ENT General Admission - 20603-QM0509-Ver4 031610

attach patient label here Array Physician Orders ADULTCare Set: ENT General Admission Orders[R] = will be orderedT= Today; N = Now (date and time ordered)*111* ENT General Admission - 20603-QM0509-Ver4 031610 Page 1 of 2attach patient label here Physician Orders ADULT Care Set: ENT General Admission Orders [R] = will be ordered T= Today; N = Now (date and time ordered)[ ]D51/2 NS KCl 20 mEq/L 1,000 mL,IV,Routine,T;N,75 mL/hrNOTE: If bleeding risk exists, and no contraindication to SCD, place order below:[ ]Sequential Compression Device Apply (SCD Apply)T;N, Apply To Lower Extremities[ ]enoxaparin 40 mg, Injection, Subcutaneous, q24h, Routine, Start on morning of post-op day 1. IfCrCl less than 30mL/min, pharmacy to adjust dose to 30mg SQ q24h. Pharmacist mayadjust administration times after first dose. Start on morning of Post-Op Day 1OR [ ]heparin 5,000 units, Injection, Subcutaneous, q8h, Routine, Start on morning of post-op day 1.Pharmacist may adjust administration times after first dose. Start on morning of Post-Op Day 1AND BOTH CBCs [ ]CBC w/o Diff Routine, T;N, once, Type: Blood[ ]CBC w/o Diff Time Study, T+2;0400, Every Other Day, Type: Blood[ ]acetaminophen-HYDROcodone 325 mg-5 mg 1 tab,Tab,PO,q4h,PRN Pain, Moderate (4-7),Routine,T;N[ ]morPHINE 2 mg, Injection, IV Push, q2h, PRN Pain, Severe (8-10), Routine[ ]famotidine 20 mg,Injection,IV Push,q12h,Routine,T;NNOTE: Consider ambulation as early as possible.[ ]Contraindication-VTE Prophylaxis T;N, Reason: patient has bleeding risk for anticoagulants, and SCDs arecontraindicated.[ ]Ambulate T;NNOTE:documented bleeding disorder NOTE:known or suspected deep vein thrombosis or PE NOTE: If not already ordered on pre-admission:[ ]Basic Metabolic Panel (BMP)T;N,Routine,once,Type: Blood [ ]CBC T;N,Routine,once,Type: Blood [ ]Chest 2VW Frontal & Lat T;N, Routine, Reason:___________________________________, Wheelchair [ ]Chest 1VW Frontal T;N, Routine, Reason:___________________________________, Portable__________________ __________________ _________________________________________________ __________________Date Time Physician's Signature MD Number Page 2 of 2Consults/NotificationsLaboratory MedicationsContinuous Infusions Diagnostic Tests VTE Prophylaxis (SURGICAL - General) Orders (order below)NOTE: If no bleeding risk exists, place either Enoxaparin and both CBC wo Diff orders below OR place the heparin and both CBC wo Diff orders below:ENT General Admission - 20603-QM0509-Ver4 031610SCD CONTRAINDICATIONSDo Not Administer VTE Prophylaxis BLEEDING RISK FACTORSPhysician Orders - ADULTOrder Set: VTE Prophylaxis (SURGICAL) Orders[R] = will be orderedT= Today; N = Now (date and time ordered)*111*22226-CC VTE PROPHYLAXISSURGICAL-QM-1008 ver8 032210 Page1 of 3Order Set: VTE Prophylaxis (SURGICAL) Orders[R] = will be ordered T= Today; N = Now (date and time ordered)[ ]enoxaparinT;N + 720, 40 mg, Injection, Subcutaneous, QDay, Routine, Start on morning of post-op day 1. If CrCl less than 30mL/min, pharmacy to adjust dose to 30mg SQ QDay.Pharmacist may adjust administration times after first dose. Start on morning of Post-Op Day 1OR[ ]heparin 5,000 units, Injection, Subcutaneous, q8h, Routine, Start on morning of post-op day 1.Pharmacist may adjust administration times after first dose. Start on morning of Post-Op Day 1AND BOTH CBCs [ ]CBC w/o Diff Routine, T;N, once, Type: Blood, Comment: baseline for VTE Prophylaxis[ ]CBC w/o Diff Time Study, T+2;0400, Ever Other Day, Type: BloodNOTE: If patient is immediate postop and no SCD contraindications exist, order SCDfor both extremities.NOTE: If SCD is contraindicated, order graduated compression stockings (GCS) onboth extremities and SCD only for otherwise intact extremity.[ ]Sequential Compression Device Apply (SCD Apply) T;N NOTE: only if SCD is contraindicated, place GCS order below:[ ]TED Hose Apply (GCS Apply)T;N, Routine, apply to bilateral lower extremities [ ]Nursing Communication T;N, After chest tubes are discontinued and if no additional bleeding risk is present,place order for "Heparin 5000 units, inj, subcutaneous, q12h, routine, T;N"[ ]CBC w/o DiffRoutine, T;N, once, Type: Blood [ ]CBC w/o DiffTime Study, T+2;0400, Every Other Day, Type: Blood NOTE:Consider ambulation as early as possible.[ ]Contraindication-VTE ProphylaxisT;N, Reason: patient has bleeding risk for anticoagulants, and SCDs are contraindicated.[ ]Ambulate T;NNOTE:documented bleeding disorder [ ]active bleeding [ ]heparin induced thrombocytopenia(HIT)[ ]coagulopathy disorder [ ]recent spinal surgery [ ]heparin allergy or pork allergy [ ]hemorrhagic stroke within 6 weeks [ ]recent intraocular or intracranial surgery [ ]severe uncoDo Not Administer VTE Prophylaxis BLEEDING RISK FACTORS22226-CC VTE PROPHYLAXISSURGICAL-QM-1008 ver8 032210 Page2 of 3General/Thoracic/GYN/OB/URO/Elective Spinal Surgical Procedures continuedNOTE: If no bleeding risk exists, place either Enoxaparin and both CBC wo Diff orders below OR place the heparin and both CBC wo Diff orders below:CABG and Valve Surgical ProceduresOrder Set: VTE Prophylaxis (SURGICAL) Orders[R] = will be ordered T= Today; N = Now (date and time ordered)NOTE:known or suspected deep vein thrombosis or PE[ ]acute stages of inflammatory phlebitis process[ ]disruptions in lower extremity skin integrity (surgical incision, recent skin graft, dermititis, etc.)[ ]arterial occlusion[ ]instances where increased venou __________________ __________________ _________________________________________________ __________________Date Time Physician's Signature MD Number SCD CONTRAINDICATIONS22226-CC VTE PROPHYLAXISSURGICAL-QM-1008 ver8 032210 Page3 of 3。