umc health system patient label here general medicine...

UMC Health System Patient Label Here

GENERAL MEDICINE PLAN

PHYSICIAN ORDERS

Diagnosis _____________________________________________________________________________________________________________

Weight ____________________________________________ Allergies ________________________________________________________

Place an "X" in the Orders column to designate orders of choice AND an "x" in the specific order detail box(es) where applicable.

ORDER ORDER DETAILS

Patient Care

Vital Signs Per Unit Standards

Daily Weight

Patient Activity Up Ad Lib/Activity as Tolerated | Assist as Needed Bedrest Bedrest | Bathroom Privileges Bedrest | Up to Bedside Commode Only

ICU Progressive Mobility Guidelines ***See Reference Text***

Strict Intake and Output Per Unit Standards q1h q2h q4h q12h

Insert Urinary Catheter Foley, To: Dependent Drainage Bag

Urinary Catheter Care

Continuous Telemetry (Intermediate Care)

Intermittent Telemetry

Communication

Notify Provider/Primary Team of Pt Admit In AM Now Upon Arrival to Unit

Dietary

Oral Diet Regular Diet AHA Diet Renal Diet Clear Liquid Diet Full Liquid Diet Clear Liquid Diet, Advance as tolerated to Full Liquid Clear Liquid Diet, Advance as tolerated to Regular Clear Liquid Diet, Advance as tolerated to AHA Clear Liquid Diet, Advance as tolerated to Renal

ADA Diet 1600 Calories 1800 Calories 2000 Calories 1400 Calories

TO Read Back Scanned Powerchart Scanned PharmScan

Order Taken by Signature: _________________________________________________________________________ Date ____________________________ Time ____________________________

Physician Signature: ___________________________________________________________________________ Date ____________________________ Time ____________________________

General Medicine Plan Version: 8 Effective on: 06/10/19

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PHYSICIAN ORDERS


ORDER ORDER DETAILS

NPO Diet NPO NPO, Except Meds T;2359, NPO After Midnight T;2359, NPO After Midnight, Except Meds T;2359, NPO After Midnight, Except Ice Chips T;2359, NPO After Midnight, Except Meds, Except Ice Chips

IV Solutions

D5 1/2 NS IV, 25 mL/hr IV, 75 mL/hr IV, 125 mL/hr IV, 150 mL/hr IV, 200 mL/hr

D5 1/2 NS + 20 mEq KCl/L IV, 25 mL/hr IV, 75 mL/hr IV, 125 mL/hr IV, 150 mL/hr IV, 200 mL/hr

D5W IV, 75 mL/hr IV, 125 mL/hr IV, 150 mL/hr IV, 200 mL/hr

1/2 NS + 20 mEq KCl/L IV, 25 mL/hr IV, 75 mL/hr IV, 125 mL/hr IV, 150 mL/hr IV, 200 mL/hr

NS (Normal Saline) IV, 25 mL/hr IV, 75 mL/hr IV, 125 mL/hr IV, 150 mL/hr IV, 200 mL/hr

LR (Lactated Ringer’s) IV, 25 mL/hr IV, 75 mL/hr IV, 125 mL/hr IV, 150 mL/hr IV, 200 mL/hr

Laboratory

Basic Metabolic Panel Next Day in AM, T+1;0300, Every AM for 3 days Routine, T;N, Every AM for 1 days Routine, T;N

CBC Routine, T;N, Every AM for 3 days Routine, T;N, Every AM for 1 days Routine, T;N

CBC with Differential Routine, T;N, Every AM for 1 days Routine, T;N

Comprehensive Metabolic Panel (CMP) Routine, T;N, Every AM for 3 days Routine, T;N, Every AM for 1 days Routine, T;N

Prothrombin Time with INR

Prothrombin Time with INR Next Day in AM, T+1;0300





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PHYSICIAN ORDERS


ORDER ORDER DETAILS

PTT

PTT Next Day in AM, T+1;0300

Beta HCG Serum Qualitative

Urinalysis with Positive Culture Reflex

Culture Blood

Diagnostic Tests

EKG-12 Lead

DX Chest Portable

DX Chest PA & Lateral

DX Abdomen AP (KUB)

CT Chest w/o

CT Abd w/ PO Contrast Only

CT Abd w/o Contrast

Respiratory

Respiratory Care Plan Guidelines

Oxygen Therapy Via: Nasal cannula, Keep sats greater than: 90% Via: Simple mask, Keep sats greater than: 90% Via: Venturi mask, Keep sats greater than: 90% Via: Nonrebreather mask, Keep sats greater than: 90% Via: Trach collar, Keep sats greater than: 90%

Physical Medicine and Rehab

Consult PT Mobility for Eval & Treat

Consult Occ Therapy for Eval & Treat

Consult Speech Therapy for Eval & Treat

Consults/Referrals

Consult MD

Consult Palliative Care

...Additional Orders





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DISCOMFORT MED PLAN

PHYSICIAN ORDERS


ORDER ORDER DETAILS

Patient Care

Perform Bladder Scan Scan PRN, If more than 250, Then: Call MD, Perform as needed for patients complaining of urinary discomfort and/or bladder distention present OR 6 hrs post Foley removal and patient has not voided.

MedicationsMedication sentences are per dose. You will need to calculate a total daily dose if needed.

benzocaine-menthol topical (Chloraseptic 6 mg-10 mg mucous membrane lozenge) 1 lozenge, mucous membrane, lozenge, q4h, PRN sore throat

dextromethorphan-guaiFENesin (dextromethorphan-guaiFENesin 20 mg-200 mg/10 mL oral liquid) 10 mL, PO, liq, q4h, PRN cough

dexamethasone-diphenhydrAMIN-nystatin-NS (Fred’s Brew) 15 mL, swish & spit, liq, q2h, PRN mucositis While awake

Analgesics

acetaminophen 500 mg, PO, tab, q6h, PRN pain-mild (scale 1-3) ***Do not exceed 4,000 mg of acetaminophen from all sources in 24 hours*** *****IF acetaminophen ineffective/contraindicated, USE ibuprofen if ordered:***** 1,000 mg, PO, tab, q6h, PRN pain-mild (scale 1-3) ***Do not exceed 4,000 mg of acetaminophen from all sources in 24 hours*** *****IF acetaminophen ineffective/contraindicated, USE ibuprofen if ordered:***** 650 mg, rectally, supp, q4h, PRN pain-mild (scale 1-3) ***Do not exceed 4,000 mg of acetaminophen from all sources in 24 hours*** *****IF acetaminophen ineffective/contraindicated, USE ibuprofen if ordered:*****

ibuprofen 400 mg, PO, tab, q6h, PRN pain-mild (scale 1-3) ***Do not exceed 3,200 mg of ibuprofen from all sources in 24 hours***. Give with food.

