Physician Orders. PED Endocrine General Admit Plan [X or R] = will be ordered unless marked out. [ ] No known allergies
|
|
- Julianna Stevenson
- 5 years ago
- Views:
Transcription
1 Height: cm Weight: kg Allergies: [ ] No known allergies [ ] Initiate Powerplan Phase T;N, Phase:PED Endo General Admit Phase Admission/Transfer/Discharge [ ] Admit Patient to Dr. Admit Status: [ ] Inpatient [ ] Routine Post Procedure <24hrs [ ] 23 hour OBS Bed Type: [ ] Med/Surg [ ] Critical Care [ ] Stepdown [ ] Telemetry; Specific Unit Location: [ ] Admit Patient T;N [ ] Notify Physician-Once T;N, Of room number on arrival to unit. Primary Diagnosis: Secondary Diagnosis: Vital Signs [ ] Vital Signs T;N, Monitor and Record T,P,R,BP, routine per unit [ ] Vital Signs w/neuro Checks T;N, q4h(std) Activity [ ] Out Of Bed T;N, Up Ad Lib Food/Nutrition [ ] NPO Start at: T;N, Instructions: NPO except for ice chips [ ] NPO Start at: T;N [ ] Breastfeed T;N [ ] Formula Per Home Routine T;N, [ ] American Diabetic Association Pediatric i Diet ( ADA Diet Pediatric i ) T;N, calories, age group, Include 3 meals and 3 snacks. [ ] Clear Liquid Diet T;N Patient Care [ ] Advance Diet As Tolerated T;N, ADA, start clear liquids and advance as tolerated to ADA Diet Pediatric calories [ ] Isolation Precautions T;N, Isolation Type: [ ] Suicide Precautions T;N, Routine, q2h(std) [ ] Strict I/O T;N, Routine, q2h(std) [ ] Restrict Fluids T;N, Routine, ml/hr over next hours (total fluids) [ ] Restrict Fluids T;N, Routine, ml/(12h-shift) (total fluids) [ ] Whole Blood Glucose Nsg ( Bedside T;N, Routine, ACHS and 0200 Glucose Nsg ) [ ] Whole Blood Glucose Nsg ( Bedside T;N, 2h post prandial Glucose Nsg ) [ ] INT Insert/Site Care T;N, Routine, qeve [ ] Daily Weights T;N, Routine, qeve [ ] O2 Sat Spot Check-NSG T;N, with vital signs [ ] O2 Sat Monitoring NSG T;N [ ] Cardiopulmonary Monitor T;N Routine, Monitor Type: CP Monitor [ ] Nursing Communication T;N, Target Blood Sugar Range- Low = 70mg/dL (greater than 3 years of age) [ ] Nursing Communication T;N, Target Blood Sugar Range- Low = 100mg/dL (below 3 years of age) [ ] Nursing Communication T;N, Target Blood Sugar Range- High = 150mg/dL *111* Page 1 of 5
2 Patient Care continued [ ] Nursing Communication T;N, If patient's blood sugar is less than 65 mg/dl and patient is UNresponsive and incapable of taking food orally, call MRT and notify physician immediately. [ ] Nursing Communication T;N, If patient's blood sugar is less than 65 mg/dl and patient is responsive and capable of taking food orally, recheck blood sugar and if still less than 65 mg/dl, give juice or milk and crackers. If about to eat a meal, feed immediatley. Notify physician. [ ] Nursing Communication T;N, Place order for ketones urine if blood glucose greater than 250 mg/dl [ ] Request Supply to Bedside ( Supply to T;N, place home supplies for urine ketone and blood sugar testing at bedside for Bedside ) diabetic education [ ] Nursing Communication T;N, If bedside glucose is greater than 500mg/dL, place order for serum glucose. [ ] Simple Facemask Respiratory Care T; N, L/min, Titrate to keep O2 sat =/> 92% Wean to room air [ ] O2 Nasal Cannula T; N, L/min, Titrate to keep O2 sat =/> 92% Wean to room air [ ] Sodium Chloride 0.9% Continuous Infusions 1,000mL,IV,Routine,T:N, at ml/hr [ ] D10 NS + 20 meq/l KCL 1000mL,IV,Routine,T:N, at ml/hr [ ] D5 1/2 NS 1000mL,IV,Routine,T:N, at ml/hr [ ] D5 1/4 NS 1000mL,IV,Routine,T:N, at ml/hr [ ] D5 1/2 NS KCl 20 meq/l 1000mL,IV,Routine,T:N, at ml/hr [ ] D5 1/4 NS KCl 20 meq/l 1000mL,IV,Routine,T:N, at ml/hr Medications [ ] acetaminophen mg(10 mg/kg), Liq, PO, q4h, PRN, Pain or Fever, T;N,Max Dose = 90mg/kg/day up to 4 g/day [ ] acetaminophen 80 mg, chew tab, PO, q4h, PRN, Pain or Fever, T;N,Max Dose = 90 mg/kg/day up to 