DRUG ALLERGIES WT: KG
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- Amberly Wade
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1 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 films for brain surgery) Communication Order Pull old chart Medications diazepam (Valium) 10 mg tab PO ONCALL Comments: To x-ray. Comments: 13 hours before procedure Comments: 7 hours before procedure. Comments: 1 hour before procedure diphenhydramine (Benadryl) 50 mg cap PO PRE-OP (DEF)* Comments: 1 hour before procedure. 50 mg inj IM PRE-OP Comments: 1 hour before procedure. 1 mg inj IM ONCE, PRN Pain Severe 0.5 mg IV Q1H, PRN Other (see comment) Comments: Breakthrough pain acetaminophen-oxycodone (Percocet 5 mg/325 mg) Comments: If ineffective in 30 minutes, may repeat dose acetaminophen-hydrocodone (Norco 325 mg-5 mg oral tablet) Comments: If ineffective in 30 minutes, may repeat dose acetaminophen (Tylenol) 650 mg tab PO Q4H, PRN Pain Mild (DEF)* 650 mg supp PR Q4H, PRN Pain Mild ***NOTE*** For Nausea/vomiting, select only 1 option. If more than one selected, orders will be null and void Page 1 of 5
2 DRUG AND TREATMENT ondansetron (Zofran ODT) 4 mg tab soluble PO Q8H, PRN Nausea/Vomiting ondansetron (Zofran) 4 mg inj IV PUSH Q8H, PRN Nausea/Vomiting promethazine (Phenergan) 12.5 mg inj IV PUSH Q6H, PRN Nausea/Vomiting Comments: If patient has running IV, dilute promethazine dose in 20 ml of normal saline and administer slowly over at least 3 minutes at the port furthest from the IV insertion site. If the patient does not have an IV running, dilute the promethazine in 50 ml normal saline and administer over 15 minutesunless otherwise specified, ondansetron (Zofran) serves as the first line anti-emetic. Radiology Myelogram Complete Myelogram Cervical Myelogram Lumbar XR Shoulder L XR Shoulder R XR Spine Cervical 2 view XR Spine Lumbar Complete w Bending 4 view w/bending XR Sacrum and Coccyx XR Pelvis 3 view XR Hips Bilat with Pelvis Pre-op, Pending Discharge - No, ONCE Post-Op Condition/Status Patient Status Inpatient Patient Status: Inpatient Place in Observation Patient Status: Outpatient- Refer for Observation Status Discharge Patient (Depart Process) Patient may be discharged 2 hours after myelogram. If fully reactive, taking PO medication for pain management, experiencing no nausea and vomiting, and vital signs have returned to admission baseline (DEF)* Patient may be discharged 4 hours after myelogram. If fully reactive, taking PO medication for pain management, experiencing no nausea and vomiting, and vital signs have returned to admission baseline Vital Signs Vital Signs ONCE, Upon arrival to unit Page 2 of 5
3 DRUG AND TREATMENT Activity Activity Bedrest with BRP, after 2 hours Diet Diet Order Regular--adult menu Comments: As tolerated Diet Message Encourage PO fluids and give two 12 ounce bottles of Gatorade Nursing Orders Elevate Head of Bed Other: See Special Instructions, 20 Degrees for 6 hours (DEF)* Other: See Special Instructions, 20 Degrees for 8 hours Other: See Special Instructions, 20 Degrees for 12 hours Other: See Special Instructions, 20 Degrees for 24 hours 30 Degrees, for 6 hours 30 Degrees, for 8 hours 30 Degrees, for 12 hours 30 Degrees, for 24 hours 45 Degrees, for 6 hours 45 Degrees, for 8 hours 45 Degrees, for 12 hours 45 Degrees, for 24 hours Semi Fowlers position for 8 hours Notify Radiologist Notify attending radiologist or call radiologist for any problems Reason Referral for Addictions Treatment Not Provided Medications Reason Alcohol/Substance Abuse Medication Not Prescribed Reason Tobacco Cessation Med Not Given 1 mg inj IM ONCE, PRN Pain Severe acetaminophen-oxycodone (Percocet 5 mg/325 mg) Comments: (pain scale 4-7). If ineffective in 30 minutes, may repeat dose acetaminophen-hydrocodone (Norco 325 mg-5 mg oral tablet) 1 tab PO Q4H, PRN Pain Moderate Comments: (pain scale 4-7). If ineffective in 30 minutes, may repeat dose acetaminophen (Tylenol) 650 mg tab PO Q4H, PRN Pain Mild (DEF)* Comments: (pain scale 1-3). 650 mg supp PR Q4H, PRN Pain Mild Comments: (pain scale 1-3). Page 3 of 5