Select either HYDROcodone-acetaminophen or acetaminophen-codeine #3, but not both

HYDROcodone-acetaminophen (HYDROcodone-acetaminophen 5 mg-325 mg oral tablet) 1 tab, PO, tab, q4h, PRN pain-moderate (scale 4-7) Do not exceed 4,000 mg of acetaminophen from all sources in 24 hours ****IF HYDROcodone-acetaminophen ineffective/contraindicated or the patient is NPO, USE ketorolac if ordered**** 2 tab, PO, tab, q4h, PRN pain-moderate (scale 4-7) Do not exceed 4,000 mg of acetaminophen from all sources in 24 hours ****IF HYDROcodone-acetaminophen ineffective/contraindicated or the patient is NPO, USE ketorolac if ordered****Continued on next page....





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DISCOMFORT MED PLAN

PHYSICIAN ORDERS


ORDER ORDER DETAILS

acetaminophen-codeine (acetaminophen-codeine (Tylenol with Codeine) 300 mg-30 mg oral tablet) 1 tab, PO, tab, q4h, PRN pain-moderate (scale 4-7) Do not exceed 4,000 mg of acetaminophen from all sources in 24 hours.***** If acetaminophen-codeine #3 ineffective/contraindicated or NPO, USE ketorolac if ordered.***** 2 tab, PO, tab, q4h, PRN pain-moderate (scale 4-7) Do not exceed 4,000 mg of acetaminophen from all sources in 24 hours.***** If acetaminophen-codeine #3 ineffective/contraindicated or NPO, USE ketorolac if ordered.*****

ketorolac 15 mg, IVPush, inj, q6h, PRN pain-moderate (scale 4-7), x 48 hr ***May give IM if no IV access***

morphine 2 mg, Slow IVPush, inj, q4h, PRN pain-severe (scale 8-10) *****IF morphine is ineffective/contraindicated, USE HYDROmorphone if ordered***** 4 mg, Slow IVPush, inj, q4h, PRN pain-severe (scale 8-10) *****IF morphine is ineffective/contraindicated, USE HYDROmorphone if ordered*****

HYDROmorphone 0.2 mg, Slow IVPush, inj, q4h, PRN pain-severe (scale 8-10) 0.4 mg, Slow IVPush, inj, q4h, PRN pain-severe (scale 8-10) 0.6 mg, Slow IVPush, inj, q4h, PRN pain-severe (scale 8-10)

Antiemetics

promethazine 25 mg, PO, tab, q4h, PRN nausea/vomiting *****IF promethazine is ineffective/contraindicated or patient is NPO, USE ondansetron if ordered*****

ondansetron 4 mg, IVPush, soln, q8h, PRN nausea/vomiting

Gastrointestinal Agents

docusate 100 mg, PO, cap, Nightly, PRN constipation *****IF docusate is contraindicated or ineffective after 12 hours, USE bisacodyl if ordered*****

bisacodyl 10 mg, rectally, supp, Daily, PRN constipation *****IF bisacodyl is contraindicated or ineffective after 6 hours, USE Fleet Enema if ordered*****

sodium biphosphate-sodium phosphate (Fleet Enema) 1 ea, rectally, enema, Daily, PRN constipation

loperamide 4 mg, PO, cap, ONE TIME, PRN diarrhea Initial dose after first loose stool 4 mg, PO, liq, ONE TIME, PRN diarrhea Initial dose after first loose stool





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DISCOMFORT MED PLAN

PHYSICIAN ORDERS


ORDER ORDER DETAILS

loperamide 2 mg, PO, cap, as needed, PRN diarrhea 2 mg after each loose stool, up to 16 mg per day 2 mg, PO, liq, as needed, PRN diarrhea 2 mg after each loose stool, up to 16 mg per day

Antacids

Al hydroxide-Mg hydroxide-simethicone (aluminum hydroxide-magnesium hydroxide-simethicone 200 mg-200 mg-20 mg/5 mL oral suspension) 30 mL, PO, susp, q4h, PRN indigestion Administer 1 hour before meals and nightly.

simethicone 80 mg, PO, tab chew, q4h, PRN gas 160 mg, PO, tab chew, q4h, PRN gas

Sedatives

ALPRAZolam 0.25 mg, PO, tab, TID, PRN anxiety *****IF ALPRAZolam is ineffective/contraindicated or patient is NPO, USE LORazepam if ordered*****

LORazepam 1 mg, IVPush, inj, q6h, PRN anxiety 0.5 mg, IVPush, inj, q6h, PRN anxiety

zolpidem 5 mg, PO, tab, Nightly, PRN insomnia may repeat x1 in one hour if ineffective

Antihistamines

diphenhydrAMINE 25 mg, PO, cap, q4h, PRN itching *****IF diphenhydrAMINE PO is ineffective or patient is NPO, USE diphenhydrAMINE inj if ordered*****

diphenhydrAMINE 25 mg, IVPush, inj, q4h, PRN itching

Anti-pyretics

acetaminophen 500 mg, PO, tab, q4h, PRN fever ***Do not exceed 4,000 mg of acetaminophen from all sources in 24 hours*** *****IF acetaminophen is ineffective/contraindicated, USE ibuprofen if ordered***** 1,000 mg, PO, tab, q6h, PRN fever ***Do not exceed 4,000 mg of acetaminophen from all sources in 24 hours*** *****IF acetaminophen is ineffective/contraindicated, USE ibuprofen if ordered*****Continued on next page....





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DISCOMFORT MED PLAN

PHYSICIAN ORDERS


ORDER ORDER DETAILS

ibuprofen 200 mg, PO, tab, q4h, PRN fever Do not exceed 3,200 mg in 24 hours. Give with food. 400 mg, PO, tab, q4h, PRN fever Do not exceed 3,200 mg in 24 hours. Give with food.

