason: If urine volume >300cc leave foley and call MD Dietary Dr. Syn s Post Gastric NO Carbonated beverages. NO sugar. NO Juice. Leave water at bedside and encourage 8 cups of water per day. ADA Diet Adult 1200 Calories, Low Fat, NO Carbonated beverages. NO sugar. NO Juice. Leave water at bedside and encourage 8 cups of water per day. IV Solutions LR IV, 125 ml/hr IV, 150 ml/hr Medications Medication sentences are per dose. You will need to calculate a total daily dose if needed. albuterol (albuterol 2.5 mg/3 ml (0.083%) inhalation solution) 2.5 mg, inhalation, soln, q6h heparin 5,000 units, subcut, inj, BID clindamycin 900 mg, IVPB, ivpb, q12h, x 2 dose, Infuse over 30 min Begin 12 hours after preoperative dose given. cyanocobalamin 1000 mcg, IM, inj, ONE TIME thiamine 100 mg, IVPB, ivpb, Daily, x 4 days ***Not to exceed 4 days*** Order Taken by Signature: Page: 2 Bariatric Surgery Post Op Plan Version: 3 Effective on: 12/18/13 **
3 Arrives to Room PHYSICIAN S insulin aspart units, subcut, inj ketorolac 30 mg, IVPush, inj, Daily, x 3 dose To be given at 6:00 AM (0600) post op day 1 HYDROcodone acetaminophen (HYDROcodone acetaminophen 5 mg 325 mg oral tablet) 2 tab, PO, tab, q4h, PRN pain Do Not Substitute ***Do not exceed 4,000 mg of acetaminophen from all sources in 24 hours*** 1 tab, PO, tab, q4h, PRN pain Do Not Substitute ***Do not exceed 4,000 mg of acetaminophen from all sources in 24 hours*** ondansetron 4 mg, IVPush, inj, q4h, PRN nausea If no refief may give Phenergan (promethazine) promethazine 12.5 mg, IVPush, inj, q6h, PRN nausea If no relief from Zofran (ondansetron) ***VESICANT*** Dilute with 10 ml NS & IVP over 2 3 min through a running IV line with large bore access. zolpidem 5 mg, PO, tab, Nightly, PRN insomnia scopolamine (scopolamine 1.5 mg transdermal film, extended release) 1.5 mg, transdermal, adh patch, Every 3 days Place behind ear and change every three days acetaminophen 1,000 mg, PO, tab, q4h, PRN fever, Temp >101 ***DO NOT administer until POD 1*** Do not exceed 4000 mg of acetaminophen per day from all sources. 500 mg, PO, tab, q4h, PRN fever, Temp >101 ***DO NOT administer until POD 1*** Do not exceed 4000 mg of acetaminophen per day from all sources. Order Taken by Signature: Page: 3 Bariatric Surgery Post Op Plan Version: 3 Effective on: 12/18/13 **
4 Arrives to Room PHYSICIAN S tramadol 50 mg, PO, tab, TID 50 mg, PO, tab, q12h, PRN pain 50 mg, PO, tab, q6h, PRN pain 100 mg, PO, tab, q6h, PRN pain 100 mg, PO, tab, q4h, PRN pain piperacillin tazobactam g, IVPB, ivpb, q6h, x 2 dose Begin 6 hours after post op dose g, IVPB, ivpb, q6h, x 2 dose Begin 6 hours after post op dose. Laboratory CBC Next Day in AM, T+1;0300 Next Day in AM, T+1;0300, Every AM for 2 days CBC with Differential Next Day in AM, T+1;0300 Next Day in AM, T+1;0300, Every AM for 2 days Basic Metabolic Panel Next Day in AM, T+1;0300 Next Day in AM, T+1;0300, Every AM for 2 days Comprehensive Metabolic Panel Next Day in AM, T+1;0300 Next Day in AM, T+1;0300, Every AM for 2 days Diagnostic Tests DX UGI (w/o Barium, Air) T+1;0500, Other (specify below), Use Gastgrograffin. Assess for leak at Gastro jejunostomy site. Respiratory Chest Physiotherapy Target Lung Area(s): All lung areas, q6h, While Awake. With Postural Drainage. Oxygen Therapy 2 6 L/min, Keep sats greater than %: 92, PRN IS Instruct 10x/day, 10 times every hour while awake. Physical Medicine and Rehab Consult PT Mobility for Eval & Treat Consults/Referrals Consult Dietician...Additional Orders Order Taken by Signature: Page: 4 Bariatric Surgery Post Op Plan Version: 3 Effective on: 12/18/13 **
