Pediatric Observation Asthma Orders

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Pediatric Observation Asthma Orders Powered By Docstoc
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PEDIATRIC OBSERVATION                                                                            PLACE LABEL HERE
ASTHMA
ORDERS
     The following orders will be implemented. Orders with a “” are choices and are NOT implemented unless checked.
DIAGNOSIS: ____________________________________________________________________________
1.     Admit: Physician initials _____ place in Observation for __________________________(reason for OBV)
2.     Primary Care Physician:  None  _____________________________
3.     Allergies: ____________________________________________________________________________________
4.     Weight: ________kg
5.     Vital signs:  q 4 hrs       q ____ hrs
6.     Diet:          Age appropriate as tolerated         Clear liquids
7.     Activity: As tolerated
8.      INT
9.     Humidified oxygen per Respiratory Care Protocol to maintain saturations > 92%
10.    If patient on oxygen:  Pulse oximeter checks q ___ hrs OR  Continuous pulse oximeter
11.    Peak flow rates before and after respiratory treatments when awake in children greater than 5 years old
12.    Laboratory:  Chem7          Other ___________________________________________________
13.    Radiology:  CXR PA and lateral indication: difficulty breathing
SCHEDULED MEDICATIONS:
14.  IV fluids ______________________ at ______ml/hrs IV
15. Aerosol medications:  Respiratory Care to evaluate and treat
                             Albuterol 2.5 mg per inhalation q ______ hrs and prn for respiratory distress/wheezing
                             Albuterol 5 mg per inhalation q ______ hrs and prn for respiratory distress/wheezing
                             Atrovent (ipratropium) 500 mcg per inhalation q ____ hrs. May give in addition to albuterol
                             Other: _________________________________________________________________
16. Steroid (choose one if needed):
        Solu-Medrol (methylprednisolone) ____ mg IV loading dose x 1 dose if not given, then _____mg IV q 6 hrs
        Prednisolone liquid _____ mg po q _____ hrs         or          Prednisone tablets _____ mg po q _____ hrs
17. Antibiotics:  Rocephin (ceftriaxone) _____ mg IV q 24 hrs (may give IM if no IV access)
                  Other: ___________________________________________________________________________
PRN MEDICATIONS:
18. Diaper rash cream with diaper changes
19. Mild Pain/temp >100.5F:
           Tylenol (acetaminophen) ____ mg (consider 15 mg/kg, max 650 mg) po or per rectum q 4 hrs prn
       or  Ibuprofen ____ mg (consider 10 mg/kg) po q 6 hrs prn
20. Nausea/vomiting:  Zofran (ondansetron) _____ mg po q 6 hrs prn
                         Zofran (ondansetron) _____ mg IV q 6 hrs prn
21. Notify physician of clinical deterioration of respiratory status (increased work of breathing or retractions), new fever,
    unstable vital signs, or inability to maintain pulse ox greater than 92% on supplemental oxygen
DISCHARGE PLANNING:  Arrange home nebulizer (notify case manager)
                                   Teach and dispense spacer device
                                   Teach and dispense peak flow meter
ADDITIONAL ORDERS:
_______________________________________________________________________________________
_______________________________________________________________________________________


______________           ___________________               _________________________________                  __________
Date                     Time                              Physician Signature                                MD Number


*1-27515*                            FORM 1-27515 INITIATED 04/2010                   Send copy to pharmacy _______
(initials)
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