Anorectal Preparations

witch hazel-glycerin topical (witch hazel-glycerin 50% topical pad) 1 app, topical, pad, as needed, PRN hemorrhoid care Wipe affected area *****IF witch hazel-glycerin ineffective/contraindicated, USE phenylephrine ointment if ordered*****

phenylephrine topical (phenylephrine 0.25%-3% rectal ointment) 1 app, rectally, oint, q6h, PRN hemorrhoid care Apply to affected area *****IF phenylephrine ointment ineffective/contraindicated, USE hydrocortisone-pramoxine foam if ordered*****





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GERIATRIC DISCOMFORT MED PLAN

PHYSICIAN ORDERS


ORDER ORDER DETAILS

Patient Care

Perform Bladder Scan Scan PRN, If more than 250, Then: Call MD, Perform as needed for patients complaining of urinary discomfort and/or bladder distention present OR 6 hrs post Foley removal and patient has not voided.


benzocaine-menthol topical (Chloraseptic 6 mg-10 mg mucous membrane lozenge) 1 lozenge, mucous membrane, lozenge, q4h, PRN sore throat

dextromethorphan-guaiFENesin (dextromethorphan-guaiFENesin 20 mg-200 mg/10 mL oral liquid) 10 mL, PO, liq, q4h, PRN cough

melatonin 2 mg, PO, tab, Nightly, PRN insomnia

Analgesics for Mild Pain

Select only ONE of the following for Mild Pain

acetaminophen 500 mg, PO, tab, q6h, PRN pain-mild (scale 1-3) ***Do not exceed 4,000 mg of acetaminophen from all sources in 24 hours*** 1,000 mg, PO, tab, q6h, PRN pain-mild (scale 1-3) ***Do not exceed 4,000 mg of acetaminophen from all sources in 24 hours*** 650 mg, rectally, supp, q4h, PRN pain-mild (scale 1-3) ***Do not exceed 4,000 mg of acetaminophen from all sources in 24 hours***

ibuprofen 400 mg, PO, tab, q6h, PRN pain-mild (scale 1-3) ***Do not exceed 3,200 mg of ibuprofen from all sources in 24 hours*** Give with food.

Analgesics for Moderate Pain

Select only ONE of the following for Moderate Pain

HYDROcodone-acetaminophen (HYDROcodone-acetaminophen 5 mg-325 mg oral tablet) 1 tab, PO, tab, q4h, PRN pain-moderate (scale 4-7) ***Do not exceed 4,000 mg of acetaminophen from all sources in 24 hours ****

acetaminophen-codeine (acetaminophen-codeine (Tylenol with Codeine) 300 mg-30 mg oral tablet) 1 tab, PO, tab, q4h, PRN pain-moderate (scale 4-7) ***** Do not exceed 4,000 mg of acetaminophen from all sources in 24 hours***** 2 tab, PO, tab, q4h, PRN pain-moderate (scale 4-7) ***** Do not exceed 4,000 mg of acetaminophen from all sources in 24 hours*****

Analgesics for Severe Pain

Select only ONE of the following for Severe Pain

morphine 2 mg, Slow IVPush, inj, q4h, PRN pain-severe (scale 8-10)

HYDROmorphone 0.2 mg, Slow IVPush, inj, q4h, PRN pain-severe (scale 8-10)





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GERIATRIC DISCOMFORT MED PLAN

PHYSICIAN ORDERS


ORDER ORDER DETAILS Antiemetics

ondansetron 4 mg, IVPush, soln, q8h, PRN nausea/vomiting

Gastrointestinal Agents

Select only ONE of the following for constipation

docusate 100 mg, PO, cap, Nightly, PRN constipation

bisacodyl 10 mg, rectally, supp, Daily, PRN constipation

Antacids

Al hydroxide-Mg hydroxide-simethicone (aluminum hydroxide-magnesium hydroxide-simethicone 200 mg-200 mg-20 mg/5 mL oral suspension) 30 mL, PO, susp, q4h, PRN indigestion Administer 1 hour before meals and nightly.

simethicone 80 mg, PO, tab chew, q4h, PRN gas 160 mg, PO, tab chew, q4h, PRN gas

Anti-pyretics

Select only ONE of the following for fever

acetaminophen 500 mg, PO, tab, q4h, PRN fever ***Do not exceed 4,000 mg of acetaminophen from all sources in 24 hours*** 1,000 mg, PO, tab, q6h, PRN fever ***Do not exceed 4,000 mg of acetaminophen from all sources in 24 hours***

ibuprofen 200 mg, PO, tab, q4h, PRN fever ***Do not exceed 3,200 mg of ibuprofen from all sources in 24 hours*** Give with food. 400 mg, PO, tab, q4h, PRN fever ***Do not exceed 3,200 mg of ibuprofen from all sources in 24 hours*** Give with food.

Anorectal Preparations

Select only ONE of the following for hemorrhoid care

witch hazel-glycerin topical (witch hazel-glycerin 50% topical pad) 1 app, topical, pad, as needed, PRN hemorrhoid care Wipe affected area

phenylephrine topical (phenylephrine 0.25%-3% rectal ointment) 1 app, rectally, oint, q6h, PRN hemorrhoid care Apply to affected area





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SLIDING SCALE INSULIN REGULAR PLAN

PHYSICIAN ORDERS


ORDER ORDER DETAILS

Patient Care

POC Blood Sugar Check Per Sliding Scale Insulin Frequency AC & HS AC & HS 3 days TID BID q12h q6h q6h 24 hr q4h q2h

Sliding Scale Insulin Regular Guidelines Follow SSI Regular Reference Text


insulin regular (Low Dose Insulin Regular Sliding Scale) 0-10 units, subcut, inj, AC & nightly, PRN glucose levels - see parameters Low Dose Insulin Regular Sliding Scale If blood glucose is less than 70 mg/dL and patient is symptomatic, initiate hypoglycemia guidelines and notify provider.

70-139 mg/dL - 0 units 140-180 mg/dL - 2 units subcut 181-240 mg/dL - 3 units subcut 241-300 mg/dL - 4 units subcut 301-350 mg/dL - 6 units subcut 351-400 mg/dL - 8 units subcut If blood glucose is greater than 400 mg/dL, administer 10 units subcut, notify provider, and repeat POC blood sugar check in 1 hour. Continue to repeat 10 units subcut and POC blood sugar checks every 1 hour until blood glucose is less than 300 mg/dL, then resume normal POC blood sugar check and insulin regular sliding scale. 0-10 units, subcut, inj, BID, PRN glucose levels - see parameters Low Dose Insulin Regular Sliding Scale If blood glucose is less than 70 mg/dL and patient is symptomatic, initiate hypoglycemia guidelines and notify provider.

70-139 mg/dL - 0 units 140-180 mg/dL - 2 units subcut 181-240 mg/dL - 3 units subcut 241-300 mg/dL - 4 units subcut 301-350 mg/dL - 6 units subcut 351-400 mg/dL - 8 units subcut If blood glucose is greater than 400 mg/dL, administer 10 units subcut, notify provider, and repeat POC blood sugar check in 1 hour. Continue to repeat 10 units subcut and POC blood sugar checks every 1 hour until blood glucose is less than 300 mg/dL, then resume normal POC blood sugar check and insulin regular sliding scale.Continued on next page....