4 DRUG AND TREATMENT ***NOTE*** For Nausea/vomiting, select only 1 option. If more than one selected, orders will be null and void ondansetron (Zofran ODT) 4 mg tab soluble PO Q8H, PRN Nausea/Vomiting ondansetron (Zofran) 4 mg inj IV PUSH Q8H, PRN Nausea/Vomiting promethazine (Phenergan) 12.5 mg inj IV PUSH Q6H, Nausea/Vomiting Comments: If patient has running IV, dilute promethazine dose in 20 ml of normal saline and administer slowly over at least 3 minutes at the port furthest from the IV insertion site. If the patient does not have an IV running, dilute the promethazine in 50 ml normal saline and administer over 15 minutesunless otherwise specified, ondansetron (Zofran) serves as the first line anti-emetic. zolpidem (Ambien) 5 mg tab PO BEDTIME, PRN Sleep/Insomnia (DEF)* Comments: For age 65 and older 10 mg tab PO BEDTIME, PRN Sleep/Insomnia Comments: For age 64 or younger IV Solutions D5 1/2NS IV bag 75 ml/hour (DEF)* IV bag 100 ml/hour LR IV bag 75 ml/hour (DEF)* IV bag 100 ml/hour IV bag 125 ml/hour Laboratory CSF Cell Count CSF Glucose CSF Protein CSF VDRL Sterile Container Extra Comments: Hold CSF for Four weeks Page 4 of 5
5 DRUG AND TREATMENT Radiology CT Spine L Post Myelogram ASAP/NOW, Pending Discharge - No, L1-S1. w/without contrast with sagittal and coronal reconstructions CT Spine Cervical Post Myelogram ASAP/NOW, Pending Discharge - No, C1-T1. w/without contrast with sagittal and coronal reconstructions CT Spine Thoracic Post Myelogram ASAP/NOW, Pending Discharge - No, T1-T12. w/without contrast with sagittal and coronal reconstructions Page 5 of 5
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***
PHYSICIAN 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
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
CBC with Differential. PHYSICIAN SIGNATURE DATE TIME DRUG ALLERGIES WT: KG
DRUG AND TREATMENT Non Categorized SUB ED Snakebite Protocol (SUB)* Non Categorized ***(NOTE)*** This plan is designed to be used as part of a larger plan, not independently. Please do NOT order individually.
PHYSICIAN 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
ALL 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
Attach 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
DRUG ALLERGIES WT: KG
DRUG AND TREATMENT Available at ALL facilities Condition/Status Place in Outpatient to a Bed Status Requested Location: PCU H3S (DEF)* Requested Location: CCU - Heart Hospital Requested Location: Heart
PHYSICIAN SIGNATURE DATE TIME DRUG ALLERGIES WT: KG
Available at: BMC-A BMC-B BMC-C BMC-D BMC-N BMC-S BMC-T BMC-W PACE Nursing Orders Patient Education Instruct patient to bring corresponding films to surgery (e.g. back films for back surgery, brain films
PHYSICIAN SIGNATURE DATE TIME DRUG ALLERGIES WT: KG
DRUG AND TREATMENT PACE Vital Signs Vital Signs PRE-OP, On arrival Nursing Orders Initiate ANES Anesthesia PACE PowerPlan Weigh Patient PRE-OP Pre op. Provide patient with incentive spirometry teaching
DRUG 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
ALL 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
PHYSICIAN SIGNATURE DATE TIME DRUG ALLERGIES WT: KG
DRUG AND TREATMENT Available at: BMC-B BMC-D BMC-N BMC-S PACE Vital Signs Vital Signs PRE-OP, On arrival Nursing Orders Initiate ANES Anesthesia PACE PowerPlan Weigh Patient PRE-OP Pre op. Provide patient
PHYSICIAN SIGNATURE DATE TIME DRUG ALLERGIES WT: KG
DRUG AND TREATMENT Available ONLY at: BMC-B BMC-D BMC-N BMC-S PACE Nursing Orders ***NOTE*** Select the "Transfuse Blood Previously on Hold" order below, to transfuse blood on hold. Transfuse Blood Previously
DRUG ALLERGIES WT: KG
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
LYSIS 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
Physician 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
ENT 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:
A UMC Health System Performance Improvement Initiative for use in all units where cardiac/surgical patients are admitted.
