DOWNTIME Physician Order CARD CHF Heart Failure
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- Ambrose Underwood
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1 DOWNTIME Physician Clinical Category ADT/Comm unication Patient Status ASC Extended Recovery Observation Services Inpatient Admission CCU Admit as Inpatient History and Physical by House Physician Vital Signs Constant, Q Shift and PRN Comments: Include pulse ox with all vitals, Notify Physician SpO2 less than 92 % T;0400, DAILY, Notify Physician if weight gain greater than 2 lbs in 24 hours. Intake and Output Q8HOURS, Strict I&O Comments: Notify Physician of UO less than 500 ml 8 hours after initial diuretic dose Activity Ambulate In hallway, TID Activity as Tolerated Constant, with assistance as needed Bathroom Privileges Constant, with assistance as needed Nutrition Diet Cardiac with No Caffeine or Decafe Bev Cardiac with No Caffeine or Decafe Bev, General Carb Controlled Cardiac with No Caffeine or Decafe Bev, Consist Carb 3 Carbs/Meal ( ADA) Cardiac with No Caffeine or Decafe Bev, Consist Carb 4 Carbs/Meal ( ADA) Cardiac with No Caffeine or Decafe Bev, Consist Carb 5 Carbs/Meal ( ADA) Misc Nutrition Constant, May resume caffeinated beverages after stress test or if not stress test IV Infusions Saline Lock Peripheral with Saline Flush QShift and PRN (pull Standard IV Catheter Flush s X) VTE Prophylaxis VIEW RELATED RESULTS FOR VTE RISK / SCORE (pull VTE Prophylaxis order X) Contraindication to Pharmacologic Prophylaxis Contraindication, to Pharmacologic Prophylaxis Currently on, anticoagulant (Lovenox, Heparin, Coumadin, Argatroban or Arixtra) LOW RISK VTE - SUBPHASE MODERATE RISK VTE - Lovenox ONLY - SUBPHASE MODERATE RISK VTE - SCDs ONLY - SUBPHASE HIGH RISK VTE - Lovenox AND SCDs - SUBPHASE Diuretics Lasix 40 mg, Injection, IV Push, BID (DIURETIC) 20 mg, Injection, IV Push, BID (DIURETIC) 20 mg, Injection, IV Push, DAILY 20 mg, Injection, IV Push, Q8HOURS 40 mg, Injection, IV Push, DAILY 40 mg, Injection, IV Push, Q8HOURS Angiotensin-Converting Enzyme Inhibitors Prinivil 2.5 mg, Tablet, ORAL, DAILY 5 mg, Tablet, ORAL, DAILY 10 mg, Tablet, ORAL, DAILY 10 mg, Tablet, ORAL, BID 20 mg, Tablet, ORAL, DAILY 20 mg, Tablet, ORAL, BID 40 mg, Tablet, ORAL, DAILY Page 1 of X MEC 0311
2 DOWNTIME Physician Angiotensin-Converting Enzyme Inhibitors - continued Vasotec 2.5 mg, Tablet, ORAL, DAILY 1.25 mg, Injection, IV Push, PRN, PRN: See Note Line Comments: SBP greater than 160 mmhg 5 mg, Tablet, ORAL, BID 5 mg, Tablet, ORAL, DAILY 10 mg, Tablet, ORAL, BID 10 mg, Tablet, ORAL, DAILY 20 mg, Tablet, ORAL, BID 20 mg, Tablet, ORAL, DAILY Core Measure Contraindications Hyperkalemia Renal Dysfunction Bilateral Renal Artery Stenosis Hypotension Moderate Severe Aortic Stenosis Allergy / Intolerance of ACEi and ARB Angiotensin Receptor Blockers Cozaar 25 mg, Tablet, ORAL, DAILY BEFORE BREAKFAST 12.5 mg, Tablet, ORAL, DAILY BEFORE BREAKFAST 50 mg, Tablet, ORAL, BIDAC 50 mg, Tablet, ORAL, DAILY BEFORE BREAKFAST 50 mg, Tablet, ORAL, ONCE 100 mg, Tablet, ORAL, DAILY BEFORE BREAKFAST Beta Blockers Toprol-XL 25 mg, Tablet CR, ORAL, DAILY WITH BREAKFAST 12.5 mg, Tablet CR, ORAL, DAILY WITH BREAKFAST 50 mg, Tablet CR, ORAL, DAILY WITH BREAKFAST 75 mg, Tablet CR, ORAL, DAILY WITH BREAKFAST 100 mg, Tablet CR, ORAL, DAILY WITH BREAKFAST 200 mg, Tablet CR, ORAL, DAILY WITH BREAKFAST 25 mg, Tablet CR, ORAL, BIDWM 50 mg, Tablet CR, ORAL, BIDWM Lopressor 5 mg, Injection, IV Push, Q4HOURS, PRN: See Note Line Comments: for HR above mg, Injection, IV Push, Q6HOURS, PRN: See Note Line Comments: for HR above mg, Tablet, ORAL, BIDWM 100 mg, Tablet, ORAL, BIDWM 5 mg, Injection, IV Push, Q3HOURS 5 mg, Injection, IV Push, Q4HOURS 5 mg, Injection, IV Push, Q6HOURS Page 2 of X MEC 0311