4 g/day [ ] acetaminophen 325mg, tab, PO, q4h, PRN, Pain or Fever, T;N,Max Dose = 90 mg/kg/day up to 4 g/day [ ] acetaminophen mg(10 mg/kg), Supp, PR, q4h, PRN, Pain or Fever, T;N,Max Dose = 90mg/kg/day up to 4 g/day [ ] insulin glargine units, (0.5 units/kg),injection, Subcutaneous, hs, routine, T;N [ ] insulin glargine units, (0.5 units/kg),injection, Subcutaneous, qam, routine, T;N NOTE: Insulin Lispro Corrective Dose per blood glucose mg/dl. Carbohydrate counting dose per grams of carbohydrate with meals. Comment, routine, T;N, Corrective dose: 1 unit for every 25 mg/dl over target 120 Comment, routine, T;N, Corrective dose: 1 unit for every 25 mg/dl over target 150 Comment, routine, T;N, Corrective dose: 1 unit for every 25 mg/dl over target 180 Comment, routine, T;N, Corrective dose: 1 unit for every 50 mg/dl over target 120 Page 2 of 5
3 Medications continued [ ] insulin lispro units, (1 unit), Injection, Subcutaneous,prn, PRN Other Specify in Comment Other Specify in Comment, routine, T;N, Corrective dose: 1 unit for every 50 mg/dl over target 150 Comment, routine, T;N, Corrective dose: 1 unit for every 50 mg/dl over target 180 [ ] insulin lispro units, (1 unit), Injection, Subcutaneous, prn,prn Other Specify in Comment, routine, T;N, Corrective dose: 1 unit for every 75 mg/dl over target 120 Comment, routine, T;N, Corrective dose: 1 unit for every 75 mg/dl over target 150 Comment, routine, T;N, Corrective dose: 1 unit for every 75 mg/dl over target t grams of carbohydrate with meals and as needed for snack(s) 7.5 grams of carbohydrate with meals and as needed for snack(s) 10 grams of carbohydrate with meals and as needed for snack(s) 15 grams of carbohydrate with meals and as needed for snack(s) 20 grams of carbohydrate with meals and as needed for snack(s) 25 grams of carbohydrate with meals and as needed for snack(s) 30 grams of carbohydrate with meals and as needed for snack(s) [ ] insulin lispro units, (0.25 units/kg), Injection, Subcutaneous, once, routine, T;N [ ] glucagon 1 mg, Injection, Subcutaneous, PRN, Hypoglycemic seizure, routine, T;N [ ] glucagon 1 mg, Injection, Subcutaneous, once, Hypoglycemia, routine, T;N, Available for diabetes education Page 3 of 5
4 Laboratory [ ] Basic Metabolic Panel ( BMP ) T;N, Routine, once, Type: Blood [ ] Osmolality Serum T;N, Routine, once, Type: Blood [ ] FSH T;N, Routine, once, Type: Blood [ ] LH T;N, Routine, once, Type: Blood [ ] Growth Hormone Human Level T;N, Routine, once, Type: Blood [ ] Anti Diuretic Hormone T;N, Routine, once, Type: Blood [ ] Prolactin Level T;N, Routine, once, Type: Blood [ ] BNP T;N, Routine, once, Type: Blood [ ] ProBNP T;N, Routine, once, Type: Blood [ ] Androstenedione T;N, Routine, once, Type: Blood [ ] Deoxycortisol-11 (Specific S) T;N, Routine, once, Type: Blood [ ] Cortisol Level T;N, Routine, once, Type: Blood [ ] DHEA Level T;N, Routine, once, Type: Blood [ ] Deoxycorticosterone T;N, Routine, once, Type: Blood [ ] 17-HydroxyPregnenolone T;N, Routine, once, Type: Blood [ ] Progesterone Level T;N, Routine, once, Type: Blood [ ] 17-HydroxyPregesterone T;N, Routine, once, Type: Blood [ ] Testosterone Level T;N, Routine, once, Type: Blood [ ] Amylase Level T;N, Routine, once, Type: Blood [ ] Lipase Level T;N, Routine, once, Type: Blood [ ] Hepatic Panel T;N, Routine, once, Type: Blood [ ] Thyroglobulin Comp Panel T;N, Routine, once, Type: Blood [ ] Microsomal Antibody T;N, Routine, once, Type: Blood [ ] TSH T;N, Routine, once, Type: Blood [ ] T4 Free ( Free T4 ) T;N, Routine, once, Type: Blood [ ] T3 Level T;N, Routine, once, Type: Blood [ ] T3 Reverse ( Reverse T3 ) T;N, Routine, once, Type: Blood [ ] Chromosome Analysis Blood T;N, Routine, once, Type: Blood [ ] Calcium Ionized T;N, Routine, once, Type: Blood [ ] Phosphorus Level