IV Acetaminophen Pain Study for Neurosurgery Post Op Non ICU Admit Plan Begin Immediately/PACU
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- Jonas Casey
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1 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 Acuity Level Floor Status Acuity Level Intermediate Communication Code Status Code Status: Full Code Code Status: DNR Do Not Resuscitate Code Status: DNI Do Not Intubate Code Status: Partial Resuscitative Effort Notify Provider/Primary Team of Pt Admit In AM Upon Arrival to Unit Now Notify Provider (Misc) Notify Dr. Jaime Villareal, Reason: For any Pain related issues., Pager Notify Dr. Jason Felton, Reason: For any Pain related issues., Pager Notify Joey Stone NP, Reason: For any Pain related issues., Pager Medications Medication sentences are per dose. You will need to calculate a total daily dose if needed. methocarbamol 750 mg, IVPB, ivpb, ONE TIME, Infuse over 30 min ***Administer within 1 hour of arriving to PACU*** ***Pt in PACU*** meperidine 12.5 mg, IVPush, inj, q15min, PRN, x 2 dose HYDROmorphone 0.5 mg, IVPush, inj, q5min, PRN pain, Do not exceed 2 mg. ***Do Not exceed 2 mg*** 0.5 mg, IVPush, inj, q10min, PRN pain, Do not exceed 2 mg. ***Do Not exceed 2 mg*** promethazine 6.25 mg, IVPush, inj, q15min, PRN nausea/vomiting, x 2 dose ***VESICANT*** Dilute with 10 ml NS & IVP over 2 3 min through a running IV line with large bore access. ondansetron 4 mg, IVPush, soln, ONE TIME, PRN nausea/vomiting PCA ***CAUTION*** Ordering a continuous rate (Basal Dose), should be reserved for opioid tolerant patients who require high dose therapy. Page: 1 Post Op Non ICU Admit Version: Plan 2 Effective on: 03/19/14
2 Post Op Non ICU Admit Plan Begin Immediately/PACU PHYSICIAN S ***DOSING NOTES*** Initial doses are for opioid naive patients. Chronic pain patients may require higher doses. Decrease initial starting dose by 25 30% in patients > 65 yrs, or patients with renal, hepatic, or pulmonary impairment. morphine (morphine 30 mg/30 ml PCA) Dose (mg) = 1, Lock out Interval (min) = 10, 4 hour Limit (mg) = 20, Start date/time T;N Dose (mg) = 1, Lock out Interval (min) = 8, 4 hour Limit (mg) = 20, Start date/time T;N Dose (mg) = 2, Lock out Interval (min) = 10, 4 hour Limit (mg) = 40, Start date/time T;N Start date/time T;N NS (Normal Saline) IV, 100 ml/hr IV, 75 ml/hr IV, 125 ml/hr IV, 150 ml/hr ACUTE MANAGEMENT OF RESPIRATORY DEPRESSION: If respiratory rate is less than 10/min or patient is unresponsive 1. Stop PCA Pump 2. Dilute naloxone (Narcan) 0.4mg / 1mL in 9mL NS and administer 0.1 mg (2.5mL) by IVP every 2 3 minutes until respiratory rate is greater than Notify Physician naloxone (naloxone 0.4 mg/ml injectable solution) 0.1 mg, IVPush, inj, q2h, PRN bradypnea, Dilute in 9mL NS and Administer every 2 3 minutes until respiratory rate is greater than 10. Continuous Pulse Oximetry While on PCA Page: 2 Post Op Non ICU Admit Version: Plan 2 Effective on: 03/19/14
3 Arrives to Room PHYSICIAN S Patient Care Vital Signs Per Unit Standards q4h q4h q1h q2h Perform Neurological Checks q4h q2h q1h Daily Weight Patient Activity Up Ad Lib/Activity as Tolerated Assist as Needed Bedrest Bedrest Bathroom Privileges Out of Bed Up in Chair Bedrest STRICT, Bed Position: HOB Flat, Can sit up for meals and to use restroom. Telemetry Monitoring Insert Urinary Catheter Foley, To: Dependent Drainage Bag Urinary Catheter Care Strict Intake and Output Wound Care by Nursing Accucheck q6h, DC if glucose is < 150 for 24hrs. Communication Notify Provider of VS Parameters Temp > 101.5, RR > 24, RR < 10, SpO2 < 92, HR > 120, HR < 60 Notify Provider (Misc) Reason: Urine output less than 30 ml/hr averaged over 4 hours. Notify Nurse (DO NOT USE FOR MEDS) For Temp > obtain UA, UA C&S, Sputum C&S, and Blood Cultures X 2. Notify Provider (Misc) Notify Dr. Jaime Villareal, Reason: For any Pain related issues., Pager Notify Dr. Jason Felton, Reason: For any Pain related issues., Pager Notify Joey Stone NP, Reason: For any Pain related issues., Pager Dietary Clear Liquid Diet Advance Diet as Tolerated Advance Diet To: Regular Diet IV Solutions Page: 3 Post Op Non ICU Admit Version: Plan 2 Effective on: 03/19/14
4 Arrives to Room PHYSICIAN S D5 1/2 NS IV, 100 ml/hr IV, 75 ml/hr IV, 125 ml/hr IV, 150 ml/hr D5 1/2 NS + 20 meq KCl/L IV, 100 ml/hr IV, 75 ml/hr IV, 125 ml/hr IV, 150 ml/hr NS + 20 meq KCl/L IV, 100 ml/hr IV, 125 ml/hr IV, 75 ml/hr IV, 150 ml/hr Medications Medication sentences are per dose. You will need to calculate a total daily dose if needed. methocarbamol 750 mg, IVPB, ivpb, q6h, x 72 hr, Infuse over 30 min ***Start 6 hours after first dose given in PACU***.Medication Management Start date T;N Schedule methocarbamol to start 6 hours after first dose given in PACU. Pain Study Analgesics investigational drug (acetaminophen or placebo 1000 mg IVPB) 1,000 mg, IVPB, ivpb, q6h, x 4 dose ***Start 6 hrs after initial dose*** Do not exceed 4000 mg of acetaminophen per day from all sources..medication Management Start date T;N Start IV Acetaminophen or Placebo 6 hours after initial dose given in OR. GI Prophylaxis esomeprazole 40 mg, IVPush, inj, q24h 40 mg, IVPush, inj, q12h famotidine 20 mg, IVPush, inj, Daily Dilute to 2 mg/ml with NS. IV push over 2 min. 20 mg, IVPush, inj, BID Dilute to 2 mg/ml with NS. IV push over 2 min. Antiemetics ondansetron 4 mg, IVPush, soln, q6h, PRN nausea/vomiting promethazine 25 mg, IVPush, inj, q6h, PRN nausea/vomiting ***VESICANT*** Dilute with 10 ml NS & IVP over 2 3 min through a running IV line with large bore access. Gastrointestinal Agents Page: 4 Post Op Non ICU Admit Version: Plan 2 Effective on: 03/19/14