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PHYSICIAN ORDERS


ORDER ORDER DETAILS

0-10 units, subcut, inj, TID, PRN glucose levels - see parameters Low Dose Insulin Regular Sliding Scale If blood glucose is less than 70 mg/dL and patient is symptomatic, initiate hypoglycemia guidelines and notify provider.

70-139 mg/dL - 0 units 140-180 mg/dL - 2 units subcut 181-240 mg/dL - 3 units subcut 241-300 mg/dL - 4 units subcut 301-350 mg/dL - 6 units subcut 351-400 mg/dL - 8 units subcut If blood glucose is greater than 400 mg/dL, administer 10 units subcut, notify provider, and repeat POC blood sugar check in 1 hour. Continue to repeat 10 units subcut and POC blood sugar checks every 1 hour until blood glucose is less than 300 mg/dL, then resume normal POC blood sugar check and insulin regular sliding scale. 0-10 units, subcut, inj, q6h, PRN glucose levels - see parameters Low Dose Insulin Regular Sliding Scale If blood glucose is less than 70 mg/dL and patient is symptomatic, initiate hypoglycemia guidelines and notify provider.

70-139 mg/dL - 0 units 140-180 mg/dL - 2 units subcut 181-240 mg/dL - 3 units subcut 241-300 mg/dL - 4 units subcut 301-350 mg/dL - 6 units subcut 351-400 mg/dL - 8 units subcut If blood glucose is greater than 400 mg/dL, administer 10 units subcut, notify provider, and repeat POC blood sugar check in 1 hour. Continue to repeat 10 units subcut and POC blood sugar checks every 1 hour until blood glucose is less than 300 mg/dL, then resume normal POC blood sugar check and insulin regular sliding scale. 0-10 units, subcut, inj, q4h, PRN glucose levels - see parameters Low Dose Insulin Regular Sliding Scale If blood glucose is less than 70 mg/dL and patient is symptomatic, initiate hypoglycemia guidelines and notify provider.






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PHYSICIAN ORDERS


ORDER ORDER DETAILS

0-10 units, subcut, inj, q2h, PRN glucose levels - see parameters Low Dose Insulin Regular Sliding Scale If blood glucose is less than 70 mg/dL and patient is symptomatic, initiate hypoglycemia guidelines and notify provider.

70-139 mg/dL - 0 units 140-180 mg/dL - 2 units subcut 181-240 mg/dL - 3 units subcut 241-300 mg/dL - 4 units subcut 301-350 mg/dL - 6 units subcut 351-400 mg/dL - 8 units subcut If blood glucose is greater than 400 mg/dL, administer 10 units subcut, notify provider, and repeat POC blood sugar check in 1 hour. Continue to repeat 10 units subcut and POC blood sugar checks every 1 hour until blood glucose is less than 300 mg/dL, then resume normal POC blood sugar check and insulin regular sliding scale.

insulin regular (Moderate Dose Insulin Regular Sliding Scale) 0-12 units, subcut, inj, AC & nightly, PRN glucose levels - see parameters Moderate Dose Insulin Regular Sliding Scale If blood glucose is less than 70 mg/dL and patient is symptomatic, initiate hypoglycemia guidelines and notify provider.

70-139 mg/dL - 0 units 140-180 mg/dL - 3 units subcut 181-240 mg/dL - 4 units subcut 241-300 mg/dL - 6 units subcut 301-350 mg/dL - 8 units subcut 351-400 mg/dL - 10 units subcut If blood glucose is greater than 400 mg/dL, administer 12 units subcut, notify provider, and repeat POC blood sugar check in 1 hour. Continue to repeat 10 units subcut and POC blood sugar checks every 1 hour until blood glucose is less than 300 mg/dL, then resume normal POC blood sugar check and insulin regular sliding scale. 0-12 units, subcut, inj, BID, PRN glucose levels - see parameters Moderate Dose Insulin Regular Sliding Scale If blood glucose is less than 70 mg/dL and patient is symptomatic, initiate hypoglycemia guidelines and notify provider.






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PHYSICIAN ORDERS


ORDER ORDER DETAILS

0-12 units, subcut, inj, TID, PRN glucose levels - see parameters Moderate Dose Insulin Regular Sliding Scale If blood glucose is less than 70 mg/dL and patient is symptomatic, initiate hypoglycemia guidelines and notify provider.

70-139 mg/dL - 0 units 140-180 mg/dL - 3 units subcut 181-240 mg/dL - 4 units subcut 241-300 mg/dL - 6 units subcut 301-350 mg/dL - 8 units subcut 351-400 mg/dL - 10 units subcut If blood glucose is greater than 400 mg/dL, administer 12 units subcut, notify provider, and repeat POC blood sugar check in 1 hour. Continue to repeat 10 units subcut and POC blood sugar checks every 1 hour until blood glucose is less than 300 mg/dL, then resume normal POC blood sugar check and insulin regular sliding scale. 0-12 units, subcut, inj, q6h, PRN glucose levels - see parameters Moderate Dose Insulin Regular Sliding Scale If blood glucose is less than 70 mg/dL and patient is symptomatic, initiate hypoglycemia guidelines and notify provider.

70-139 mg/dL - 0 units 140-180 mg/dL - 3 units subcut 181-240 mg/dL - 4 units subcut 241-300 mg/dL - 6 units subcut 301-350 mg/dL - 8 units subcut 351-400 mg/dL - 10 units subcut If blood glucose is greater than 400 mg/dL, administer 12 units subcut, notify provider, and repeat POC blood sugar check in 1 hour. Continue to repeat 10 units subcut and POC blood sugar checks every 1 hour until blood glucose is less than 300 mg/dL, then resume normal POC blood sugar check and insulin regular sliding scale. 0-12 units, subcut, inj, q4h, PRN glucose levels - see parameters Moderate Dose Insulin Regular Sliding Scale If blood glucose is less than 70 mg/dL and patient is symptomatic, initiate hypoglycemia guidelines and notify provider.






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PHYSICIAN ORDERS


ORDER ORDER DETAILS

0-12 units, subcut, inj, q2h, PRN glucose levels - see parameters Moderate Dose Insulin Regular Sliding Scale If blood glucose is less than 70 mg/dL and patient is symptomatic, initiate hypoglycemia guidelines and notify provider.


insulin regular (High Dose Insulin Regular Sliding Scale) 0-14 units, subcut, inj, AC & nightly, PRN glucose levels - see parameters High Dose Insulin Regular Sliding Scale If blood glucose is less than 70 mg/dL and patient is symptomatic, initiate hypoglycemia guidelines and notify provider.