T;N, Routine, once, Type: Blood [ ] Magnesium Level T;N, Routine, once, Type: Blood [ ] PTH T;N, Routine, once, Type: Blood [ ] Lactic Acid Level ( Lactate Level ) T;N, Routine, once, Type: Blood [ ] Pyruvate T;N, Routine, once, Type: Blood [ ] Insulin Like Growth Factor I T;N, Routine, once, Type: Blood [ ] Insulin Like Growth Factor II T;N, Routine, once, Type: Blood [ ] IGF Binding Protein 1 T;N, Routine, once, Type: Blood [ ] IGF Binding Protein 3 T;N, Routine, once, Type: Blood [ ] PED GTT 2Hr with Insulin Plan see separate sheet [ ] Ketones Urine Routine, T;N, once, Type: Urine, Nurse Collect [ ] Osmolality Urine Routine, T;N, once, Type: Urine, Nurse Collect [ ] Catecholamine Urine Random Routine, T;N, once, Type: Urine, Nurse Collect [ ] Iodide Urine Random Routine, T;N, once, Type: Urine, Nurse Collect [ ] GGT Routine, T;N, once, Type: Blood [ ] Vitamin D 25 Hydroxy Routine, T;N, once, Type: Blood [ ] Vitamin D1, 25 Dihydroxy Routine, T;N, once, Type: Blood Page 4 of 5
5 Laboratory continued [ ] Hemoglobin A1C Routine, T;N, once, Type: Blood [ ] Hemoglobinopathy Evaluation Routine, T;N, once, Type: Blood (Abnormal Hemoglobin Analysis(HPLC) ) [ ] Erythrocyte Sedimentation Rate ( Sed Routine, T;N, once, Type: Blood Rate ) [ ] FISH Study, t(22;11) Routine, T;N, once, Type: Blood [ ] Cortisol Level Routine, T+1;0400, once, Type: Blood [ ] Lipid Profile Routine, T+1;0400, once, Type: Blood [ ] Hepatitis Profile (A,B,&C) PED Routine, T;N, once, Type: Blood Diagnostic Tests [ ] Chest 2VW Frontal & Lat ( Chest PA & T;N, Routine, Routine, Transport: Wheelchair Lateral) [ ] Abd Sing AP VW ( KUB ) T;N, Routine, Routine, Transport: Wheelchair [ ] GI Upper Air Cont w Sm Bowel see separate sheet Follow Thro w/delay diet Plan [ ] Urethrocystogram Voiding T;N, Routine, Routine, Transport: Wheelchair [ ] US Retroperitoneal B Scan/Real Time T;N,Routine,Routine, Transport: Wheelchair Comp ( Renal Ultrasound ) [ ] US Head & Neck Soft Tissues Thyroid/Para ( Thyroid Ultrasound ) T;N, Reason for Exam: Goiter, Routine, Wheelchair [ ] Abd Ltd Sing Organ F/U w/delay diet see separate sheet Plan [ ] US Pelvic Non OB Comp T;N, Reason for Exam: Other, Enter in Comments, ROUTINE, Wheelchair, Comment: ambiguous genitalia [ ] Echocardiogram Pediatric (0-18 yrs) T;N,Routine,Routine, Transport: Wheelchair [ ] NM Thyroid Imag Only T;N,Routine, Routine, Transport: Wheelchair Consults/Notifications [ ] Notify Physician-Continuing T;N, For: All Blood Sugar Results, Who : [ ] Physician Group Consult T;N, Consult Who:,Reason: [ ] Physician Consult T;N, Consult Who:,Reason: [ ] Consult Medical Social Work T;N, Routine, Reason [ ] Diabetic Teaching Consult T;N, Reason [ ] Dietitian Consult T;N, Type of Consult: Education Date Time Physician's Signature MD Number Page 5 of 5
Physician Orders LEB PICU Status Epilepticus Plan. [ ] No known allergies
Height: cm Weight: kg Allergies: [ ] No known allergies [ ] Initiate Powerplan Phase T;N, Phase: LEB PICU Admit Phase Admission/Transfer/Discharge [ ] Admit Patient to Dr. [ ] Admit Status: [ ] Inpatient
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 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 informationPhysician Orders PEDIATRIC: LEB NEURO Epilepsy Monitoring Unit Admit Plan
Initiate Orders Phase Care Sets/Protocols/PowerPlans Initiate Powerplan Phase Phase: LEB Neuro Epilepsy Monitoring Unit Admit Phase, When to Initiate: LEB Neuro Epilepsy Monitor Unit Admit Phase Non Categorized
More informationPhysician Orders PEDIATRIC: LEB Stroke Admit Plan
Initiate Orders Phase Care Sets/Protocols/PowerPlans Initiate Powerplan Phase Phase: LEB Stroke Admit Phase. When to Initiate: LEB Stroke Admit Phase Admission/Transfer/Discharge Patient Status Initial
