Post Cardiac Catheterization Physician'S Order Sheet
ADVERTISEMENT
1POST CARDIAC CATHETERIZATION
PHYSICIAN'S ORDER SHEET
ALL ORDERS WILL BE FULFILLED UNLESS CROSSED OUT
AFTER EACH ORDER IS PROPERLY CHECKED, FAX ORDER SHEET
TO PHARMACY WHETHER OR NOT ORDERS INVOLVE MEDICATION.
√
Check ( )
√
Check ( )
Allergy
Each
Pharmacy
Order As
Orders
Transcribed
PHYSICIAN'S ORDER
DATE:
TIME:
( Military Time )
MEDICATIONS GIVEN DURING CATH
I. VERSED ____________ mg / IV
II. FENTANYL ____________ mcg / IV
PATIENT STATUS - POST CARDIAC CATH ORDERS
1.
ADMIT (inpatient) -OR-
OBSERVE (outpatient) x __________ hrs & discharge to home at ______________.
2.
Complete bedrest x ____________ hrs with right / left leg extended, may elevate
HOB 30 degrees; may logroll side to side. Then activity as follows:
________ OOB to chair as tol.; ________ BRP only; ________ activity ad lib; -OR-
DO NOT USE PROCEDURE SITE ARM FOR BP. May sit up.
RIGHT
LEFT
Procedure arm used:
3. Check cath site for bleeding & distal pulses with vital signs as follows:
every 15min x 4; every 30min x 2; every 1 hour x 4; then _______________________
4. Resume pre-cath diet at _________________________________________________
5. Encourage patient to drink ________ ml fluids today.
6. Tylenol ___ or Tylenol with Codeine #3 ___ ; 2 tablets po every 4 hours prn for cath site pain.
7. May insert Foley Catheter; remove when OOB.
8. Continue IV of ________ at ________ ml / hour. May d/c IV at ________ .
9.
Sandbag to right / left groin x __________ hours.
10A.
Angioseal right / left groin.
10B.
Femstop applied at _________ hours: remove in 3 hours at __________.
FAXED BY/TIME: TIME NOTED:
Doctor's Signature ____________________________________,MD Date __________
Military Time > >
Nurse's Signature / Title___________________________________________________
USE BALL POINT PEN ONLY - PRESS FIRMLY
PART OF THE MEDICAL RECORD
PAGE 1 of 1
8850141 Rev 04/06
Post Cardiac Catheterization Physicians Order_NURSING_MEDICAL AFFAIRS
ADVERTISEMENT
0 votes
Related Articles
Related forms
Related Categories
Parent category: Business