70-139 mg/dL - 0 units 140-180 mg/dL - 4 units subcut 181-240 mg/dL - 6 units subcut 241-300 mg/dL - 8 units subcut 301-350 mg/dL - 10 units subcut 351-400 mg/dL - 12 units subcut If blood glucose is greater than 400 mg/dL, administer 14 units subcut, notify provider, and repeat POC blood sugar check in 1 hour. Continue to repeat 10 units subcut and POC blood sugar checks every 1 hour until blood glucose is less than 300 mg/dL, then resume normal POC blood sugar check and insulin regular sliding scale. 0-14 units, subcut, inj, BID, PRN glucose levels - see parameters High Dose Insulin Regular Sliding Scale If blood glucose is less than 70 mg/dL and patient is symptomatic, initiate hypoglycemia guidelines and notify provider.






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PHYSICIAN ORDERS


ORDER ORDER DETAILS

0-14 units, subcut, inj, TID, PRN glucose levels - see parameters High Dose Insulin Regular Sliding Scale If blood glucose is less than 70 mg/dL and patient is symptomatic, initiate hypoglycemia guidelines and notify provider.

70-139 mg/dL - 0 units 140-180 mg/dL - 4 units subcut 181-240 mg/dL - 6 units subcut 241-300 mg/dL - 8 units subcut 301-350 mg/dL - 10 units subcut 351-400 mg/dL - 12 units subcut If blood glucose is greater than 400 mg/dL, administer 14 units subcut, notify provider, and repeat POC blood sugar check in 1 hour. Continue to repeat 10 units subcut and POC blood sugar checks every 1 hour until blood glucose is less than 300 mg/dL, then resume normal POC blood sugar check and insulin regular sliding scale. 0-14 units, subcut, inj, q6h, PRN glucose levels - see parameters High Dose Insulin Regular Sliding Scale If blood glucose is less than 70 mg/dL and patient is symptomatic, initiate hypoglycemia guidelines and notify provider.

70-139 mg/dL - 0 units 140-180 mg/dL - 4 units subcut 181-240 mg/dL - 6 units subcut 241-300 mg/dL - 8 units subcut 301-350 mg/dL - 10 units subcut 351-400 mg/dL - 12 units subcut If blood glucose is greater than 400 mg/dL, administer 14 units subcut, notify provider, and repeat POC blood sugar check in 1 hour. Continue to repeat 10 units subcut and POC blood sugar checks every 1 hour until blood glucose is less than 300 mg/dL, then resume normal POC blood sugar check and insulin regular sliding scale. 0-14 units, subcut, inj, q4h, PRN glucose levels - see parameters High Dose Insulin Regular Sliding Scale If blood glucose is less than 70 mg/dL and patient is symptomatic, initiate hypoglycemia guidelines and notify provider.






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PHYSICIAN ORDERS


ORDER ORDER DETAILS

0-14 units, subcut, inj, q2h, PRN glucose levels - see parameters High Dose Insulin Regular Sliding Scale If blood glucose is less than 70 mg/dL and patient is symptomatic, initiate hypoglycemia guidelines and notify provider.


insulin regular (Blank Insulin Sliding Scale) See Comments, subcut, inj, PRN glucose levels - see parameters If blood glucose is less than ____mg/dL , initiate hypoglycemia guidelines and notify provider.

70-139 mg/dL - ____ units 140-180 mg/dL - ____ units subcut 181-240 mg/dL - ____ units subcut 241-300 mg/dL - ____ units subcut 301-350 mg/dL - ____ units subcut 351-400 mg/dL - ____ units subcut If blood glucose is greater than 400 mg/dL, administer ____ units subcut, notify provider, and repeat POC blood sugar check in 1 hour. Continue to repeat ____ units subcut and POC blood sugar checks every 1 hour until blood glucose is less than 300 mg/dL, then resume normal POC blood sugar check and insulin regular sliding scale.

HYPOglycemia Guidelines

HYPOglycemia Guidelines ***See Reference Text***

glucose 15 g, PO, gel, as needed, PRN glucose levels - see parameters Use if patient is symptomatic and able to swallow. See hypoglycemia guidelines.

glucose (D50) 25 g, IVPush, syringe, as needed, PRN glucose levels - see parameters Use if patient is symptomatic and unable to swallow / NPO with IV access. See hypoglycemia guidelines.

glucagon 1 mg, IM, inj, as needed, PRN glucose levels - see parameters Use if patient is symptomatic and unable to swallow / NPO WITHOUT IV access. See hypoglycemia guidelines.





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VTE PROPHYLAXIS PLAN

PHYSICIAN ORDERS


ORDER ORDER DETAILS

Patient Care

VTE Guidelines See Reference Text for Guidelines

***If VTE Pharmacologic Prophylaxis not given, choose the Contraindications for VTE below and complete reason contraindi cated***

Contraindications VTE Active/high risk for bleeding Treatment not indicated Patient or caregiver refused Other anticoagulant ordered Anticipated procedure within 24 hours Intolerance to all VTE chemoprophylaxis

Apply Elastic Stockings Apply to: Bilateral Lower Extremities, Length: Knee High Apply to: Left Lower Extremity (LLE), Length: Knee High Apply to: Right Lower Extremity (RLE), Length: Knee High Apply to: Bilateral Lower Extremities, Length: Thigh High Apply to: Left Lower Extremity (LLE), Length: Thigh High Apply to: Right Lower Extremity (RLE), Length: Thigh High

Apply Sequential Compression Device Apply to Bilateral Lower Extremities Apply to Left Lower Extremity (LLE) Apply to Right Lower Extremity (RLE)

Apply Pedal Pump Apply to Bilateral Feet Apply to Left Foot Apply to Right Foot


***Recommended Trauma Dose = 40 mg, subcut, q12h*** ***Recommended Dose for Morbidly Obese Patients = 40 mg, subcut, q12h***

enoxaparin (enoxaparin for weight 40 kg or GREATER) 40 mg, subcut, syringe, q24h, Prophylaxis, Pharmacy to Adjust Dose per Renal Function 30 mg, subcut, syringe, q12h, Prophylaxis, Pharmacy to Adjust Dose per Renal Function 30 mg, subcut, syringe, q24h, Prophylaxis, Pharmacy to Adjust Dose per Renal Function 40 mg, subcut, syringe, q12h, Prophylaxis, for BMI greater than 39, Pharmacy to Adjust Dose per Renal Function

heparin 5,000 units, subcut, inj, q12h 5,000 units, subcut, inj, q8h

Fondaparinux may only be used in adults 50 kg or GREATER. Prophylactic use is contraindicated in patients LESS than 50 kg.

fondaparinux 2.5 mg, subcut, syringe, q24h

rivaroxaban 10 mg, PO, tab, In PM

warfarin 5 mg, PO, tab, In PM

aspirin 81 mg, PO, tab chew, Daily 325 mg, PO, tab, Daily

Laboratory





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VTE PROPHYLAXIS PLAN

PHYSICIAN ORDERS


ORDER ORDER DETAILS

Anti Xa Level is to be drawn after three consecutive doses of enoxaparin.