5 Arrives to Room Sliding Scale Insulin Aspart Protocol Plan PHYSICIAN S Patient Care Accucheck Per Sliding Scale Insulin Frequency AC & HS AC & HS 3 days TID BID q12h q6h q6h 24 hr q4h q2h Sliding Scale Insulin Protocol Follow SSI Reference Text Medications Medication sentences are per dose. You will need to calculate a total daily dose if needed. insulin aspart (Low Dose Insulin Aspart Sliding Scale) 0 10 units, subcut, inj, AC & nightly, PRN glucose levels see parameters Blood glucose <70 and patient is symptomatic; Initiate hypoglycemic protocol and Call physician units; units subq; units subq; units subq; units subq; units subq; > units IV now, repeat accucheck in 30 minutes; continue to repeat 10 units IV and accuchecks every 30 minutes until BG <300, then resume normal accucheck and sliding scale routine. Call physician units, subcut, inj, q6h, PRN glucose levels see parameters Blood glucose <70 and patient is symptomatic; Initiate hypoglycemic protocol and Call physician units; units subq; units subq; units subq; units subq; units subq; > units IV now, repeat accucheck in 30 minutes; continue to repeat 10 units IV and accuchecks every 30 minutes until BG <300, then resume normal accucheck and sliding scale routine. Call physician units, subcut, inj, q4h, PRN glucose levels see parameters Blood glucose <70 and patient is symptomatic; Initiate hypoglycemic protocol and Call physician units; units subq; units subq; units subq; units subq; units subq; > units IV now, repeat accucheck in 30 minutes; continue to repeat 10 units IV and accuchecks every 30 minutes until BG <300, then resume normal accucheck and sliding scale routine. Call physician. Order Taken by Signature: Page: 5 Bariatric Surgery Post Op Plan Version: 3 Effective on: 12/18/13 **
6 Arrives to Room Sliding Scale Insulin Aspart Protocol Plan PHYSICIAN S 0 10 units, subcut, inj, q2h, PRN glucose levels see parameters Blood glucose <70 and patient is symptomatic; Initiate hypoglycemic protocol and Call physician units; units subq; units subq; units subq; units subq; units subq; > units IV now, repeat accucheck in 30 minutes; continue to repeat 10 units IV and accuchecks every 30 minutes until BG <300, then resume normal accucheck and sliding scale routine. Call physician units, subcut, inj, TID, PRN glucose levels see parameters Blood glucose <70 and patient is symptomatic; Initiate hypoglycemic protocol and Call physician units; units subq; units subq; units subq; units subq; units subq; > units IV now, repeat accucheck in 30 minutes; continue to repeat 10 units IV and accuchecks every 30 minutes until BG <300, then resume normal accucheck and sliding scale routine. Call physician units, subcut, inj, BID, PRN glucose levels see parameters Blood glucose <70 and patient is symptomatic; Initiate hypoglycemic protocol and Call physician units; units subq; units subq; units subq; units subq; units subq; > units IV now, repeat accucheck in 30 minutes; continue to repeat 10 units IV and accuchecks every 30 minutes until BG <300, then resume normal accucheck and sliding scale routine. Call physician. Order Taken by Signature: Page: 6 Bariatric Surgery Post Op Plan Version: 3 Effective on: 12/18/13 **
7 Arrives to Room Sliding Scale Insulin Aspart Protocol Plan PHYSICIAN S insulin aspart (Moderate Dose Insulin Aspart Sliding Scale) 0 12 units, subcut, inj, AC & nightly, PRN glucose levels see parameters Blood glucose <70 if patient is symptomatic; Initiate hypoglycemic protocol and Call physician units subq; units subq; units subq; units subq; units subq; units subq; > units IV now, repeat accucheck in 30 minutes; continue to repeat 10 units IV and accuchecks every 30 minutes until BG <300; then resume normal accucheck and sliding scale routine. Call physician units, subcut, inj, q6h, PRN glucose levels see parameters Blood glucose <70 if patient is symptomatic; Initiate hypoglycemic protocol and Call physician units subq; units subq; units subq; units subq; units subq; units subq; > units IV now, repeat accucheck in 30 minutes; continue to repeat 10 units IV and accuchecks every 30 minutes until BG <300; then resume normal accucheck and sliding scale routine. Call physician units, subcut, inj, q4h, PRN glucose levels see parameters Blood glucose <70 if patient is symptomatic; Initiate hypoglycemic protocol and Call physician units subq; units subq; units subq; units subq; units subq; units subq; > units IV now, repeat accucheck in 30 minutes; continue to repeat 10 units IV and accuchecks every 30 minutes until BG <300; then resume normal accucheck and sliding scale routine. Call physician units, subcut, inj, q2h, PRN glucose levels see parameters Blood glucose <70 if patient is symptomatic; Initiate hypoglycemic protocol and Call physician units subq; units subq; units subq; units subq; units subq; units subq; > units IV now, repeat accucheck in 30 minutes; continue to repeat 10 units IV and accuchecks every 30 minutes until BG <300; then resume normal accucheck and sliding scale routine. Call physician. Order Taken by Signature: Page: 7 Bariatric Surgery Post Op Plan Version: 3 Effective on: 12/18/13 **