A UMC Health System Performance Improvement Initiative for use in all units where cardiac/surgical patients are admitted Denotes guideline requirement Attending Physician: Resident/Fellow: Allergies_ Diagnosis:
PHYSICIAN 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,
PEDIATRIC 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
Physician 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
1. 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
Physician 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
EPIDURAL / 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.
IR Central Venous Access [ ] Pre Procedure
![IR Central Venous Access [ ] Pre Procedure](/thumbs/90/104119758.jpg "IR 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
ENT 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
morphine 30 mg/ 30 ml (1 mg/ml) Opioid of choice
PATIENT CONTROLLED ANALGESIA (PCA) PLAN Allergies: Medication Selection: morphine 30 mg/ 30 ml (1 mg/ml) Opioid of choice HYDROmorphone (Dilaudid ) 6 mg/ 30 ml (0.2 mg/ml) fentanyl 300 mcg/ 30 ml (10 mcg/ml)
Bariatric 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
Bariatric 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
PHYSICIAN 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,
OB/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
WHS 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.
PICU 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
OB/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
PEDIATRIC 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
***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
GENERAL 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
Physician 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
(30689) PROT Pain PCA Adult Patient Controlled Analgesia
Diagnosis Allergies Nursing Assess and Document PCA: 1. Assess and document pain rating, sedation level and respiratory rate every 2 hours; assess and document pain rating, sedation level and respiratory
PHYSICIAN SIGNATURE DATE TIME
DRUG AND TREATMENT Condition/Status Patient Status (WCH) Patient Status: Inpatient Update Resident Team C (DEF)* A B X Vital Signs Vital Signs Q4H, Do not wake for vitals 2300-0700 (DEF)* DAILY Q4H Blood
(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
Physician 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,
PHYSICIAN 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
PHYSICIAN 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
Physician 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,
Physician 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
Physician 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
IV 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
GENERAL 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
THROMBOLYTIC 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
Physician 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
ORTHO 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
Hip 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
UMC 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
DRUG 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
Pediatric 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
BARIATRIC 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
Orthopedic 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
Physician 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
Physician 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
UMC 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
A 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
GENERAL 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
OB/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
DR. ATKINSON S POSTOPERATIVE HAND INSTRUCTIONS Trigger Finger, Carpal Tunnel & DeQuervain s Surgery
DR. ATKINSON S POSTOPERATIVE HAND INSTRUCTIONS Trigger Finger, Carpal Tunnel & DeQuervain s Surgery BANDAGE CARE & BATHING: Elevate your hand above your heart for the next 24 48 hours, keep operative area
Total 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
ALL 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
PHYSICIAN 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
Initials * 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
PHYSICIAN ORDER SET : Patient: DOB: Gender: Patient Phone #: Height: Weight:
. (Patient Sticker) CDH 208-203 Approved 2/18 - Page 1 of 5 Patient: DOB: Gender: Patient Phone #: Height: Weight: Diagnosis: ICD-10 Code: Treatment Start Date: Provider Facility Name: Ordering Provider:
UMC Health System Patient Label Here. PHYSICIAN ORDERS Diagnosis
COPD PLAN UMC Health System PHYSICIAN S Diagnosis Weight Allergies DETAILS Patient Care Vital Signs Per Unit Standards Daily Weight Patient Activity Up Ad Lib/Activity as Tolerated Assist as Needed Bedrest
1 of 5. Integrated Order Set Inpatient, Adult. Gynecological Surgery Enhanced Recovery Orders apply to patients 18 years and older.
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
Procedure: Laser Transurethral Resection of Prostate or Transurethral Resection of Prostate
Laser Transurethral Resection Of Prostate Or Transurethral Resection Of Prostate Post-Operative Plan Patient Label Here A UMC Health System Performance Improvement Initiative for use in all units where
10 mg hydrocodone equals how much oxycodone
Cari untuk: Cari Cari 10 mg hydrocodone equals how much oxycodone Posts about dilaudid 8 vs oxycodone 30 written by buyprescriptionmedication. Can you help me with the conversion of Oxycodone IR (5mg tab)
Physician 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:
Physician 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
ADMIT 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
Management of elective cervical and lumbar spine surgery candidates age 18 years and older.
