Mr Form 1c - Neurology Epilepsy Monitoring Hospital Orders Page 2
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3PHYSICIAN ORDERS
DIAGNOSIS:
DRUG SENSITIVITY:
Patient Identification
NEUROLOGY EPILEPSY MONITORING HOSPITAL ORDERS
MISCELLANEOUS:
Neurophysiology Tech will record seizures documenting in chart:
Body Parts involved, sequence, character of movements, eye deviation
Loss of bladder/bowel incontinence
Duration
Injury
Complex Partial Seizures: Tech will document in chart
Mental Status:
Orientation: Name, age, place
Recall: Give a color (Red) to remember
Comprehension: Close eyes, raise right arm, left arm
Language: Repeats a phrase, names 2 objects, read a sentence
Check Recall: What was color?
Neurology Tech will notify Dr. Kirmani if Clinical Seizure greater than 3 minutes and notify
nurse to begin protocol.
DIAGNOSTIC ORDERS:
Stat laboratory studies on admission.
G CBC
G CMP
G Dilantin Level
G Depakote Level
G Phenobarbital Level
G Tegretol Level
G Trileptal Level
G Lamictal Level
G Neurontin Level
G Keppra Level
G Tranxene Level
G Mysoline Level
G Zonegram
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Initials
Rev. 9/12 rpl 9/21/12
Page 2 of 3
MR FORM 1C
8/96
Distribution: White - Chart Copy
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