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 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 Kidney Transplant Post Op Plan
Initiate Orders Phase Care Sets/Protocols/PowerPlans Initiate Powerplan Phase Phase: LEB Kidney Transplant Post Op Phase, When to Initiate: LEB Kidney Transplant Post Op Phase Admission/Transfer/Discharge
More informationPhysician Orders ADULT: LEB Asthma Admit Plan. Anticipated LOS: 2 midnights or more Patient Status Initial Outpatient T;N Attending Physician:
Initiate Orders Phase Care Sets/Protocols/PowerPlans Initiate Powerplan Phase, Phase: LEB Asthma Admit Phase, When to Initiate: LEB Asthma Admit Phase Non Categorized Add To Problem List Problem: Asthma
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 informationPhysician Orders PEDIATRIC: LEB Eating Disorder Admit Plan
Initiate Orders Phase Care Sets/Protocols/PowerPlans Initiate Powerplan Phase Phase: LEB Eating Disorder Admit Phase, When to Initiate: When patient arrives to unit LEB Eating Disorder Admit Phase Admission/Transfer/Discharge
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: Acute MI/Acute Coronary Syndrome Adult Plan
Initiate Orders Phase Care Sets/Protocols/PowerPlans Initiate Powerplan Phase Phase: Acute MI/Acute Coronary Syndrome Adult Phase, When to Initiate: Acute MI/Acute Coronary Syndrome Adlt Phase Non Categorized
More informationPhysician Orders: Pediatric. Title: LEB PICU Asthma Plan [X or R] = will be ordered unless marked out.
Height: cm Weight: kg Allergies: [ ] No known allergies [ ]Medication allergy(s): [ ] Latex allergy [ ]Other: Uncategorized [X] Initiate Powerplan Phase T;N, Phase: LEB PICU Asthma Phase When to Initiate:
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 informationPhysician Orders PEDIATRIC: LEB ED Hx of DKA with Hyperglycemia Plan
LEB ED Triage Hx of DKA w Hyperglycemia Non Categorized Criteria for use: Patients less than 18 years of age with known or suspected Diabetes Mellitus and blood glucose greater than 300mg/dL.(NOTE)* Vital
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 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 information*111* attach patient label here
Physician Orders ADULT [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
More informationADMIT DIABETIC KETOACIDOSIS (DKA) PLAN - Phase: Begin Immediately/Emergency Center
- Phase: Begin Immediately/Emergency Center Weight PHYSICIAN S Allergies Admit/Discharge/Transfer Patient Status Requested Location: MICU, Pt Status: Inpatient (LOS > 2 midnights) Requested Location: 5E
More informationPICU ADMIT DKA PLAN - Phase: Begin Immediately
- Phase: Begin Immediately Diagnosis Weight Allergies Admit/Discharge/Transfer Patient Status Requested Location: PICU, Pt Status: Inpatient (LOS > 2 midnights) Requested Location: PICU, Pt Status: Observation
More informationPhysician Orders PEDIATRIC: : LEB ED Trauma (Major) Plan
LEB ED Standing Orders Trauma (Major) Ph Non Categorized Criteria: Patients between 0-18 years of age that present with a Major Trauma that meet LeBonheur Trauma stat or Trauma Alert Guidelines.(NOTE)*
More informationPhysician Orders Pediatric: LEB ED Asthma Plan
LEB ED Triage Standing SOB/Wheeze Asthma Non Categorized Criteria: Patients greater than 2 years of age with a history of asthma or airway active disease or two or more previous illnesses treated with
More informationIDPH ESF-8 Plan: Pediatric and Neonatal Surge Annex Sample Pediatric Admission Orders 2015
Purpose: To provide guidance to practitioners caring for pediatric patients who need inpatient hospital care during a disaster. Disclaimer: This guideline is not meant to be all inclusive, replace an existing
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 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. LEB NICU Sepsis Plan [X or R] = will be ordered unless marked out.