8 Arrives to Room Sliding Scale Insulin Aspart Protocol Plan PHYSICIAN S 0 12 units, subcut, inj, TID, PRN glucose levels see parameters Blood glucose <70 if patient is symptomatic; Initiate hypoglycemic protocol and Call physician units subq; units subq; units subq; units subq; units subq; units subq; > units IV now, repeat accucheck in 30 minutes; continue to repeat 10 units IV and accuchecks every 30 minutes until BG <300; then resume normal accucheck and sliding scale routine. Call physician units, subcut, inj, BID, PRN glucose levels see parameters Blood glucose <70 if patient is symptomatic; Initiate hypoglycemic protocol and Call physician units subq; units subq; units subq; units subq; units subq; units subq; > units IV now, repeat accucheck in 30 minutes; continue to repeat 10 units IV and accuchecks every 30 minutes until BG <300; then resume normal accucheck and sliding scale routine. Call physician. insulin aspart (High Dose Insulin Aspart Sliding Scale) 0 14 units, subcut, inj, AC & nightly, PRN glucose levels see parameters Blood glucose <70 and patient is symptomatic; Initiate hypoglycemic protocol and Call physician; units subq; units subq; units subq; units subq; units subq; units subq; > units IV now, repeat accucheck in 30 minutes; continue to repeat 10 units IV and accuchecks every 30 minutes until BG <300, then resume normal accucheck and sliding scale routine. Call physician 0 14 units, subcut, inj, q6h, PRN glucose levels see parameters Blood glucose <70 and patient is symptomatic; Initiate hypoglycemic protocol and Call physician; units subq; units subq; units subq; units subq; units subq; units subq; > units IV now, repeat accucheck in 30 minutes; continue to repeat 10 units IV and accuchecks every 30 minutes until BG <300, then resume normal accucheck and sliding scale routine. Call physician Order Taken by Signature: Page: 8 Bariatric Surgery Post Op Plan Version: 3 Effective on: 12/18/13 **
9 Arrives to Room Sliding Scale Insulin Aspart Protocol Plan PHYSICIAN S 0 14 units, subcut, inj, q4h, PRN glucose levels see parameters Blood glucose <70 and patient is symptomatic; Initiate hypoglycemic protocol and Call physician; units subq; units subq; units subq; units subq; units subq; units subq; > units IV now, repeat accucheck in 30 minutes; continue to repeat 10 units IV and accuchecks every 30 minutes until BG <300, then resume normal accucheck and sliding scale routine. Call physician 0 14 units, subcut, inj, q2h, PRN glucose levels see parameters Blood glucose <70 and patient is symptomatic; Initiate hypoglycemic protocol and Call physician; units subq; units subq; units subq; units subq; units subq; units subq; > units IV now, repeat accucheck in 30 minutes; continue to repeat 10 units IV and accuchecks every 30 minutes until BG <300, then resume normal accucheck and sliding scale routine. Call physician 0 14 units, subcut, inj, TID, PRN glucose levels see parameters Blood glucose <70 and patient is symptomatic; Initiate hypoglycemic protocol and Call physician; units subq; units subq; units subq; units subq; units subq; units subq; > units IV now, repeat accucheck in 30 minutes; continue to repeat 10 units IV and accuchecks every 30 minutes until BG <300, then resume normal accucheck and sliding scale routine. Call physician 0 14 units, subcut, inj, BID, PRN glucose levels see parameters Blood glucose <70 and patient is symptomatic; Initiate hypoglycemic protocol and Call physician; units subq; units subq; units subq; units subq; units subq; units subq; > units IV now, repeat accucheck in 30 minutes; continue to repeat 10 units IV and accuchecks every 30 minutes until BG <300, then resume normal accucheck and sliding scale routine. Call physician insulin aspart (Blank Insulin Aspart Sliding Scale) Order Taken by Signature: Page: 9 Bariatric Surgery Post Op Plan Version: 3 Effective on: 12/18/13 **
