_00194_postpartum_orders

_00194_postpartum_orders - SCANNED TO PHARMACY STAT...

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Unformatted text preview: SCANNED TO PHARMACY STAT MEDICATION Date _______________ Time _____________ 1. Patients with general, spinal or epidural must be stable and able to move legs before leaving recovery room. 2. BPP fundal check and blood loss assessment as per recovery routine; oral temperature Q shift only (unless febrile greater than 38° C (100.4°F)) 3. Notify physician if: • pulse greater than 100; • systolic BP greater than 150 or less than 90; • diastolic BP greater than or equal to 100; • temperature greater than 38° C (100.4°F). 4. Ambulate with assistance until stable, then ad lib ambulation. 5. Clear liquids until stable and observations per unit routine for 1½ hours post delivery, then place on regular diet. 6. a. Discontinue existing IV when complete. b. IV Solution of 20 units of Oxytocin in 1000 mL Lactated Ringers at _______ mL/hr x ______ liters Other ____________________________________________________________________ Then plain IV solution of ____________ at _______ mL/hr x ______ liters, then discontinue IV. c. If unusual bleeding, notify MD and continue intravenous fluids. 7. May shower PRN. 8. Routine perineal care daily as outlined in the standardized low risk postpartum patient care plan. Benzocaine spray/Tucks pads PRN to perineum. Sitz bath Q shift PRN. 9. After transfer to postpartum unit, if unable to void or bladder distended, catheterize with straight catheter. If necessary to catheterize a second time, place #16 Foley to dependent drainage for 24 hours. 10. Pain medication: Hydrocodone 5mg and Acetaminophen 325mg: tab(s) PO Q hours PRN moderate to severe pain. OR Acetaminophen and Codeine 30mg: tab(s) PO Q hours PRN moderate to severe pain. Ibuprofen mg: tab(s) Q hours PRN mild uterine pain/cramping. Acetaminophen 325mg: tab(s) PO Q hours PRN mild pain. (No more than 4 gm in 24 hours). __________________________________________________________________________________________ 11. Stool softener: Docusate Sodium 100mg: cap(s) PO BID. 12. Sleep: Hydroxyzine (Vistaril) ________mg PO at bedtime PRN sleeplessness. Zolpidem (Ambien) ________mg PO at bedtime PRN sleeplessness. (usual dose = 5 mg). 13. Other medications: ____________________________________________________________________________________________ ____________________________________________________________________________________________ ____________________________________________________________________________________________ 14. Lab work: ____________________________________________________________________________________ ____________________________________________________________________________________________ 15. RhoGam and Fetal Blood Screen if indicated. 16. Rubella immunization (Rubella virus vaccine 0.5 mL SubQ) if non-immune or equivocal. Substitute MMR 0.5 mL SubQ if Rubella unavailable. 17. Lactation consult per criteria. Emergency Procedures for Monitored and Non-Monitored Areas. M.D. Signature______________________________________________________________ Physician # ____________________ Authorization for therapeutic substitution is given unless checked here Patient Identification Sutter Center for Women’s Health Sutter Memorial Hospital Sacramento California Postpartum Orders 00194 (6/18/09) ORDERS ...
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