Height: cm Weight: kg Allergies: [ ] No known allergies [ ] Latex allergy [ ]Other: [ ] Initiate Powerplan Phase, Phase: LEB NICU Sepsis Phase Admission/Transfer/Discharge [ ] Patient Status Initial Inpatient
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 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 informationPEDIATRIC CYSTIC FIBROSIS PLAN - Phase:.
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 informationPEDIATRIC SPINE SURGERY POST-OP PLAN - Phase:.
- Phase:. PHYSICIAN S Diagnosis Weight Allergies DETAILS Patient Care Patient Activity Bedrest Maintain Surgical Drain Maintain JP Drain, Measure Output q12h, and PRN Convert IV to INT when tolerating
More informationPhysician Orders ADULT
Admission Height (Actual) : cm Admission Weight (Actual): kg Allergies: No known allergies Medication allergy(s): Latex allergy Other: Non-Categorized ATTENTION SURGEON: Please discontinue Open Heart Post
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 informationPhysician Orders PEDIATRIC: LEB Critical Care Respiratory Plan
LEB Critical Care Respiratory Plan Patient Care Cardiopulmonary Monitor T;N Routine, Monitor Type: End Tidal Co2 (DEF)* T;N Routine, Monitor Type: Transcutaneous Co2 Respiratory Care Initiate Pediatric
More information***SPECIAL CONSIDERATION:
ADULT ANESTHESIA POST-OP OUTPATIENT SURGERY PLAN Dx PHYSICIAN S Weight Allergies DETAILS Admit/Discharge/Transfer Return Patient to PACU Patient Care ***Patients who are at high risk for obstructive sleep
More informationPhysician Orders PEDIATRIC: LEB Ortho Accelerated Posterior Spinal Fusion Post Op Plan
Initiate Orders Phase Care Sets/Protocols/PowerPlans Initiate Powerplan Phase Phase: LEB Ortho Accelerated PSF Post Op Initial Phase, When to Initiate: Initiate Powerplan Phase Phase: LEB Ortho Accelerated
More informationPhysician Orders ADULT: Vascular Surgery AAA Repair Open Post Op Plan
Initiate Orders Phase Care Sets/Protocols/PowerPlans Initiate Powerplan Phase Phase: AAA Repair Open Postop Phase, When to Initiate: Initiate Powerplan Phase Phase: Mechanically Ventilated Patients Phase,
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
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*** Nursing Orders
More informationGabapentin Research Pain Study for Ortho Total Knee Replacement Post-Op Plan - PACU Ortho Phase
Total Knee Replacement Post-Op Plan - PACU Ortho Phase Diagnosis Weight Allergies Admit/Discharge/Transfer Patient Status Requested Location: 3W, Pt Status: Inpatient (LOS > 2 midnights) Patient Condition
More informationPHYSICIAN SIGNATURE DATE TIME DRUG ALLERGIES WT: KG
DRUG AND TREATMENT *****ALSO ORDER SUB ACUTE DKA IV FLUIDS REGIMEN & SUB ACUTE ELECTROLYTE REPLACEMENT on separate forms ***** Condition/Status For purpose of this DKA Regimen, DKA is considered clear
More informationPhysician Orders ADULT: Vascular Surgery AAA Endovascular Post Op Plan
Initiate Orders Phase Care Sets/Protocols/PowerPlans Initiate Powerplan Phase Phase: AAA Endovascular PACU Phase, When to Initiate: Initiate Powerplan Phase Phase: Mechanically Ventilated Patients Phase,
More informationPEDIATRIC SPINE SURGERY POST-OP PLAN - Phase: Pediatric Spine Surgery General Orders
- Phase: Pediatric Spine Surgery General Orders PHYSICIAN S Diagnosis Weight Allergies Patient Care Patient Activity Bedrest Maintain Surgical Drain Maintain JP Drain, Measure Output q12h, and PRN Convert
More informationDRUG ALLERGIES WT: KG
DRUG AND TREATMENT Acute Diabetic Ketoacidosis Condition/Status ***(NOTE)*** For purpose of this DKA Regimen, DKA is considered clear only when the CO2 is GREATER than 18 meq/l and the anion gap is LESS
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 informationPHYSICIAN SIGNATURE DATE TIME DRUG ALLERGIES WT: KG