Anti Xa Level





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ASP THERAPY FOR CELLULITIS/WOUND INFECTION PLAN

PHYSICIAN ORDERS


ORDER ORDER DETAILS


For UNCOMPLICATED/non-diabetic, NONPURULENT, MILD cellulitis with suspected Streptococcus (Groups A, B, C, and G)- Order empiric ORAL therapy

If MRSA is suspected, see below. If MRSA not suspected, choose either penicillin VK OR cephalexin as a single agent

penicillin V potassium 500 mg, PO, tab, QID, x 10 days

cephalexin 500 mg, PO, cap, QID, x 10 days

Alternatively, if patient has an allergy to or has received penicillin or cephalexin in the previous 90 days, choose clindamycin

clindamycin 300 mg, PO, cap, TID, x 10 days 450 mg, PO, cap, TID, x 10 days

If MRSA is suspected:

Step 1: Choose clindamycin unless contraindicated

clindamycin 300 mg, PO, cap, TID, x 10 days 450 mg, PO, cap, TID, x 10 days

Alternatively, if patient has an allergy to or has received clindamycin in the previous 90 days, select either sulfamethoxazole-trimethoprim or doxycycline. Then add EITHER cephalexin or amoxicillin.

Step 1: Add either TMP/SMZ or doxycycline.

sulfamethoxazole-trimethoprim (sulfamethoxazole-trimethoprim DS) 1 tab, PO, tab, BID, x 10 days 2 tab, PO, tab, BID, x 10 days

doxycycline 100 mg, PO, cap, BID, x 10 days

Step 2: Choose EITHER cephalexin or amoxicillin.

cephalexin 500 mg, PO, cap, TID, x 10 days

amoxiCILLIN 250 mg, PO, cap, TID, x 10 days 500 mg, PO, cap, TID, x 10 days

For UNCOMPLICATED/non-diabetic, NONPURULENT, MODERATE cellulitis with suspected Streptococcus (Groups A, B, C, and G) - Order empiric IV therapy

Choose ONE of the following as a single agent:

penicillin G potassium 2.5 million_unit, IVPB, ivpb, q6h, x 10 days

ceFAZolin 1 g, IVPush, inj, q8h, x 10 days Reconstitute with 10 mL of Sterile Water or NS Administer IV Push over 3 minutesContinued on next page....





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ASP THERAPY FOR CELLULITIS/WOUND INFECTION PLAN

PHYSICIAN ORDERS


ORDER ORDER DETAILS

cefTRIAXone 1 g, IVPush, inj, q24h, x 10 days Reconstitute with 10 mL of Sterile Water or NS Administer IV Push over 3 minutes

Alternatively, if patient has an allergy to or has received penicillin or a cephalosporin in the previous 90 days, choose clindamycin

clindamycin 600 mg, IVPB, ivpb, q8h, x 10 days, Infuse over 30 min

For MRSA only. If vancomycin selected, add order for vancomycin loading dose (If not already done), and add a second order for vancomycin maintenance dose

vancomycin 25 mg/kg, IVPB, ivpb, ONE TIME, Infuse over 120 min

vancomycin 15 mg/kg, IVPB, ivpb, q12h, Infuse over 90 min, [MONITORING ADVISED] Pharmacy to dose and monitor

For patients with malignancy, severe systemic features (high fever & hypotension), unusual predisposing factors, order empiric IV therapy PURULENT/MODERATE/INPATIENT - Always I&D and C&S

For Streptococcus and MSSA, choose ONE of the following as a single agent:

ceFAZolin 1 g, IVPush, inj, q8h, x 10 days Reconstitute with 10 mL of Sterile Water or NS Administer IV Push over 3 minutes

nafcillin 1 g, IVPB, ivpb, q4h, x 10 days, Infuse over 30 min 2 g, IVPB, ivpb, q4h, x 10 days, Infuse over 30 min 12 g, IVPB, ivpb, q24h, x 10 days, Infuse over 24 hr

For MRSA only, choose ONE of the following as a single agent. If vancomycin selected, add order for vancomycin loading dose (If not already done), and add a second order for vancomycin maintenance dose

vancomycin 25 mg/kg, IVPB, ivpb, ONE TIME, Infuse over 120 min, [MONITORING ADVISED] Pharmacy to dose and monitor


For MRSA only, if documented allergy to vancomycin or Vanc MIC greater than or equal to 2 (must be verified by micro lab), ONE of the following may be ordered

DAPTOmycin 4 mg/kg, IVPB, ivpb, q24h, x 10 days, Infuse over 30 min

linezolid 600 mg, IVPB, ivpb, q12h, x 10 days, Infuse over 120 min

ceftaroline 600 mg, IVPB, ivpb, q12h, x 10 days, Infuse over 60 min





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ASP THERAPY FOR COMMUNITY ACQUIRED PNEUMONIA PLAN

PHYSICIAN ORDERS


ORDER ORDER DETAILS


Step 1: Select Primary Therapy

For Non-ICU status:

Choose cefTRIAXone AND azithromycin

cefTRIAXone 1 g, IVPush, inj, q12h Reconstitute with 10 mL of Sterile Water or NS Administer IV Push over 3 minutes

azithromycin 500 mg, IVPB, ivpb, q24h, Infuse over 60 min

Alternatively, if patient is allergic to or has received cefTRIAXone/azithromycin in the previous 90 days, choose levoFLOXacin as single agent.

levoFLOXacin 750 mg, IVPB, ivpb, q24h, Infuse over 90 min

For ICU status withOUT Pseudomonal risk:

Choose cefTRIAXone. Then choose either azithromycin OR levoFLOXacin.

cefTRIAXone 1 g, IVPush, inj, q12h Reconstitute with 10 mL of Sterile Water or NS Administer IV Push over 3 minutes

And ADD EITHER azithromycin OR levoFLOXacin



Alternatively, if patient is allergic to or has received cefTRIAXone/azithromycin in the previous 90 days, choose levoFLOXacin AND aztreonam.


aztreonam 2 g, IVPush, inj, q8h Reconstitute with 10 mL of Sterile Water or NS Administer IV Push over 3-5 minutesContinued on next page....





