Acute Exacerbation Copd/asthma -Adult
ADVERTISEMENT
1
2ACUTE EXACERBATION
COPD/AsTHMA -ADULT
®
ADMIssION ORDERs,
PAgE 1 OF 2
1. ADMIT TO UNIT: _______________________
Acute _________________________________________
£
DIAgNOsIs: (check applicable)
Acute exacerbation of COPD
Acute exacerbation of asthma
£
£
ATTENDINg: ___________________________
PRIMARY CARE PHYsICIAN ______________________
Consult: Dr. _____________________________
Reason __________________________________________
Dr. _____________________________
Reason __________________________________________
Palliative Care consult: goal setting & symptom Management
£
H&P to be done by H&P Service.
£
2.
£
For COPD exacerbation: Case manager (or Pulmonary Rehab as designated) to screen for pulmonary rehab
(Acute exacerbation COPD)
£
Begin evaluation for home oxygen if pulse ox on Day 2 continues at less than 89% on room air.
Order home oxygen per oxygen requirement study.
Other ________________________________________
£
Home Care
£
3. Laboratory studies:
Check to be sure all Emergency Dept. initial orders are complete and results are posted on the chart.
T
If any of these orders are not complete, do them now: CBC with differential, BUN/CR, LYTES, GLUCOSE
T
Theophylline level
£
ABG
£
Labs in A.M.: _______________________________________.
£
4. Ancillary orders:
Pulse ox on admission to unit then per Oxygen Therapy guideline/protocol.
T
Oxygen _________________________________. Titrate to maintain oxygen saturation greater than or
£
equal to 92%. Re-evaluate need in 24 hrs per Oxygen Therapy guideline/protocol.
For Asthma exacerbation: Peak flows by Respiratory Therapy daily in a.m. Respiratory Therapy to instruct patient
T
in use of Peak Flow Meter at home.
2 View Chest XRay if not done in ED. Reason: ________________________________________________
£
5. Diet
__________________________________________________________________________________
6. Activity:
Progress as tolerated.
T
Other ________________________________________________________________________________
£
7. Miscellaneous:
Obtain old medical records.
£
Vital Signs and breath sounds per unit protocol
Other ______________________________________
T
£
Obtain & record admission height & weight.
T
Remove foley catheter in AM if in place unless history of long term indwelling catheter. Monitor urine
T
output & notify physician if no output in 8 hours.
Nursing pneumococcal and influenza vaccination screen and administration per local protocol.
T
Nursing and Respiratory Therapy to provide patient education prior to discharge, re: oral/inhaled medications,
T
when to contact physician. Give Healthy Living Guide to Living with Asthma or COPD.
Smoking cessation counseling if positive history of smoking: Tips to quit smoking, Smoking resources and
T
Quitting smoking video.
Date/Time:
Phone order taken by and read back by:
Transcriber's Signature:
Date/Time:
Prescriber's Printed Name:
Noting Nurse's Signature:
Date/Time:
Prescriber's signature:
Beeper Number/ID Number Date/Time:
Acute Exacerbation COPD/Asthma - Adult
Form transmitted to pharmacy: Date/Time:_____________ By:______________
Admission Orders Page 1 of 2
sO-047
Original - Chart
Copy or transmit to pharmacy
10-6000-229 REV 9/26/08
ADVERTISEMENT
0 votes
Related Articles
Related forms
Related Categories
Parent category: Medical