549460-PhysOrder-PreOp-OpenHeart

549460-PhysOrder-PreOp-OpenHeart - PRINTED BY HARTFORD...

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DATE/TIME MD SIGNATURE PHYSICIAN’S ORDERS (excludes medication orders) NOTED BY WHOM DATE/TIME MD SIGNATURE MEDICATION ORDERS (includes iv’s blood components) NOTED BY WHOM ALLERGIC: NO YES *6804* 6804 P H Y S I C I A N ’ S O R D E R F O R M IMPORTANT Position patient ID plate so it is to the LEFT of the arrow Check box to initiate order HH Forms 549460 R05/08 PRE-OPERATIVE OPEN HEART ORDERS PRINTED BY HARTFORD HOSPITAL’S DIGITALPRINT CENTER 549460 R05/08 Pg. 1 of 3 - History & Physical on chart - Cardiac Catheterization report on chart - Anesthesia evaluation - Consent form on chart These orders are to be carried out in PATC CXR EKG Skin prep: 2 showers / bed baths from neck down with Chlorhexidine gluconate (Hibiclens or Cidastat) within 24 hours of surgery. Clean Catch Urinalysis - reflex to culture (valve cases) Lab work: Lytes, BUN, Cr, BS, CBC without Differential, PT, PTT, Type and Crossmatch Also draw HgA1Cif if patient is a known diabetic. These orders are to be carried out on C8 -Admit as inpatient -Vital Signs: per unit standard/Critical Path Diet: Activity: Document perioperatice Sa02 Insert #16 gauge, 1 1/4” peripheral IV (or larger) If unable to insert 16 gauge, insert a #18 guage instead
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