Mr Form 1c - Neurology Epilepsy Monitoring Hospital Orders
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1
2
3PHYSICIAN ORDERS
DIAGNOSIS:
DRUG SENSITIVITY:
Patient Identification
NEUROLOGY EPILEPSY MONITORING HOSPITAL ORDERS
ADULT ONLY
LOCATION: NEUROLOGY/EPILEPSY MONITORING UNIT
RESPONSIBLE SERVICE/PHYSICIANS:
Notify Attending: Dr. Kirmani (Beeper 762-0894) of Room Number on Arrival to Ward
Neurology Staff Physician: __________________________________
Beeper _______________
Resident Physician: _______________________________________
Beeper _______________
Diagnosis: ____________________________________________________________________
CONDITION:
stable
guarded
severe
G
G
G
VITALS:
Weight on Admission
Vital signs: BP, P, RR, Temp, Orientation daily
Notify MD for temp greater than 100° F and perform blood cultures x 2, CBC, and urine C & S if not
cultured in past 48 hours
Neurophysiology Technician will monitor EEG
ACTIVITY: Ad Lib in Room
Restricted to room only
G
Sponge Bath only
NUTRITION:
Diet :
Regular
Cardiac
Diabetic
Other _________________________
G
G
G
G
NURSING ORDERS:
Heplock IV
Place on Telemetry Monitoring
Record number of seizures per shift
Padded Bed with Seizure Precautions
Place patient on EEG with Video monitoring
During Seizure:
Turn on side
Asses:
Airway patency
Aspiration risk
Pulse oximetry
Vital signs
Asses post seizure every 15 mins until stable:
Airway patency
Aspiration risk
BP, P, R
Behavioral change, Duration
Injury
Contact Dr. Kirmani for routine orders between 8 a.m.- 5 p.m. Contact Neurologist on call for any
routine orders between 5 p.m.-8 a.m.
Contact Dr. Kirmani if seizure fails to respond to two 1 mg doses of IV Lorazepam in 5 minutes.
If seizure does not respond to two doses of Ativan and the anticonvulsant load or in case of respi-
ratory depression, call Dr. Rapid.
____________
Initials
Rev. 9/12 rpl 9/21/12 Page 1 of 3
MR FORM 1C
8/96
Distribution: White - Chart Copy
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