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ASP THERAPY FOR COMMUNITY ACQUIRED PNEUMONIA PLAN

PHYSICIAN ORDERS


ORDER ORDER DETAILS

For ICU status WITH Pseudomonal risk:

Choose levoFLOXacin and aztreonam


aztreonam 2 g, IVPush, inj, q8h Reconstitute with 10 mL of Sterile Water or NS Administer IV Push over 3-5 minutes

Step 2: If MRSA coverage is needed, add order for vancomycin loading dose (if not already done) and add a second order for vancomycin maintenance dose

vancomycin 25 mg/kg, IVPB, ivpb, ONE TIME, Infuse over 120 min, [Loading Dose]






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ASP THERAPY FOR FEBRILE NEUTROPENIA PLAN

PHYSICIAN ORDERS


ORDER ORDER DETAILS


Step 1: Choose one of the following. If coverage needed for extended- spectrum beta-lactamase (ESBL), choose piperacill in-tazobactam or meropenem.

cefepime 2 g, IVPush, inj, q8h, x 7 days Discontinue at 7 days or continue until neutropenia resolves. Reconstitute with 20 mL or sterile water or NS. Administer IV Push over 3 minutes.

piperacillin-tazobactam 3.375 g, IVPB, ivpb, q6h, x 7 days, Infuse over 30 min Discontinue at 7 days or continue until neutropenia resolves

meropenem 1 g, IVPB, ivpb, q8h, x 7 days, Infuse over 30 min Discontinue at 7 days or continue until neutropenia resolves

Step 2: Add either amikacin or gentamicin.

amikacin 15 mg/kg, IVPB, ivpb, q24h, x 7 days, Infuse over 60 min, [MONITORING ADVISED] Pharmacy to dose and monitor Discontinue at 7 days or continue until neutropenia resolves

gentamicin 7 mg/kg, IVPB, ivpb, q24h, x 7 days, Infuse over 60 min, [MONITORING ADVISED] Pharmacy to dose and monitor

Step 3: Add coverage for MRSA or VRE. For MRSA select vancomycin. For VRE or documented allergy to vancomycin, select daptomycin.

If vancomycin chosen, add order for loading dose (if not already done) and a second order for maintenance dose.

vancomycin 25 mg/kg, IVPB, ivpb, ONE TIME, x 14 days, Infuse over 120 min, [MONITORING ADVISED] Pharmacy to dose and monitor

vancomycin 15 mg/kg, IVPB, ivpb, q12h, x 14 days, Infuse over 90 min, [MONITORING ADVISED] Pharmacy to dose and monitor


Step 4: Add acyclovir for prophylactic antiviral therapy.

acyclovir 400 mg, PO, tab, BID, x 14 days 800 mg, PO, tab, BID, x 14 days

Step 5: Add order for prophylactic antifungal therapy ONLY if after 5 day of broad spectrum antibacterial coverage, patient continues to run fever. Select either fluconazole or voriconazole or micafungin.

fluconazole 400 mg, PO, tab, Daily, x 14 days

voriconazole 200 mg, PO, tab, BID, x 14 days





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ASP THERAPY FOR FEBRILE NEUTROPENIA PLAN

PHYSICIAN ORDERS


ORDER ORDER DETAILS

micafungin 100 mg, IVPB, ivpb, x 14 days





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ASP THERAPY FOR MENINGITIS PLAN

PHYSICIAN ORDERS


ORDER ORDER DETAILS


Step 1: Select the following as empiric therapy for S. pneumo, meningococci, H. flu.


Alternatively, if patient has an allergy to beta-lactams, choose aztreonam

aztreonam 2 g, IVPush, inj, q8h, x 14 days Reconstitute with 10 mL of Sterile Water or NS Administer IV Push over 3-5 minutes

Step 2: For age greater than or equal to 50 years OR alcoholism, debilitating disease, impaired cellular immunity, add coverage for Listeria:

ampicillin 2 g, IVPB, ivpb, q4h, x 14 days, Infuse over 30 min, CNS infection

Step 3: Add vancomycin. Select order for vancomycin loading dose (If not already done), and add a second order for vancomycin maintenance dose.



Step 4: If aseptic meningitis due to HSV is suspected (eg, concomitant genital lesions), add acyclovir. Discontinue Acyclovir if/when CSF analysis and HSV results are not consistent with viral meningitis.

acyclovir 10 mg/kg, IVPB, inj, q8h, Infuse over 60 min

Step 5: Add dexamethasone. Give before or at time of 1st dose of antibiotics. Discontinue if S. pneumoniae is ruled out for adults.

dexamethasone 10 mg, IVPush, inj, q6h, x 4 days Give before or at time of 1st dose of antibiotics. Discontinue if S. pneumo is ruled out for adults.Continued on next page....





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ASP THERAPY FOR MENINGITIS PLAN

PHYSICIAN ORDERS


ORDER ORDER DETAILS





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ASP THERAPY FOR NOSOCOMIAL PNEUMONIA PLAN

PHYSICIAN ORDERS


ORDER ORDER DETAILS


Step 1: Choose either piperacillin-tazobactam OR cefepime

If ordering piperacillin-tazobactam, place order for BOTH items

piperacillin-tazobactam 4.5 g, IVPB, ivpb, ONE TIME, Infuse over 30 min Pharmacy - Ensure maintenance Extended Infusion dose is also ordered

piperacillin-tazobactam 4.5 g, IVPB, ivpb, q6h, Infuse over 4 hr

cefepime 2 g, IVPush, inj, q12h Reconstitute with 10-20 mL of Sterile Water or NS Administer IV Push over 3 minutes

Alternatively, if patient has an allergy to or has received any of these in the previous 90 days, choose aztreonam

aztreonam 1 g, IVPush, inj, q8h Reconstitute with 10 mL of Sterile Water or NS Administer IV Push over 3 minutes

Step 2: Add either an antipseudomonal fluoroquinolone (levoFLOXacin) OR an antipseudomonal aminoglycoside (gentamicin OR tobramycin)


gentamicin 7 mg/kg, IVPB, ivpb, q24h, Infuse over 60 min, [MONITORING ADVISED] Pharmacy to dose and monitor

tobramycin 7 mg/kg, IVPB, ivpb, q24h, Infuse over 90 min, [MONITORING ADVISED] Pharmacy to dose and monitor