5 Arrives to Room PHYSICIAN S docusate 100 mg, PO, cap, Nightly, PRN constipation *****IF docusate is contraindicated or ineffective after 12 hours, USE bisacodyl***** bisacodyl 10 mg, rectally, supp, Daily, PRN constipation *****IF bisacodyl is contraindicated or ineffective after 6 hours, USE Fleet Enema***** senna 8.6 mg, PO, tab, Nightly, PRN constipation Antibiotics cefazolin 1 g, IVPB, ivpb, q6h, Infuse over 30 min vancomycin 1000 mg, IVPB, ivpb, q12h, Infuse over 90 min 1000 mg, IVPB, ivpb, q24h, Infuse over 90 min clindamycin 900 mg, IVPB, ivpb, q8h, Infuse over 30 min 600 mg, IVPB, ivpb, q8h, Infuse over 30 min Antacids Al hydroxide Mg hydroxide simethicone (Mylanta) 30 ml, PO, susp, q4h, PRN indigestion Administer 1 hour before meals and nightly. Respiratory Incentive Spirometry 10 times each hour while awake....additional Orders Page: 5 Post Op Non ICU Admit Version: Plan 2 Effective on: 03/19/14
6 Arrives to Room Sliding Scale Insulin 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 regular (Low Dose Insulin Sliding Scale) 0 10 units, subcut, inj, AC & nightly, PRN glucose levels see parameters Low Dose Insulin Sliding Scale 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 Low Dose Insulin Sliding Scale 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 Low Dose Insulin Sliding Scale 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. Continued on next page... Page: 6 Post Op Non ICU Admit Version: Plan 2 Effective on: 03/19/14
7 Arrives to Room Sliding Scale Insulin Protocol Plan PHYSICIAN S 0 10 units, subcut, inj, q2h, PRN glucose levels see parameters Low Dose Insulin Sliding Scale 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 Low Dose Insulin Sliding Scale 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 Low Dose Insulin Sliding Scale 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. Page: 7 Post Op Non ICU Admit Version: Plan 2 Effective on: 03/19/14
8 Arrives to Room Sliding Scale Insulin Protocol Plan PHYSICIAN S insulin regular (Moderate Dose Insulin Sliding Scale) 0 12 units, subcut, inj, AC & nightly, PRN glucose levels see parameters Moderate Dose Insulin Sliding Scale 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 Moderate Dose Insulin Sliding Scale 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 Moderate Dose Insulin Sliding Scale 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 Moderate Dose Insulin Sliding Scale 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. Continued on next page... Page: 8 Post Op Non ICU Admit Version: Plan 2 Effective on: 03/19/14
9 Arrives to Room Sliding Scale Insulin Protocol Plan PHYSICIAN S 0 12 units, subcut, inj, TID, PRN glucose levels see parameters Moderate Dose Insulin Sliding Scale 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 Moderate Dose Insulin Sliding Scale 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 regular (High Dose Insulin Sliding Scale) 0 14 units, subcut, inj, AC & nightly, PRN glucose levels see parameters High Dose Insulin Sliding Scale 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 High Dose Insulin Sliding Scale 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 Continued on next page... Page: 9 Post Op Non ICU Admit Version: Plan 2 Effective on: 03/19/14
10 Arrives to Room Sliding Scale Insulin Protocol Plan PHYSICIAN S 0 14 units, subcut, inj, q4h, PRN glucose levels see parameters High Dose Insulin Sliding Scale 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 High Dose Insulin Sliding Scale 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 High Dose Insulin Sliding Scale 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 High Dose Insulin Sliding Scale 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 Continued on next page... Page: 10 Post Op Non ICU Admit Version: Plan 2 Effective on: 03/19/14
11 Arrives to Room Sliding Scale Insulin Protocol Plan PHYSICIAN S insulin regular (Blank Insulin Sliding Scale) 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. Page: 11 Post Op Non ICU Admit Version: Plan 2 Effective on: 03/19/14
12 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*** Page: 12 Post Op Non ICU Admit Version: Plan 2 Effective on: 03/19/14
13 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 Page: 13 Post Op Non ICU Admit Version: Plan 2 Effective on: 03/19/14
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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
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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
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- 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
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PHYSICIAN S Diagnosis Weight Allergies Patient Care Perform Oral Care Per Unit Standards, Perform night before surgery. Brush teeth with toothpaste. Peridex mouth wash (15 ml swish and spit). chlorhexidine
More informationCARD POST CARDIAC CATHETERIZATION PLAN
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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
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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