10 Arrives to Room Sliding Scale Insulin Aspart Protocol Plan PHYSICIAN S See Comments, subcut, inj, PRN glucose levels see parameters Blood glucose < ; Initiate hypoglycemic protocol and Call physician; units; units subq; units subq; units subq; units subq; units subq; units subq; >400 units IV now, repeat accucheck in 30 minutes; continue to repeat 10 units IV and accuchecks every 30 minutes until BG <, then resume normal accucheck and sliding scale routine. Call physician HYPOglycemia Protocol HYPOglycemia Protocol If BS < 70 mg/dl, and patient SYMPTOMATIC, give 6 oz. of juice PO (if applicable) and/or follow HYPOglycemia Protocol meds. glucose (D50) 25 g, IVP, syringe, as needed, PRN glucose levels see parameters Patient unable to swallow / NPO WITH IV access. Dextrose 50% 50 ml IV. Recheck BG in minutes. Repeat treatment until blood glucose > 100 mg/dl. If not NPO provide additional snack once able to swallow. glucose 15 g, PO, gel, as needed, PRN glucose levels see parameters glucagon 1 mg, IM, inj, as needed, PRN glucose levels see parameters Patient UNABLE to swallow / NPO WITHOUT IV access. Administer Glucagon 1 mg IM or SubQ. Contact physician for further orders. Establish IV access with saline lock. Recheck BG every 15 to 20 minutes. Use aspiration precautions as glucagon may cause nausea and vomiting. Order Taken by Signature: Page: 10 Bariatric Surgery Post Op Plan Version: 3 Effective on: 12/18/13 **
11 Arrives to Room VTE Prophylaxis Plan PHYSICIAN S Patient Care VTE Guidelines See Reference Text for Guidelines ***If VTE Pharmacologic Prophylaxis not given, choose the Contraindications for VTE below and complete reason contraindi cated*** Contraindications VTE Patient low risk for VTE Patient is ambulatory Patient Refusal Family/Caregiver Refusal Cont IV heparin day of/after admission Anticoag therapy not warfarin for Afib Warfarin prior to admit; on hold r/t INR Risk of Bleeding Thrombocytopenia Active Bleeding Alteplase Administered w/in 24 hrs IV Heparin w/in 24 hrs of Surgery Apply Elastic Stockings Apply to: Bilateral Lower Extremities, Length: Knee High Apply to: Left Lower Extremity (LLE), Length: Knee High Apply to: Right Lower Extremity (RLE), Length: Knee High Apply to: Bilateral Lower Extremities, Length: Thigh High Apply to: Left Lower Extremity (LLE), Length: Thigh High Apply to: Right Lower Extremity (RLE), Length: Thigh High Apply Sequential Compression Device Apply to Bilateral Lower Extremities Apply to Left Lower Extremity (LLE) Apply to Right Lower Extremity (RLE) Apply Pedal Pump Apply to Bilateral Feet Apply to Left Foot Apply to Right Foot Medications Medication sentences are per dose. You will need to calculate a total daily dose if needed. ***Recommended Trauma Dose = 30 mg, subcut, q12h*** ***Recommended Dose for Morbidly Obese Patients = 40 mg, subcut, q12h*** enoxaparin 40 mg, subcut, syringe, q24h 30 mg, subcut, syringe, q24h 30 mg, subcut, syringe, q12h 40 mg, subcut, syringe, q12h heparin 5,000 units, subcut, inj, q12h 5,000 units, subcut, inj, q8h fondaparinux 2.5 mg, subcut, syringe, Daily ***If you order RIVAROXABAN for your patient, please indicate the reason below*** Order Taken by Signature: Page: 11 Bariatric Surgery Post Op Plan Version: 3 Effective on: 12/18/13 **
12 Arrives to Room VTE Prophylaxis Plan PHYSICIAN S Reason for Oral Factor Xa Inhibitor Reason: Atrial fibrillation Reason: Persistent atrial fibrillation Reason: Paroxysmal atrial fibrillation Reason: Atrial flutter Reason: Hx Afib/flutter NA w/in 8wks post CABG Reason: Partial hip arthroplasty Reason: Total hip arthroplasty Reason: Total hip replacement Reason: Total knee arthroplasty Reason: Total knee replacement rivaroxaban 10 mg, PO, tab, Daily warfarin 5 mg, PO, tab, QPM aspirin 81 mg, PO, tab, Daily 325 mg, PO, tab, Daily Order Taken by Signature: Page: 12 Bariatric Surgery Post Op Plan Version: 3 Effective on: 12/18/13 **
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PHYSICIAN S Diagnosis Weight Allergies Patient Care Vital Signs Per Unit Standards Per Unit Standards, with Sleeping SpO2 nightly until sat greater than 92% Daily Weight Every AM In AM on Monday, Wednesday,
More informationTRANSCATHETER AORTIC VALVE REPLACEMENT POST- OP PLAN - Phase:.