Step 3: If coverage is needed for atypical pathogen(s), add azithromycin


Step 4: If MRSA coverage is needed, choose either vancomycin OR linezolid

Add order for vancomycin loading dose (if not already done) AND add a second order for vancomycin maintenance dose

vancomycin 25 mg/kg, IVPB, ivpb, ONE TIME, Infuse over 120 min, [Loading Dose]






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ASP THERAPY FOR NOSOCOMIAL PNEUMONIA PLAN

PHYSICIAN ORDERS


ORDER ORDER DETAILS

linezolid 600 mg, PO, tab, BID 600 mg, IVPB, ivpb, q12h, Infuse over 120 min

Step 5: If anaerobic coverage is needed, and patient is not already on piperacillin-tazobactam, order clindamycin

clindamycin 900 mg, IVPB, ivpb, q8h, Infuse over 30 min





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ASP THERAPY FOR OSTEOMYELITIS PLAN

PHYSICIAN ORDERS


ORDER ORDER DETAILS


Order empiric IV therapy for PROSTHETIC JOINT INFECTIONS or VERTEBRAL OSTEOMYELITIS

For Staphylococcus

If oxacillin susceptible and no allergy to penicillin or cephalosporin, select one of the following. Agents listed in order of ASP preference

nafcillin 2 g, IVPB, ivpb, q6h, x 42 days, Infuse over 30 min

ceFAZolin 1 g, IVPush, inj, q8h, x 42 days Reconstitute with 10 mL of Sterile Water or NS Administer IV Push over 3 minutes 2 g, IVPush, inj, q8h, x 42 days Reconstitute each vial with 10 mL of Sterile Water or NS Administer IV Push over 3-5 minutes

cefTRIAXone 1 g, IVPush, inj, q24h, x 42 days Reconstitute with 10 mL of Sterile Water or NS Administer IV Push over 3 minutes 2 g, IVPush, inj, q24h, x 42 days Reconstitute with 20 mL of Sterile Water or NS Administer IV Push over 3 minutes

If oxacillin resistant or allergy to penicillin or cephalosporin, select one of the following. Agents listed in order of ASP preference. If vancomycin chosen, add order for loading dose (if not already done) and a second order for maintenance dose




Based on provider preference, if covering for MRSA, may add rifampin.

rifAMPin 300 mg, PO, cap, BID, x 42 days

For Enterococcus

If penicillin susceptible and no allergy, select one of the following. Agents listed in order of ASP preference

penicillin G potassium 20 million_unit, IVPB, ivpb, q24h, x 42 days, Infuse over 24 hr Must be infused over 24 hours.





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PHYSICIAN ORDERS


ORDER ORDER DETAILS

ampicillin 2 g, IVPB, ivpb, q4h, x 42 days, Infuse over 60 min, Bone/Joint

If penicillin resistant or allergy, select vancomycin. If vancomycin chosen, add order for loading dose (if not already done) and a second order for maintenance dose.



If vancomycin resistant, select daptomycin

DAPTOmycin 6 mg/kg, IVPB, ivpb, q24h, x 42 days

For Pseudomonas aeruginosa

Choose one of the following as a single agent. Agents listed in order of ASP preference

cefTAZidime (Fortaz) 2 g, IVPush, inj, q8h, x 42 days Reconstitute with 10 mL of Sterile Water or NS Administer IV Push over 3 minutes

ciprofloxacin 400 mg, IVPB, ivpb, q12h, x 42 days, Infuse over 60 min

cefepime 2 g, IVPush, inj, q12h, x 42 days Reconstitute with 20 mL of Sterile Water or NS Administer IV Push over 3 minutes

meropenem 1 g, IVPB, ivpb, q8h, x 42 days, Infuse over 30 min

For Enterobacter



cefepime 2 g, IVPush, inj, q12h, x 42 days Reconstitute with 10-20 mL of Sterile Water or NS Administer IV Push over 3 minutesContinued on next page....





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PHYSICIAN ORDERS


ORDER ORDER DETAILS

For Salmonella species








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ASP THERAPY FOR URINARY TRACT INFECTION PLAN

PHYSICIAN ORDERS


ORDER ORDER DETAILS


Acute Uncomplicated Cystitis Women

For UNCOMPLICATED UTI in women that warrants treatment (dysuria, frequency, and urgency plus urinalysis confirmation), select oral therapy as either cefdinir or nitrofurantoin. If early pyelonephritis suspected, treat as pyelonephritis and reference that section below.

cefdinir 300 mg, PO, cap, BID, x 5 days

nitrofurantoin (nitrofurantoin monohydrate 100 mg oral capsule) 100 mg, PO, cap, BID, x 5 days

Acute Complicated Cystitis Men or Women (diabetic, pregnant, chronic foley catheter, obstruction, anatomic abnormalities , immunosuppression)

Select ONE of the following:

cefTRIAXone 1 g, IVPush, inj, q24h, x 7 days Reconstitute with 10 mL of sterile water or NS. Administer IV Push over 3 minutes.

ampicillin-sulbactam 3 g, IVPB, ivpb, q6h, x 7 days, Infuse over 30 min, Genitourinary infection

Alternatively, if patient has an allergy to penicillin or cephalosporin choose either gentamicin or aztreonam

gentamicin 5 mg/kg, IVPB, ivpb, q24h, x 7 days, Infuse over 60 min, [MONITORING ADVISED] Pharmacy to dose and monitor

aztreonam 2 g, IVPush, inj, q8h, x 7 days

Pyelonephritis

Select ONE of the following:

cefepime 1 g, IVPush, inj, q12h, x 14 days Reconstitute with 10 mL of Sterile Water or NS Administer IV Push over 3 minutes

piperacillin-tazobactam 3.375 g, IVPB, ivpb, q6h, x 14 days, Infuse over 30 min

Alternatively, if patient has an allergy to penicillin or cephalosporin, select aztreonam

aztreonam 2 g, IVPush, inj, q8h, x 14 days Reconstitute with 10 mL of Sterile Water or NS Administer IV Push over 3-5 minutesContinued on next page....





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ASP THERAPY FOR URINARY TRACT INFECTION PLAN

PHYSICIAN ORDERS


ORDER ORDER DETAILS





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BB TYPE AND SCREEN PLAN

PHYSICIAN ORDERS


ORDER ORDER DETAILS

Laboratory

BB Blood Type (ABO/Rh)

BB Antibody Screen





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umc health system patient label here general medicine...

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