DRUG AND TREATMENT Available at: BMC-B BMC-D BMC-N BMC-S Condition/Status Patient Status Inpatient Patient Status: Inpatient, Level of Care: Med/Surg without Telemetry (1) (DEF)* Patient Status: Inpatient,
More informationLIBERTYHEALTH. Jersey City Medical Center Department of Patient Care Services. Approved by Policy Committee:
LIBERTYHEALTH Jersey City Medical Center Department of Patient Care Services Guidelines: CRITICAL CARE INSULIN PROTOCOL (MICU/SICU, CCU, ED) Developed by: Pharmacy Dept Approved by: Rita Smith, DNP Senior
More informationBariatric Surgery Post Op Plan PACU Phase
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
More informationDKA Adult ICU Powerplan
DKA Adult ICU Powerplan Key Points for ED to ICU DKA power plan In addition to NS fluids and maintenance the regular insulin drip will either already be infusing from ED or needs to be initiated. Regular
More informationPatient: Becky Smith DOB: 01/26/XXXX Age: 5 y/o Attending: Dr. D. Miles Allergies: NKA MR#: 203. Patient Chart #203 Becky Smith
Patient Chart #203 Becky Smith 1 Property of CSCLV CSCLV Rev: 06/04/2018 Chief Complaint: Abdominal pain. Informant: Parents. HISTORY & PHYSICAL HPI: Ill looking patient, healthy until 2 days ago when
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 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 informationTables of Normal Values (As of February 2005)
Tables of Normal Values (As of February 2005) Note: Values and units of measurement listed in these Tables are derived from several resources. Substantial variation exists in the ranges quoted as normal
More informationPhysician Orders ADULT: Medical Response Team Standing Orders Protocol Plan
Initiate Orders Phase Care Sets/Protocols/PowerPlans Initiate Powerplan Phase When to Initiate: Other-See Special Instructions, If MRT is notified per MD, Condition H or any associate, review and Initiate
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 informationADMIT GENERAL MEDICINE PLAN - Phase: Begin Immediately
- Phase: Begin Immediately Weight PHYSICIAN S Allergies Admit/Discharge/Transfer Patient Status Patient Condition Acuity Level Floor Status Acuity Level Critical Acuity Level Intermediate Continuous Telemetry
More informationENT THYROIDECTOMY/PARATHYROIDECTOMY POST OP PLAN - Phase: Begin Immediately/PACU
- Phase: Begin Immediately/PACU PHYSICIAN S Diagnosis Weight Allergies Laboratory Calcium Level STAT Outpatient/PACU, T;N PTH Intact STAT Outpatient/PACU, T;N 1 of 7 - Phase: When Patient Arrives to Room
More informationPhysician Orders ADULT
Physician Orders ADULT attach patient label here Order Set: ED Non-STEMI Unstable Angina Orders Height: cm Weight: kg Allergies: No known allergies Medication allergy(s): Latex allergy Other: Admission/Transfer/Discharge
More informationORTHO TOTAL KNEE REPLACEMENT POST-OP PLAN - Phase: PACU Ortho Phase
- Phase: PACU Ortho Phase PHYSICIAN S Diagnosis Weight Allergies DETAILS Admit/Discharge/Transfer Patient Status Patient Condition Acuity Level Floor Status Acuity Level Critical Acuity Level Intermediate
More informationPHYSICIAN SIGNATURE DATE TIME DRUG ALLERGIES WT: KG
DRUG AND TREATMENT Available ONLY at: BMC-B BMC-D BMC-N BMC-S Nursing Orders Communication Order If CVP unavailable, administer fluid boluses every 30 minutes except monitor O2 requirements Comments: Every
More informationBARIATRIC SURGERY POST-OP PLAN - Phase: PACU Phase
- Phase: PACU Phase Diagnosis Weight Allergies DETAILS Admit/Discharge/Transfer Patient Status Pt Status: Inpatient (LOS > 2 midnights) Pt Status: Observation (LOS < 2 midnights) Pt Status: Inpatient (Inpatient
More informationLIFEGIFT BRAIN DEATH PLAN
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 procedure)
More informationTHROMBOLYTIC THERAPY FOR PERIPHERAL OCCLUSION
THROMBOLYTIC THERAPY FOR PERIPHERAL OCCLUSION PHYSICIAN S Diagnosis Weight Allergies Admit/Discharge/Transfer ***PROVIDER MUST CHECK MEDICATION LIST PRIOR TO PLACING THESE S*** Patient Care Vital Signs
