_20001_scn_physician_admitting

_20001_scn_physician_admitting - SCANNED TO PHARMACY STAT...

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Unformatted text preview: SCANNED TO PHARMACY STAT MEDICATION DATE: ______________________ TIME: ______________ Infant’s Weight_________ Admit to Special Care Nursery NICU / INTERMEDIATE STATUS PRINCIPLE DIAGNOSIS: _____________________________________________________________________________________ _________________________________________________________________________________________________________ _________________________________________________________________________________________________________ 1) RESPIRATORY: Continuous O2 saturation monitoring, adjusting FiO2 to maintain O2 sats ____________________________________________ Continuous TcCO2 monitoring, notify MD / do ABG if TcCO2 under ________________________ or over __________________ Nasal/Bubble CPAP _____________________________________________________________________________________ Nasal Cannula _________________________________________________________________________________________ Ventilation: PIP ____________ PEEP ___________ PS ______________ lt ____________ IMV ____________ SIMV ____________ Tv ______________ Hz ____________ Wean PIP by ___________ every ________ PRN for TCO2 equal or under _______ until PIP = ________________________ Wean FiO2 by ____________ % every ________ to maintain O2 sat equal or over ___________________________________ ABG Q _________________ hours with scheduled ABG’s at _____________ Inhaled Nitric Oxide (iNO)_________PPM. Wean iNO by ____________ PPM every _______ PRN for O2 sat equal or over _______. Methemaglobin Level every 24 hours. Poractant Alfa (Curosurf) _______ mL via ET tube. Repeat in ______ hours if PIP equal or over ______ and/or FiO2 = ______ Stat AP Chest / Abdominal X-ray AP Chest x-ray in a.m. Notify MD of mean BP under _______________ 2) NUTRITION: UAC: _________________ with ________ units Heparin/mL at ______ mL/hour Heparin Flush PF 1 unit/mL PRN to clear line UVC: _________________ with ________ units Heparin/mL at ______ mL/hour Heparin Flush PF 1 unit/mL PRN to clear line PICC Line _____________ with ________ units Heparin/mL at ______ mL/hour Heparin Flush PF 1 unit/mL PRN to clear line PIV: ___________________ at _________ mL/hour Heparin Flush PF 1 unit/mL PRN to clear line NPO Feed - _______________________________________________________________________________________________ 3) MEDICATIONS: Dopamine: Standard concentration at __________________ mcg/kg/min IV Ampicillin - ________ mg. IV every _______ hours Dobutamine: Standard concentration at Gentamicin - ________ mg. IV every _____ hours __________________ mcg/kg/min IV Gentamicin level pre/post 3rd dose Alprostadil (PGE1), - Standard concentration at Cefotaxime - _________ mg. IV every ______ hours __________________ mcg/kg/min IV ___________ - ____________ mg. IV every _______ hours Epinephrine: Standard concentration at _____ mcg/kg/ Fentanyl - ________ mcg. IV every ______ , PRN irritability min IV Lorazepam - _________ mg. IV every ______ , PRN irritability ___________________________________________ __________________________________________________ 4) LABORATORY: CBC Manual Diff ABG Blood Culture E-T Aspirate if intubated Urine Tox Screen CRP Other Labs: ___________________________________________________________________________________________ Order following labs for morning: __________________________________________________________________________ Apply Aquaphor to skin ad lib x 5 days 5) OTHER: PT/OT evaluation and treatment for: Head ultrasound ________________ • Less than or equal to 32 weeks gestation when at Eye exam per protocol least 1350 grams and medically stable Lactation Consultation • 32-34 weeks gestation multiples and medically stable Car Seat Evaluation before Discharge Dietary Consultation __________________________________ ___________________________________________ __________________________________ ___________________________________________ Physician Signature: __________________________________________ Physician # ________________________ ZZ20001 (7/30/08) Patient Identification SAFH SDH SMCS SRMC NICU / SCN Physician Admitting Orders ...
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