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Unformatted text preview: SCANNED TO PHARMACY STAT MEDICATION
Date: ________________ Time: ________________ 1. Diagnosis: ________________________________________________________ Date of Surgery: ______________________ 2. Have patient sign consents for procedure planned: ____________________________________________________________ ______________________________________________________________________________________________________ 3. Notify Cardiologist, ___________________________________________________ of patient's admission. 4. Surgeon: ___________________________________________________________ 5. Upon admission to unit, obtain list of current medications. A. Notify Cardiovascular Nurse Coordinator, Beeper #650-9013 or 650-9014, who will see patient for preop orientation. B. Notify Cardiologist and review list of medications. C. Notify surgeon's office of admission. 6. Vital signs per unit routine 7. IV Access 8. Activity: ambulate ad lib 9. Diet: regular, (NPO am admission) 10. Labs: CBC No Diff, PT, PTT, Comprehensive Metabolic Panel, cholesterol, triglycerides, UA A. Outside labs must include all of the above B. If done within last two weeks and lab results are normal, do not repeat 11. RA/Pulse Ox = __________ %. If less than 90%, obtain ABGs. Also obtain ABG’s if history of pulmonary disease or on any pulmonary Rx. 12. If patient has heart cath lines present, contact cardiologist to ask if they may be pulled evening before surgery. 13. Incentive spirometry and pulmonary toilet instruction to be given by respiratory therapy/RN. 14. Type and crossmatch 4 units packed red blood cells. 15. Chest x-ray film PA and left lateral. X-ray film must be in hosp - call ext. 11616 to verify. If done within three months, do not repeat. 16. EKG (if done within three months, do not repeat). 17. Old chart to unit ASAP 18. Preoperative Preparation: A. NPO for 8 hours preop except continue all cardiac meds with sip of water. B. Total body prep excluding axilla and back with clippers. C. On evening before surgery, have patient shower with Hibiclens, with special attention to chest, legs, and groin. AM admission - Hibiclens bed bath after OR prep. D. Evening before surgery check for presence of signed forms: • Surgeon’s Informed Consent • Hospital Consent for Surgery form • Paul Gann Transfusion Information form • On all valve surgeries obtain permit for Intraoperative Transesophogeal Echocardiogram. Place order in SHIPER. E. If pre-op sedation given, place patient on 6L nasal prongs and transport to OR with O2. 19. Standing weight – if contraindicated, use bed scale. 20. Notify cardiovascular surgeons and cardiologists of chest pain, shortness of breath, or significant change in vital signs. 21. Collect above lab work and have in chart the evening before surgery. 22. For patients under 70 years of age: Temazepam (Restoril) 15 mgm PO at bedtime PRN insomnia. May repeat x1 if less than 65 years of age. 23. IPOC for Adult Cardiac Surgery. 24. Notify cardiovascular surgeon if patient on anticoagulant/antiplatelet drugs (i.e., Ticlid, Reopro, Coumadin, Plavix, Lovenox, Integrilin, Aggrastat, Prasugrel). Do not notify if on aspirin or IV heparin. 25. Have patient view preoperative Open Heart Surgery video. 26. Do not administer pneumonia / flu vaccines until postoperatively. ___________________________________________________________ Physician # ___________________________________ Physician’s Signature Authorization for therapeutic substitution is given unless checked here
Patient Identification Sutter Medical Center, Sacramento
A Sutter Health Affiliate Adult Open Heart Surgery Admission Orders
Michael T. Ingram, M.D., James Longoria, M.D. Robert Kincade, M.D.
09332 (10/16/09) ORDERS ...
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This note was uploaded on 12/26/2009 for the course PHYS 341 taught by Professor Mavromatis during the Spring '09 term at American University of Beirut.
- Spring '09