More informationGENERAL MEDICINE PLAN
GENERAL MEDICINE PLAN 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 Bedrest Bathroom
More informationPediatric Order Set 0 through 16 yrs age Addressograph Stamp
Date Pediatric Order Set 0 through 16 yrs age Time 1. [ ] Place in Observati: [ ] Mitored Telemetry Bed [ ] Unmitored Bed OR [ ] Admit to Inpatient: [ ] Med-Surg Telemetry Mitor [ ] Med-Surg 2. Diagnosis:
More informationENT THYROIDECTOMY/PARATHYROIDECTOMY POST OP ADMIT PLAN - Phase: Begin Immediately/PACU
- Phase: Begin Immediately/PACU Diagnosis Weight Allergies DETAILS Admit/Discharge/Transfer Patient Status Pt Status: Inpatient (LOS > 2 midnights) Pt Status: Observation (LOS < 2 midnights) Pt Status:
More informationStandardized Nurse Activated Protocols (SNAPs)
SNAPs by presenting complaint/problem help nurses initiate care before the patient is seen by a physician. SNAPs should be approved by ED team consensus If patient unstable in any way, immediately notify
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 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 informationSaskatchewan ND Price List
Saskatchewan ND Price List Note: There is a $55 per requisition documentation fee. Prices valid only in Saskatchewan. PANEL Healthy Living Assessment Panel $115.00 Enhanced Healthy Living Assessment Panel
More informationIV Acetaminophen Pain Study for Neurosurgery Post Op Non ICU Admit Plan Begin Immediately/PACU
Post Op Non ICU Admit Plan Begin Immediately/PACU PHYSICIAN S Weight Allergies Admit/Discharge/Transfer Request Patient Bed Requested Location: 3W, Pt Status: Inpatient (LOS > 2 midnights) Patient Condition
More informationALL orders are active unless: 1. Order is manually lined through to inactivate 2. Orders with check boxes ( ) are unchecked
Available at: BMC-B BMC-D BMC-N BMC-S Condition/Status ***(NOTE)***For purpose of this DKA Regimen, DKA is considered clear only when the CO2 is GREATER than 18 meq/l and the anion gap is LESS than 12
More informationOB/GYN POSTPARTUM VAGINAL DELIVERY PLAN
OB/GYN POSTPARTUM VAGINAL DELIVERY PLAN PHYSICIAN S Diagnosis Weight Allergies DETAILS Admit/Discharge/Transfer Patient Discharge Anticipated in 24 Hour (Patient Discharge Anticipated in 24 Hours) Patient
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 informationPediatric Outpatient Surgery Plan - Diagnostic/Pre-Op Orders
Pediatric Outpatient Surgery Plan - Diagnostic/Pre-Op Orders Diagnosis Weight PHYSICIAN S Allergies Admit/Discharge/Transfer Request for Outpatient Services Location: Outpatient Surgery Communication Misc
More informationGENERAL SURGERY POST-OP PLAN
GENERAL SURGERY POST-OP PLAN PHYSICIAN S Diagnosis Weight Allergies Patient Care Vital Signs Per Unit Standards Patient Activity Up Ad Lib/Activity as Tolerated Assist as Needed Bedrest Bedrest Bathroom
More informationAnalyte Specimen Demographic Reference Range Units
Acetone Negative titer Alanine aminotransferase (ALT/SGPT) 10-49 U/L Albumin 3.2-4.8 g/dl Alcohol < 10 Alpha-fetoprotein (AFP) < 1.3-8.1 ng/ml Alkaline phosphatase 0 7 days 7 30 days 1 3 3 6 6 12 1 3 3
More informationStudy Orders Center for Clinical Investigation
Please indicate if this visit is an INPATIENT admission or an OUTPATIENT visit Subject Legal Name: D.O.B.: Age: Medical Record #: Gender: Ethnicity: Race: Admitting Information INPATIENT or OUTPATIENT
More informationICL Integrative Laboratory Services Test Menu Contact ICL Client Care x300
Alletess Food Sensitivity Fingerstick 96 Foods IgG with or without Wellness Program 184 Foods IgG with or without Wellness Program Alletess Food Allergy/Sensitivity Serum 96 Foods IgG with or without Wellness
More informationMonitor patient s ability to self-administer insulin. (To evaluate safe administration of drug.)