3 DOWNTIME Physician continued Beta Blockers - continued Tenormin 25 mg, Tablet, ORAL, DAILY 25 mg, Tablet, ORAL, BID 12.5 mg, Tablet, ORAL, DAILY 50 mg, Tablet, ORAL, DAILY 50 mg, Tablet, ORAL, BID 100 mg, Tablet, ORAL, DAILY Coreg mg, Tablet, ORAL, BIDWM 6.25 mg, Tablet, ORAL, BIDWM 12.5 mg, Tablet, ORAL, BIDWM mg, Tablet, ORAL, BIDWM 37.5 mg, Tablet, ORAL, BIDWM Core Measure Contraindications Severe Reactive Airway Disease Hypotension Bradycardia / Heart Block Allergy / Intolerance of Beta Blocker Antihypertensives Apresoline 25 mg, Tablet, ORAL, TIDWM 50 mg, Tablet, ORAL, TIDWM 100 mg, Tablet, ORAL, TIDWM 100 mg, Tablet, ORAL, BIDWM Imdur 30 mg, Tablet CR, ORAL, DAILY BEFORE BREAKFAST 15 mg, Tablet CR, ORAL, DAILY BEFORE BREAKFAST 60 mg, Tablet CR, ORAL, DAILY BEFORE BREAKFAST 120 mg, Tablet CR, ORAL, DAILY BEFORE BREAKFAST Nitrates Nitropaste 2% 1 in, Ointment, Topical, Q6HOURS Comments: Pharmacy to order Patch Site Check NitroDur (nitroglycerin) Patch Nitro-Dur 0.1 mg, Patch, Transderm, DAILY 0.2 mg, Patch, Transderm, DAILY 0.3 mg, Patch, Transderm, DAILY 0.4 mg, Patch, Transderm, DAILY 0.6 mg, Patch, Transderm, DAILY NITROGLYCERIN REMOVE PATCH 1 patch(es), Patch, Transderm, QHS 1 patch(es), Patch, Transderm, DAILY NITROGLYCERIN PATCH SITE CHECK 1 patch(es), Transderm, Q8HOURS nitroglycerin drip 250 ML, IV, titrate Comments: concentration 0.2mg/ml, dose per protocol Page 3 of X MEC 0311
4 DOWNTIME Physician continued HMG-CoA Reductase Inhibitors Crestor 5 mg, Tablet, ORAL, QHS Pravachol 80 mg, Tablet, ORAL, QHS Zocor 80 mg, Tablet, ORAL, QHS Core Measure Contraindications Not Tolerated Elevated Liver Enzymes Allergy / Intolerance of Lipid Agents PRN nitroglycerin 0.4 mg, Tablet, Sublingual, Q5MIN, PRN: Chest Pain morphine 2 mg, Injection, IV Push, Q5MIN, PRN: Chest Pain Comments: max. dose 10mg q 1 hr PRN for chest pain not relieved with Nitroglycerin RAMO PRN SUBPHASE (pull RAMO order X) Laboratory Misc Nursing Task, Repeat Labs, S. Cardiac and Troponin Q 6 h x 2. Start 6 hrs after initial set. LIPID PANEL ROUTINE, T+1; Comments: 12 hour fasting, if not done within 6 months CBCWD STAT CBCND ROUTINE T+1;0500 COMPMETA STAT BASICMETA ROUTINE - T+1;0500, DAILY, 2, Day(s) MG STAT MG ROUTINE, T+1;0500 DAILY, 2, Day(s) B TYPE PEP STAT B TYPE PEP ROUTINE, T+1;0500 THYROID GROUP ROUTINE UA NURSE COLLECT Misc Nursing Task HgA1C, T+1;0500, if Fasting Blood Sugar is greater than 150 Radiology XR CHEST 2V PA LAT STAT, CONGESTIVE HEART FAILURE XR CHEST PORTABLE STAT, CONGESTIVE HEART FAILURE Other Diagnostic Procedures Other Diagnostic Procedures EKG STAT ECHO with Definity Definity 2 ML, Injection, IV Push, ONCE, PRN: See Note Line - Dose per protocol Other Diagnostic Procedures Echo Routine Echo CHF, Routine Page 4 of X MEC 0311
5 DOWNTIME Physician Respiratory Oxygen Therapy Nasal Cannula, See additional notes, Constant, 2-5 L NC PRN (if pt has COPD, oxygen at 2 L NC) ABG STAT Consults Cardiac Rehab Consult Phase I and II Heart Failure Home Health Consults Consult Social Services Discharge Planning, Heart Failure Patient Education Heart Failure BID, Document Pt/Family response on Educucation Record and HF Care Education Path Page 5 of X MEC 0311
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PHYSICIAN SIGNATURE DATE TIME DRUG ALLERGIES WT: KG
Available at ALL facilities Non Categorized SUB ED Chest Pain: STEMI Protocol(SUB)* SUB ED Chest Pain: STEMI Protocol Lab Orders(SUB)* ED Rainbow Tubes(SUB)* ***Reminder: Order ED Rainbow Tubes (SUB) as
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PHYSICIAN SIGNATURE DATE TIME DRUG ALLERGIES WT: KG
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ALL orders are active unless: 1. Order is manually lined through to inactivate 2. Orders with check boxes ( ) are unchecked DRUG AND TREATMENT ORDERS
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TELEMETRY BED TRANSFER 1 of 4 9 Actual 9 Estimated Patient ID Area Weight kg 9 Actual 9 Estimated Height cm ALLERGIES: REFER TO ALLERGY PROFILE/ POWERCHART Transfer to: 10 South Attending Physician: Diagnosis:
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PHYSICIAN SIGNATURE DATE TIME DRUG ALLERGIES WT: KG
DRUG AND TREATMENT Available at: ALL Adult Facilities Non Categorized SUB Protocol(SUB)* SUB Protocol Lab Orders(SUB)* ED Rainbow Tubes(SUB)* ***Reminder: Order ED Rainbow Tubes (SUB) as a separate form***
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ALL orders are active unless: 1. Order is manually lined through to inactivate 2. Orders with check boxes ( ) are unchecked DRUG AND TREATMENT ORDERS
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