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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
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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
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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
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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
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- 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
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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,
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(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
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- 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
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Date & Time Post-Op Inpatient General Orthopedic Page 1 of 5 Pharmacy Mnemonic: POIGOP1 1. Admit as inpatient to Dr. 2.Diagnosis: 3.Admit to PACU and then to floor ICU 4.Radiology: AP Pelvis in PACU AP
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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
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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
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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.
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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
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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
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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
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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
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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
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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,
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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
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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
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Orders apply to patients 18 years and older. All preprinted doses are based on normal renal and hepatic function and must be assessed for adjustment against the individual patient s renal and hepatic function
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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
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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
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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,
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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)
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Post Operative Above and Below Knee Amputation Admission [3041300028] Consider adding Insulin Adult -- Subcutaneous Insulin and Hypoglycemia Management [3041300000] General Admission (Single Response)
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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
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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
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Unique Plan Description: Neurosurgery Subarachnoid Hemorrhage Admission Adult Plan Selection Display: Neurosurgery Subarachnoid Hemorrhage Admission Adult PlanType: Medical Version: 10 Begin Effective
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
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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
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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
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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
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DRUG AND TREATMENT Available ONLY at: BMC-B BMC-D BMC-N BMC-S NEURO Intracranial Hemorrhage (Factor VII) Condition/Status Patient Status Inpatient Patient Status: Inpatient, Level of Care: Intensive Care
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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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UROLOGY POST OPERATIVE PLAN Patient Label Here A UMC Health System Performance Improvement Initiative for use in all units where surgical patients receive care in support of Surgical Care Improvement Program
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down ADULT POST-OPERATIVE 1 of 4 9 Actual 9 Estimated Patient ID Area Weight kg 9 Actual 9 Estimated Height cm ALLERGIES: REFER TO ALLERGY PROFILE/ POWERCHART Admit to: Post Anesthesia Care Unit (PACU),
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University of Virginia Health System Clinical Pathway: Whipple Enhanced Recovery After () LOS: 4-5 days Date of Origin/Revision: June 29, 2016/September 6, 2017/January 31, 2018 : SAS : : : D1 D2 D 3/
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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:
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