Nursing Process Focus: Patients Receiving Regular Insulin (Humulin, Novolin) Assessment Prior to administration: Assess any patient allergies. Older forms of insulin are made from beef and pork and may
More informationPHYSICIAN S ORDERS Page 1 of 1 Providence Hospital ICU Insulin Drip Protocol
DTE PROVIDENCE HOSPITL 6801 irport Boulevard, Mobile L 36608, PHYSICIN S ORDERS Page 1 of 1 Providence Hospital ICU Insulin Drip Protocol 1. Discontinue all previous insulin and oral diabetic medications
More informationInitiation of Diets: Inpatient & Outpatient
Kaiser Permanente Los Angeles Medical Center Center Initiation of Diets: Inpatient & Outpatient Epilepsy & Brain Mapping Program, Huntington Memorial Hospital, Pasadena CA Danine Mele-Hayes, RD History
More informationPHYSICIAN SIGNATURE DATE TIME DRUG ALLERGIES WT: KG
DRUG AND TREATMENT Non Categorized SUB Sub Phase (SUB)* Non Categorized Quality Measures STK Diet ED NPO Until Bedside Swallow Screen passed Nursing Orders Activate Code Stroke Vital Signs Q15MINS Int
More informationPOST-OP CARDIAC SURGERY PHYSICIAN S ORDER SHEET USE BALLPOINT PEN ONLY. CARDIAC INTENSIVE CARE UNIT
PHYSICIAN S SHEET Automatically Activate, if not in agreement, cross out and initial Activated by Checking Box ALLERGIES: None known YES Patient s Height: Patient s Weight: ALL MEDICATION and INTRAVENOUS
More informationPediatric Intensive Care Unit (PICU) Pediatric Diabetic Ketoacidosis (DKA) Admission Order Set
Discontinue all previous orders Weight: kg DKA admit order set is for initial management Ongoing management required based on frequent reassessment of TFI, fluid balance and lab results. Admit to PICU
More informationGENERAL SURGERY PLAN - Phase:.
- Phase:. 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 Bedrest Bathroom Privileges
More informationPHYSICIAN SIGNATURE DATE TIME DRUG ALLERGIES WT: KG
DRUG AND TREATMENT Available at: ALL Adult Facilities Non Categorized SUB ED Abdominal Pain Protocol(SUB)* ***The above subphase is available at the end of the plan*** SUB ED Abdominal Pain Protocol Lab
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 informationOB/GYN POSTPARTUM VAGINAL DELIVERY PLAN
OB/GYN POSTPARTUM VAGINAL DELIVERY 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
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 informationLYSIS OF ADHESIONS POST-OP PLAN - Phase: PACU Phase
- Phase: PACU Phase PHYSICIAN S Diagnosis Weight Allergies Communication Place Device at Bedside Confirm there are 3 x Aliquots of 0.2% Ropivacaine. 2 x Medfusion Infusion pumps. Confirm 3 x PF Aliquots
More information1. Attending Physician: Dr Syn Pager: Cell: Co-Morbidities:
BARIATRIC SURGERY IMMEDIATE POST-OP PLAN (Includes Post Op Day 1) Denotes order requirement Antibiotic administered in the OR at: 1. Attending Physician: Dr Syn Pager: 740-6545 Cell: 438-9415 2. To remain
More informationDiabetes and Kids- Keeping them Safe at School. Presented by Vanessa Skolness, DNP, APRN-CNP, CDE March 30 th, Diabetes Summit
Diabetes and Kids- Keeping them Safe at School Presented by Vanessa Skolness, DNP, APRN-CNP, CDE March 30 th, 2017- Diabetes Summit Objectives Brief review of type 1 and type 2 diabetes in children Discuss
More informationDiagnosis: Allergies:
Patient Name: Diagnosis: Allergies: ICU Sepsis Version 5 1/11/17 This order set must be used with an admission order set if patient not already admitted. Nursing Orders Verify that cultures have been obtained
More informationPhysician Orders ADULT: Routine Deceased Donor Adult Plan
Initiate Orders Phase Non Categorized NOTE: Nurse - confirm PM Discharge disposition set to "Donor and or Life Support" on hospital encounter. Enter these orders on new OP encounter created by Access/Registration
More informationAcute Stroke with Alteplase Administration Order Set
Review Due Date: 2017 October PATIENT CARE DERS Weight: Adverse Reactions or Intolerances Drug No Yes (list) Food No Yes (list) _ Latex No Yes Admission Admit to Neurology service: Dr. Critical Care Diagnosis:
More informationRISK FACTORS OR COMPLICATIONS AND RECOMMENDED TREATMENT GOALS AND FREQUENCY OF EVALUATION FOR ADULTS WITH DIABETES
RISK FACTORS OR COMPLICATIONS AND RECOMMENDED TREATMENT GOALS AND FREQUENCY OF EVALUATION FOR ADULTS WITH DIABETES Risk Factors or Complications Glycemic Control Fasting & Capillary Plasma Glucose Anti-platelet
More informationOrgan Donor Management Recommended Guidelines ADULT Brain Death (NDD)
Date: Time: = Always applicable = Check if applicable ADMISSION INSTRUCTIONS Neurological Determination of Death (NDD) has been performed by at least 2 licensed physicians Contact initiated with BC Transplant
More informationClinical Guideline DKA
Clinical Guideline DKA Pediatric Emergency & Critical Care Medicine! This guideline should not replace clinical judgment. Inclusion criteria: Known Diabetes Mellitus Concern for new onset Diabetes Mellitus
More information