- Phase:. PHYSICIAN S Diagnosis Weight Allergies DETAILS Patient Care Vital Signs Per Unit Standards, q15min x 4, q30min x 2, then q1h x 4 until sheath discontinued. Per Unit Standards Perform Neurovascular
More informationUMC Health System Patient Label Here. PHYSICIAN ORDERS Diagnosis
CHEST PAIN PLAN UMC Health System PHYSICIAN S Diagnosis Weight Allergies Patient Care Vital Signs Per Unit Standards Daily Weight Patient Activity Up Ad Lib/Activity as Tolerated Assist as Needed Bedrest
More informationOPEN AAA/MAJOR ABDOMINAL POST-OP PLAN - Phase:.
- Phase:. PHYSICIAN S Diagnosis Weight Allergies Patient Care Vital Signs Per Unit Standards Maintain Gastric Tube Maintain Nasogastric - NG, Low Intermittent Suction Maintain Nasogastric - NG, Low Constant
More informationInitials * Page 1 of 6. (place patient label here) Patient Name: Diagnosis: Allergies with reaction type:
Patient Name: Diagnosis: Allergies with reaction type: Orthopedic Upper Ext Post Op Version 3 4/20/17 Patient Placement General Diagnosis/Procedure: Preferred Location/Unit Ortho/Neuro General Medical
More informationUMC Health System Patient Label Here PHYSICIAN ORDERS
Diagnosis Weight Allergies Patient Care Vital Signs Per Unit Standards q12h q12h, Temperature Only - Every Shift and PRN Patient Activity Assist as Needed, Bed Position: As Tolerated, elevate to patient
More informationDONATION AFTER CARDIAC DEATH PLAN
DONATION AFTER CARDIAC DEATH PLAN Diagnosis Weight Allergies Patient Care Core Body Temperature Monitoring Maintain body temp 96-99 degrees Farenheit. Utilize Hyper/Hypothermia blanket prn Insert Gastric
More informationNeurosurgery Pre-Op [1710] Patient Name MRN. General. Nursing. Case Request [ ] Case request operating room Scheduling/ADT, Scheduling/ADT [ ] Other
Neurosurgery Pre-Op [1710] Patient Name MRN General Case Request [ ] Case request operating room Scheduling/ADT, Scheduling/ADT Inpatient Only Procedure (Single Response) ( ) Admit to Inpatient Diagnosis:
More informationWHS POSTOPERATIVE POWERPLAN CHANGES
Medications simplified and standardized to improve safety and effectiveness in the management of pain, itching, nausea/vomiting. Management: o The Anesthesiologist will continue to manage pain in the PACU.
More informationLONG TERM CARE FACILITY ADMIT ORDERS
Page 1 of 7 LONG TERM CARE FACILITY ADMIT ORDERS ADMISSION: Admit patient to Skilled Nursing Facility: Admit patient to Acute Rehabilitation Facility: Admit patient to Subacute Rehabilitation Facility:
More informationPEDIATRIC LIFEGIFT BRAIN DEATH PLAN
PHYSICIAN S Diagnosis Weight Allergies Admit/Discharge/Transfer THIS PLAN IS TO BE ED ONLY ON THE LIFEGIFT ENCOUNTER, WITH DR LIFEGIFT AS THE ATTENDING. Patient Status Pt Status: Inpatient (Inpatient only
More informationOB/GYN ANTEPARTUM PLAN
OB/GYN ANTEPARTUM PLAN PHYSICIAN S Diagnosis Weight Allergies Patient Care Vital Signs Per Unit Standards Patient Activity Up Ad Lib/Activity as Tolerated Bedrest STRICT Bedrest Up to Bedside Commode Only
More informationOrthopedic Admission Hip Fracture Version 2 1/25/2017
Patient Name: Initial each page and Sign/Date/Time last page Diagnosis: Allergies with reaction type: Orthopedic Admission Hip Fracture Version 2 1/25/2017 Patient Placement Patient Status If the physician
More informationHip Hemiarthroplasty Post Op Version 2 4/20/17
Patient Name: Diagnosis: Allergies with reaction type: Hip Hemiarthroplasty Post Op Version 2 4/20/17 Patient Placement General Diagnosis/Procedure: Preferred Location/Unit Ortho/Neuro PCU ICU General
More information(Page 1 of 5) Diagnosis: Procedure: Right Total Knee Replacement Unicompartmental Knee Left Total Hip Revision Total Shoulder
(Page 1 of 5) Allergies/Sensitivities/Reactions: Height: Inches cm Weight: Kg Pounds = Automatic = Physician s option, Check off to Order Diagnosis: Procedure: Right Total Knee Replacement Unicompartmental
More informationPHYSICIAN ORDERS Diagnosis
PICU PROCEDURE PLAN PHYSICIAN S Diagnosis Weight Allergies DETAILS Admit/Discharge/Transfer Patient Status Pt Status: Inpatient (LOS > 2 midnights) Pt Status: Observation (LOS < 2 midnights) Patient Care
More informationPhysician s Order Form. Physician s Order Form. Telemetry/Progressive Care Orders. Continued on next page. >>>>>>> Continued on next page.
