C007-ZZ00167 - SCANNED TO PHARMACY STAT MEDICATION...

Info iconThis preview shows page 1. Sign up to view the full content.

View Full Document Right Arrow Icon
This is the end of the preview. Sign up to access the rest of the document.

Unformatted text preview: SCANNED TO PHARMACY STAT MEDICATION Diagnosis: Pneumonia Aspiration Pneumonia Other Diagnosis:____________________________________________________ Admitting Dr: ____________________________________________________________ Admit Status: Inpatient Observation Admit Unit: Med/Surg Tele ICU Code Status: Full code No code Limited Code Discussed with: Family Patient Estimated length of stay (circle): 1 2 3 4 5 6 7 >7 Estimated Disposition: Home SNF Home Health Assisted Living Allergies: _______________________________________________________________ _______________________________________________________________________ Diet: Regular Other _____________________________________________ Aspiration suspected, keep NPO Swallow eval Activity Ad lib Bedrest Up w/ assist BSC BRP PT eval Other ___________________________________________ Intake & Output: Q shift Other_______________________________________ Immunizations: Implement pneumococcal/influenza immunization protocol Education: Smoking cessation education (if current Hx of smoking, or quit smoking within last 12 months) Diagnostic Tests: Order if not done in Emergency Department Sputum for gram stain & culture: If unable to obtain, RCP for induction Blood Cultures now x 2 (Required for ICU patients) ABG’s room air on oxygen repeat in am Chest X-ray indication: pneumonia PA/ lateral upright portable Echo CBC no diff auto diff manual diff CMP BMP UA – culture if indicated Other:__________________________________________________________________ AM Labs: CBC no diff auto diff CMP BMP Other:__________________________________________________________________ Respiratory: Oxygen Protocol Place patient on oxygen to maintain SpO2 greater than or equal to ________% Respiratory Medication Protocol Additional Respiratory Care orders ______________________________________________________________________________________________________________ Medications: Saline Lock IV__________________________________________________________________________ Laxative / Bowel Protocol: Regular Renal Antiemetic: Ondansetron HCL (Zofran) 4 mg IV Q 6 h PRN x 2 doses/24 hr. If over 2 doses needed, use Metoclopramide 10 mg IV Q 6 h PRN nausea / vomiting. -OR_____________________________________________________________________________________________________________________ Hypnotic: Temazepam (Restoril) _________mg PO at hour of sleep PRN -ORZolpidem (Ambien) __________mg PO at hour of sleep PRN Antibiotics: Select appropriate regimen. (Choose one) Community Acquired Non-ICU Patients Community Acquired ICU Patients Health Care Associated ICU and non-ICU Ceftriaxone (Rocephin) 1 gm IV Q 24 h –AND– Azithromycin 500 mg IV x 1 then 500 mg PO Daily x 2 days (3 days total) Ceftriaxone (Rocephin) 1 gm IV Q 24 h –AND– Azithromycin 500 mg IV Q 24 h x 3 days Cefepime per pharmacy dosing guidelines –AND– Levofloxacin 500 mg or 750 mg IV now and Q 24 h per pharmacy guidelines Levofloxacin 500 mg or 750 mg IV now and Q 24 h per pharmacy guidelines Ceftriaxone (Rocephin) 1 gm IV Q 24 h –AND– Levofloxacin 500 mg or 750 mg IV now and Q 24 h per pharmacy guidelines Cefepime per pharmacy dosing guidelines –AND– Tobramycin per pharmacy dosing guidelines –AND Azithromycin 500 mg IV Q 24 h x 3 days –OR– Levofloxacin 500 mg or 750 mg IV now and Q 24 h per pharmacy dosing guidelines Ceftriaxone (Rocephin) 1 gm IV Q 24 h –AND– Doxycycline 100 mg IV or PO Q 12 h If Hx of or highly suspected ß-lactam allergy: Levofloxacin 500 mg or 750 mg IV now and Q 24 h per pharmacy dosing guidelines –AND– Aztreonam (Azactam) per pharmacy dosing guidelines If Hx of or highly suspected ß-lactam allergy: Levofloxacin 500 mg or 750 mg IV now and Q 24 h per pharmacy dosing guidelines –AND– Aztreonam (Azactam) per pharmacy dosing guidelines –AND– Tobramycin per pharmacy dosing guidelines Renal Insufficiency: Aztreonam (Azactam) IV –AND– Levofloxacin (IV or PO) 750 mg dosage for PNA If aspiration add B-lactam Zosyn 3.75 mg Q 6 hrs per pharmacy dosing guidelines If MRSA suspected: Vancomycin per pharmacy dosing guidelines If MRSA known or highly suspected: Zyvox 600 mg IV or PO Q 12 hours Pain: For mild pain, begin with #1. If not effective, or pain is moderate to severe, give #2 or #3 based upon patient’s pain report, physiologic status and previous medication history. #1 For mild pain (pain score 0-3) give (choose one): Acetaminophen 650 mg PO /PR Q 4 h PRN not to exceed 4 gm / day from all sources –OR– Ibuprofen 400 mg 600 mg PO Q 6 h PRN #2 For moderate pain (pain score 4-6) give (choose one): Hydrocodone/APAP (Norco) 5/325 7.5/325 1-2 PO Q 4 h PRN –OR– Other ______________________________________________________ #3 For severe pain (pain score 7-10) give (choose one): Morphine Sulfate _______mg IV Q______hours PRN –OR– Hydromorphone (Dilaudid) ______mg IV Q _______ hours PRN –OR– Other ________________ VTE Prophylaxis: None SCDs Enoxaparin (Lovenox) 40 mg subcutaneous daily (Pharmacy to adjust for renal function) Heparin 5000 units subcutaneous Q 8 hours Date_____________ Time____________ Physician_______________________________________ Physician #________________ Authorization for therapeutic substitution is given unless checked here ZZ00167 (9/8/09) Patient Identification SAFH SDH SMCS SRMC Pneumonia Order Set - Adult ORDERS ...
View Full Document

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.

Ask a homework question - tutors are online