H006-21937 - SCANNED TO PHARMACY STAT MEDICATION Date:...

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Unformatted text preview: SCANNED TO PHARMACY STAT MEDICATION Date: ________________ Time: _____________ Allergies: INDUCTION 1. 2. 3. 4. Admit to Labor and Delivery for Induction of Labor at ______ weeks gestation Routine Labor and Delivery Admission Orders Indication for Induction (check one) Postdates – EDC: _______________________ Preeclampsia: Mild Severe Elective Diabetes Fetal Indication: ________________________ Other: __________________________________ Complete Pre-Induction Checklist AUGMENTATION 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. 15. 16. Augment Labor with Oxytocin. Complete Pre-Augmentation Checklist. Indication for Augmentation: _____________________________________________________________ Monitor FHR and Uterine contractions per Oxytocin / Augmentation of Labor Protocol IV Oxytocin Concentration: 15 units in 250 mL Lactated Ringers solution – Note: 1 milliUnit = 1 mL/hour Start Oxytocin Infusion at 1 milliUnit / minute Increase Oxytocin Infusion Rate by: 1 milliUnit / minute 2 milliUnit / minute (May increase by only 1 milliUnit if 4 contractions in 10 minutes and/or when contractions are lasting greater than 90 seconds). Frequency of increase in Oxytocin infusion rate: • Every 30 minutes, until contractions are consistently 2-3 minutes apart and painful and/or there is evidence of cervical change. Increase only if all the In-Use Checklist criteria met. Notify MD when Oxytocin infusion rate reaches 20 milliUnits / minute Initiate intra-uterine resuscitation measures as indicated for FHR pattern, which may include: • Give oxygen by non-rebreather mask at 10 L/min. • Increase primary IV to bolus rate 500 mL over 10 minutes x 1 • Contact physician for further IV bolus orders When the In-Use Checklist FHR criteria NOT MET, and the Uterine criteria MET: • Decrease infusion rate of Oxytocin by 2 milliUnits/min or more, and initiate intrauterine resuscitation measures. • Notify physician if interventions not effective. When the In-Use Checklist Uterine criteria NOT MET, and the FHR criteria MET: • Decrease infusion rate of Oxytocin by 2 milliUnits/min Q 10 minutes, or more frequently, until tachysystole or prolonged contractions have resolved. • May resume increasing the Oxytocin infusion rate, as ordered above, when In-Use Checklist Criteria have been met. • Consult physician for plan of care if the Oxytocin dose has been decreased two (2) consecutive times prior to resuming increase of Oxytocin When both the In-Use Checklist FHR criteria and Uterine criteria NOT MET: • Discontinue oxytocin • Initiate intra-uterine resuscitation measures • Notify physician If Oxytocin infusion discontinued, infusion may be resumed when all the In-Use Checklist criteria have been met. • If the Oxytocin has been discontinued for less than 30 minutes, restart the infusion at 1/2 the PREVIOUS rate and increase per initial orders. • If the Oxytocin has been discontinued for more than 30 minutes, restart the infusion at 1 milliUnit/minute and increase per initial orders. Physician ____________________________________________________________ Physician # _________________________ Authorization for therapeutic substitution is given unless checked here Patient Identification Sutter Medical Center, Sacramento A Sutter Health Affiliate Oxytocin Orders Induction/Augmentation 21937 (4/30/09) 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.

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