DATE: TIME: DATE TIME INTRAVENOS FLID and MEDICATION Status: Admit to Telemetry Admit to Progressive Care nit Transfer to Progressive Care nit Note: Discontinue Previous Orders Transfer to Telemetry nit
More informationPhysician Orders PEDIATRIC: LEB Oral Maxillofacial Post Op Plan
Initiate Orders Phase Care Sets/Protocols/PowerPlans Initiate Powerplan Phase Phase: LEB Oral Maxillofacial Postop Phase, When to Initiate: LEB Oral Maxillofacial Post Op Phase Admission/Transfer/Discharge
More informationUMC Health System Patient Label Here. PHYSICIAN ORDERS Diagnosis
Diagnosis Weight Allergies Patient Care Vital Signs Per Unit Standards q12h q12h, Temperature Only - Every Shift and PRN Patient Activity Assist as Needed, Bed Position: As Tolerated, elevate to patient
More informationBariatric Surgery Post Op Day Version 2 Approved 11/13/2017
Patient Name: Diagnosis: Allergies with reaction type: Bariatric Surgery Post Op Day Version 2 Approved 11/13/2017 Diagnosis Preferred Location/Unit Surgical ICU Code Status: Full Code Activity Ambulate
More informationStandard Precautions Droplet Precautions Standard Precautions Contact Precautions Droplet Precautions Standard Precautions Neutropenic Precautions
Unique Plan Description: Neurosurgery Subarachnoid Hemorrhage Admission Adult Plan Selection Display: Neurosurgery Subarachnoid Hemorrhage Admission Adult PlanType: Medical Version: 10 Begin Effective
More informationPICU BRONCHIOLITIS PLAN
PICU BRONCHIOLITIS PLAN Diagnosis Weight PHYSICIAN S Allergies Admit/Discharge/Transfer Patient Status Pt Status: Inpatient (LOS > 2 midnights) Pt Status: Observation (LOS < 2 midnights) Patient Care Code
More informationPhysician Orders ADULT: Ortho Total Joint Plan
Initiate Orders Phase Non Categorized R Powerplan Open Care Sets/Protocols/PowerPlans Initiate Powerplan Phase Phase: Ortho Total Joint Preop Phase, When to Initiate: Other-See Special Instructions, initiate
More informationALL orders are active unless: 1. Order is manually lined through to inactivate 2. Orders with check boxes ( ) are unchecked DRUG AND TREATMENT ORDERS
DRUG AND TREATMENT Available at: BMC-B BMC-D BMC-N BMC-S Vital Signs Vital Signs Q4H (DEF)* Q2H Q1H Vital Signs Orthostatic Activity Activity Bedrest, for 12 hours then Up ad lib (DEF)* Bedrest, for 24
More informationEPIDURAL / INTRATHECAL POST-OP PLAN
EPIDURAL / INTRATHECAL POST-OP PLAN Diagnosis Weight PHYSICIAN S Allergies Patient Care Vital Signs Per Unit Standards, PLUS check and record RR q1h x 12, then q2h x 6, until 24h following narcotic administration.
More informationDRUG ALLERGIES WT: KG
DRUG AND TREATMENT Available at: BMC-B BMC-D BMC-N BMC-S Vital Signs Vital Signs Q4H (DEF)* Q2H Q1H Vital Signs Orthostatic Activity Activity Bedrest, for 12 hours then Up ad lib (DEF)* Bedrest, for 24
More informationPhysician Orders ADULT: Head and Neck Postoperative Plan
Initiate Orders Phase Care Sets/Protocols/PowerPlans Initiate Powerplan Phase, Phase: Head and Neck Postoperative Phase, When to Initiate: Head and Neck Post Operative Phase, Monitor and Record T,P,R,BP,
More informationTotal Hip Replacement Post Op Version 4 4/20/17
Patient Name: Diagnosis: Allergies with reaction type: Total Hip Replacement Post Op Version 4 4/20/17 Patient Placement General Diagnosis/Procedure: Preferred Location/Unit Ortho/Neuro General Medical
More informationGeneral. Code Status (Single Response) ( ) Full Code Details ( ) Full code - unverified Details ( ) DNRCC Allow additional therapies?