IMPORTANCE OF FOCUS According to the Spine Journal (2009), projections based on national health expenditure for spine surgery indicate spine surgical procedures/revisions are expected to grow significantly
Gabapentin 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
ST. DOMINIC-JACKSON MEMORIAL HOSPITAL JACKSON, MISSISSIPPI
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
OB/GYN CESAREAN SECTION POST-OP PLAN - Phase: General Orders
- Phase: General Orders DETAILS Patient Care Vital Signs Per Unit Standards Patient Activity Up Ad Lib/Activity as Tolerated Assist as Needed Bedrest Bedrest Bathroom Privileges Bedrest Up to Bedside Commode
PHYSICIAN 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
Admit 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
INFLIXIMAB RHEUMATOLOGY LOAD DOSE (SCHEDULE WEEKS 0, 2, 6)
. INFLIXIMAB RHEUMATOLOGY LOAD DOSE (SCHEDULE CDH 208-211 Approved 2/18 - Page 1 of 5 Patient: DOB: Gender: Patient Phone #: Height: Weight: Diagnosis: ICD-10 Code: Treatment Start Date: Provider Facility
RITUXIMAB RHEUMATOLOGY VASCULITIS
. PHYSICIAN (Patient Sticker) ORDER SET : CDH 208-237 Approved - Page 1 of 5 Patient: DOB: Gender: Patient Phone #: Height: Weight: Diagnosis: ICD-10 Code: Treatment Start Date: Provider Facility Name:
Physician 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,
6) One tablespoon is equivalent to how many milliliters?
Name Date 1) The patient has dropped off the prescription. In the diagram below what does the letter X represent in relation to workflow terminology? Drop Offà X à Fillà Verificationà Y a) Pickup b) Order
PAIN. TREATMENT TABLES Analgesics. NON-OPIOID ANALGESICS Generic Name Trade Names (Examples) Duration Initial Dose
NON-OPIOID SHORT-ACTING LONG-ACTING **** O PAIN TREATMENT TABLES Analgesics NON-OPIOID ANALGESICS Generic Name Trade Names (Examples) Duration Initial Dose Tramadol 50 mg Ultram Every 4 hours 1-2 tabs,
PHYSICIAN ORDERS Diagnosis
GENERAL UROLOGY PLAN PHYSICIAN S Diagnosis Weight Allergies Patient Care Vital Signs Per Unit Standards Strict Intake and Output Per Unit Standards q4h q12h Patient Activity Assist as Needed Up in Chair,
Neurosurgery 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. Nursing. Case Request [ ] Case request operating room Scheduling/ADT, Scheduling/ADT [ ] Other](/thumbs/96/128298591.jpg "Neurosurgery 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:
1. Attending Physician: Resident/Fellow: 2. Admit: MEDICAL/SURGICAL ICU Other: Designation: In Patient Out Patient. 5.
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
Physician 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)*
* * 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
ADMIT 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
PHYSICIAN SIGNATURE DATE TIME DRUG ALLERGIES WT: KG
DRUG AND TREATMENT Pre-Procedure Diet NPO NPO except for meds with sip of water, Give all medications as scheduled except diabetic medications. Nursing Orders Start IV/INT Start IV/INT To use as a dedicated
Post Operative Hip Arthroscopy Information Packet for Patients of John McDonald, M.D. This Packet is for: Allergies: Medications
Post Operative Hip Arthroscopy Information Packet for Patients of John McDonald, M.D. This Packet is for: Allergies: Medications Indomethacin ER 75mg First dose to be taken the day after surgery upon arrival
HOW TO SMOKE TYLENOL WITH CODEINE CAN YOU TAKE IBUPROFEN 800 MG
HOW TO SMOKE TYLENOL WITH CODEINE CAN YOU TAKE IBUPROFEN 800 MG How To Smoke Tylenol With Codeine Can You Take Ibuprofen 800 Mg Prescription with codeine cough syrup name Phosphate tablets 30 300 mg oral