Post Operative Above and Below Knee Amputation Admission [3041300028] Consider adding Insulin Adult -- Subcutaneous Insulin and Hypoglycemia Management [3041300000] General Admission (Single Response)
More informationPhysician Orders ADULT: Asthma and Bronchitis Plan
Initiate Orders Phase Care Sets/Protocols/PowerPlans Initiate Powerplan Phase, Phase: Asthma and Bronchitis Phase, When to Initiate: Asthma and Bronchitis Phase Non Categorized Problem: Asthma Problem:
More informationAdmit date (YYYY/MM/DD): Cardiologist On-Call: Diagnosis: Lab Tests. CBC, Electrolytes, Urea, Creatinine, Glucose, INR, PTT, Urinalysis
of nurse 1. Admit under ward Attending Physician: Dr. Admit date (YYYY/MM/DD): Cardiologist On-Call: Diagnosis: Lab Tests 2. On admission (if not already performed in Emergency Department or in Coronary
More informationUMC Health System Patient Label Here. PHYSICIAN ORDERS Diagnosis
PICU GENERAL PLAN UMC Health System PHYSICIAN S Diagnosis Weight Allergies Patient Care Vital Signs Per Unit Standards Daily Weight Patient Activity Bedrest Up Ad Lib/Activity as Tolerated Strict Intake
More informationIR Central Venous Access [ ] Pre Procedure
IR Central Venous Access [1050200001] Pre Procedure Case Request/Scheduling Procedure Enter IR Case Request if not already completed (All hospitals except Grant Medical Center) [ ] Case Request IR Lab
More informationPhysician Orders ADULT: ANES Enhanced Recovery After Surgery (ERAS) Plan
Initiate Orders Phase Non Categorized R Powerplan Open Care Sets/Protocols/PowerPlans Initiate Powerplan Phase Phase: Anes (ERAS) Pre-insertion Phase, When to Initiate: Other-See Special Instructions,
More informationSEPSIS PLAN - Phase:.
- Phase:. UMC Health System PHYSICIAN S Diagnosis Weight Allergies Patient Care Vital Signs Per Unit Standards Patient Activity Bedrest Bedrest Bathroom Privileges Bedrest Up to Bedside Commode Only Up
More informationPhysician Orders ADULT: Kidney-Panc/PancTransplant Post Op Plan
Initiate Orders Phase Care Sets/Protocols/PowerPlans Initiate Powerplan Phase T;N, Phase: Kidney-Panc/Panc Transp Post Op Phase, When to Initiate: Kidney-Panc/Panc Transp Post Op Phase Vital Signs Vital
More informationUMC Health System Patient Label Here. PHYSICIAN ORDERS Diagnosis
PHYSICIAN S Diagnosis Weight Allergies Admit/Discharge/Transfer Patient Status Requested Location: NICU, Pt Status: Inpatient (LOS > 2 midnights) Pt Status: Observation (LOS < 2 midnights) Pt Status: Inpatient
More informationPHYSICIAN SIGNATURE DATE TIME DRUG ALLERGIES WT: KG
Available at: BMC-B BMC-D BMC-N BMC-S Activity Activity Bedrest with BRP, with assistance at nurse's discretion (DEF)* Ambulate with Assistance Diet Communication Order Patient to remain NPO while in PACU
More informationPEDIATRIC ARGININE CLONIDINE STIMULATION TEST PLAN
Diagnosis Weight Allergies Patient Care Arginine Clonidine Stimulation Test Guid (Arginine Clonidine Stimulation Test Guidelines) See Reference Guidelines. Vital Signs Routine, q1h, With BP, During the
More informationINPATIENT INTERVENTIONAL RADIOLOGY PLAN - Phase: Pre-Procedure Orders
- Phase: Pre-Procedure Orders DETAILS Patient Care Obtain Consent If one is not present on chart today. Vital Signs Per Policy Insert Peripheral Line T;N, Start IV on right side If left radial access is
More informationUMC Health System Patient Label Here PHYSICIAN ORDERS
Weight Allergies Patient Care Vital Signs Per Unit Standards, Q5 min during critical event. Insert Peripheral Line Use 20 gauge or larger. Notify Nurse (DO NOT USE FOR MEDS) Place crash cart with cardiac
More informationSample. Fractured Hip Post-Operative Orders. Legend < Mandatory fields o Optional fields. Height Allergies: List or o Up to date in electronic system
Legend Mandatory fields o Optional fields Height Allergies: List or o Up to date in electronic system cm Weight Diagnosis kg Date (yyyy-mon-dd) Time (hh:mm) Anticipated Date Of Discharge (ADOD) o Greater
More informationr*po1004*r PHYSICIAN S ORDERS Page 1 of 7 HOUR THORACOTOMY POSTOPERATIVE ORDERS General x Admit to Inpatient Status x Admitting Physician: Admit to:
PHYSICIAN S ORDERS Page 1 of 7 General x Admit to Inpatient Status x Admitting Physician: Admit to: SICU Telemetry Med/Surg room x Resuscitation status: see Resuscitation Status Order Activity x Bed rest
More informationPICU Therapeutic Hypothermia Post Cardiac Arrest Re Warming Phase
Arrest Re Warming Phase Weight Allergies Patient Care ***After 24 hours initiate re warming (or after 72 hours for an infant less than one month old)*** PICU Re Warming Protocol ***See Reference Text***
More informationA UMC Health System Performance Improvement Initiative for use in all units where patients with are admitted for Surgical Care Improvement Project.
ENDOLUMINAL AAA POST-OP PLAN A UMC Health System Performance Improvement Initiative for use in all units where patients with are admitted for Surgical Care Improvement Project. *Denotes guideline requirement
More informationPhysician Orders ADULT: PCI Post Procedure Plan
Initiate Orders Phase Care Sets/Protocols/PowerPlans Initiate Powerplan Phase Phase: PCI Post Procedure Phase, When to Initiate: Initiate Powerplan Phase Phase: Post Cath/PCI Hydration Protocol Phase,
More informationAttach patient label here. Physician Orders ADULT: Palliative Care Plan
Initiate Orders Phase Care Sets/Protocols/PowerPlans Initiate Powerplan Phase T;N, Phase: Palliative Care Phase, When to Initiate: Palliative Care Phase Admission/Transfer/Discharge Patient Status Initial
More informationDRUG ALLERGIES WT: KG
DRUG AND TREATMENT Available ONLY at: BMC-B BMC-D BMC-N BMC-S Pre-Op Nursing Orders Communication Order Confirm patient has brought corresponding films for surgery (e.g. back films for back surgery, brain
More informationPhysician Orders PEDIATRIC: LEB NEURO SURG Surgical Spine Post Op Plan
Initiate Orders Phase Care Sets/Protocols/PowerPlans Initiate Powerplan Phase Phase: LEB Neuro Surg Spine Postop Phase, When to Initiate: LEB Neuro Surgical Spine Post Op Phase Admission/Transfer/Discharge
More informationPhysician Orders ADULT: Sickle Cell Inpatient Plan
Initiate Orders Phase Care Sets/Protocols/PowerPlans Initiate Powerplan Phase Phase: Sickle Cell Inpatient Phase, When to Initiate: When patient arrives to unit Sickle Cell Inpatient Phase Admission/Transfer/Discharge
More informationPhysician Orders ADULT: Atrial Fib/Flutter Plan
Initiate Orders Phase Care Sets/Protocols/PowerPlans Initiate Powerplan Phase Phase: Atrial Fib/Flutter Phase, When to Initiate: Atrial Fib/Flutter Phase Non Categorized Problem: Atrial fibrillation Problem:
More informationPhysician Orders ADULT Order Set: Respiratory Failure Orders
[R] = will be ordered Height: cm Weight: kg Allergies: [ ] No known allergies [ ]Medication allergy(s): [ ] Latex allergy [ ]Other: Admission/Transfer/Discharge [ ] Patient Status Initial Inpatient Attending
More informationPhysician Orders PEDIATRIC: LEB DKA Diabetes Mellitus Admit Plan
Initiate Orders Phase Non Categorized R Powerplan Open Care Sets/Protocols/PowerPlans Initiate Powerplan Phase Phase: Admit DKA Two-Bag Calculations Phase, When to Initiate: Initiate Powerplan Phase Phase:
More information* * FORM REV. 02/2019 Page 1 of 4. TNKASE (tenecteplase) / ACUTE STEMI ORDERS SCHEDULED MEDICATIONS:
1. Is this a CMS inpatient only procedure? Yes, admit as inpatient, proceed to # 3 No, proceed to # 2 2. Do you expect that the patient s condition will require a hospital stay that will cross two midnights
More informationPHYSICIAN SIGNATURE DATE TIME DRUG ALLERGIES WT: KG
DRUG AND TREATMENT Condition/Status Patient Status Inpatient Patient Status: Inpatient, Level of Care: Intensive Care (8) Place in Observation Patient Status: Outpatient- Refer for Observation Status,
More informationPhysician Orders ADULT: Renal Transplant Admit Plan
Initiate Orders Phase Care Sets/Protocols/PowerPlans Initiate Powerplan Phase, Phase: Renal Transplant Admit Phase, When to Initiate: Renal Transplant Admit Phase Non Categorized Initiate Powerplan Phase,
More information