Heart failure - diastolic

Physician Orders
Adult Pneumonia, Community Acquired
Admission Height:_________ Admission Weight:_________

Amission Status
Admit to inpatient to Dr. _______________________service. IV Fluids
Assign to observation status to Dr. ________________ service Dextrose 5% with 0.9% NaCl @ __________mL/hr Admit Location
Dextrose 5% with 0.45% NaCl @ _________mL/hr □ Medical floor □ Telemetry monitor □ ICU Sodium Chloride 0.9% @ ____________mL/hr Allergies
Additives _________________________________ Saline lock flush per protocol ______________________________________________ Medications
Code Status
Antibiotics
Beta-Lactam (3rd-Generation Cephalosporin,
Partial Code (□ Intubation □ Defibril ation □ ACLS Meds Penicillin) + Macrolide
Cephalosporins, 3rd-Generation
 Do Not Resuscitate (allow natural death) cefTRIAXone / ROCEPHIN 1 gram intravenously every Nursing Orders
Vital Signs
Macrolides
azithromycin / ZITHROMAX 500 milligrams intravenously every 24 hours times 2 days, then 500 milligrams orally Activity/Positioning
azithromycin / ZITHROMAX 500 milligrams intravenously Ambulate with Assistance TID with O2 walker Bed rest □ BRP □ BSC azithromycin / ZITHROMAX 500 milligrams orally daily clarithromycin / BIAXIN 500 milligrams orally two times daily Assessments
Quinolones
levofloxacin / LEVAQUIN 750 milligrams orally every 24 hours Glucose: finger stick q___________________________ levofloxacin / LEVAQUIN 750 milligrams intravenously Assess smoking status & provide smoking education Contingency
Notify physician for Temp >101 F, HR < 60 or > 120, Antipyretics
RR < 8 or >30, SBP < 90 or >180, acetaminophen / TYLENOL 650 milligrams orally Urine Output < 120 ml for 4 hrs, Pulse Ox <90% □ every 4 hours □ every 6 hours as needed for fever >100.4 Interventions: GI/ GU
acetaminophen / TYLENOL 650 milligrams rectally □ every 4 hours □ every 6 hours as needed for fever >100.4 Analgesics
Respiratory
Mild Pain (1- 3)
Oxygen and Oximetry
ace minophen / TYLENOL 650 milligrams orally Oxygen via _______________________ at _____________ □ every 4 hours □ every 6 hours as needed for pain maintain O2 sat at______% via pulse Oximetry or per O2 protocol ace minophen / TYLENOL 650 milligrams rectally □ every 4 hours □ every 6 hours as needed for pain ibuprofen / MOTRIN 400 milligrams orally Blood Gases
 Arterial Blood Gas _______________________ Moderate Pain (4- 6)
□ 5/500 □ 7.5/500 □ 10/500 tablet orally □ every 4 hours □ every 6 hours as needed for pain Cardiac _____________________________ □ 5/325 □ 7.5/325 □ 10/325 tablet orally Diabetic__________________________________ □ every 4 hours □ every 6 hours as needed for pain  Regular _________________________________  Other __________________________________ □ every 4 hours □ every 6 hours as needed for pain Physician Orders
Adult Pneumonia, Community Acquired
Admission Height:_________ Admission Weight:_________
VTE: Prophylaxis – General Measures
Severe Pain (7 - 10)
 Ambulate – TID with assistance with O2 walker start today Graded compression stockings -TED Hose □ every 4 hours □ every 6 hours as needed for pain □ knee high □ thigh high (call measurements to pharmacy) HYDROmorphone / DILAUDID 1 milligram subcutaneously □ every 4 hours □ every 6 hours as needed for pain morphine _____ milligram intravenously VTE: Unfractionated Heparin
heparin 5,000 units subcutaneously every 8 hours Antidotes and Rescue Agents
heparin 5,000 units subcutaneously every 12 hours naloxone / NARCAN _____ (0.2-2) mil igram VTE: Low -Molecular-Weight Heparin
intravenously every ______min. (2-3) as needed for for opiate reversal. May repeat times one. Give if decreased enoxaparin / LOVENOX 40 milligrams subcutaneously daily mentation and/or RR < 10 and notify physician STAT enoxaparin / LOVENOX 30 milligrams subcutaneously daily Sedatives
(dose for patients with CrCl < 30 mL/min) LORazepam / ATIVAN 1 milligram intravenously Laboratory
CBC now and every other day while on Heparin or Lovenox LORazepam / ATIVAN 1 milligram orally 2 times a day CBC with auto diff Now and _________________ zolpidem / AMBIEN 5 milligrams orally daily, at bedtime Culture, blood now two separate sites zolpidem /AMBIEN 10 milligrams orally daily, at bedtime Bronchodilators
albuterol / PROVENTIL MDI ______puffs (use spacer) every ______hours as needed for wheezing Cardiology
albuterol 2.5 mg/0.5 mL neb solution /PROVENTIL via Radiology/Imaging
nebulizer every _______hours as needed for wheezing Levalbuterol / XOPENEX 0.63 mg neb solution via Physician Consults
nebulizer every _____ hours as needed for wheezing Reason _________________________________ Smoking Cessation Medications
nicotine 7 mg/24 hr transdermal film, extended Reason__________ ____________________________ Other Consults
nicotine 14 mg/24 hr transdermal film, extended nicotine 21 mg/24 hr transdermal film, extended Laxatives
magnesium hydroxide / MILK OF MAGNESIA 30 milliliters orally daily as needed for constipation
Other Orders:
docusate sodium / COLACE 100 milligrams orally 2 times daily bisacodyl / DULCOLAX 5 milligrams orally daily bisacodyl / DULCOLAX 10 milligrams suppository rectally daily as needed for constipation □TO/VO Read Back & Verified________________________________________ Date/Time: _________________________ Physician _____________________________________________ Date/Time: _____________________ Version 11/11/2010

Source: http://kentucky.prod2.bonsecours.com/includes/modules/portal/Adult_Pneumonia_Community_Acquired_11-11-10_OLBH.pdf

curriculum vitae

CURRICULUM VITAE Texas A&M Health Science Center (TAMU 1266) E-ma EDUCATION: University of Houston, Houston, Texas Professor, Department of Health Policy and Management, College of Rural Public Health, Texas A&M Health Science Center, College Station, Texas. Scientific Advisor, U.S. Health Economics, Oxford Outcomes, Ltd., Morristown, New Jersey. Professor, Department of Health Man

Tsdnc proceedings 2010 - adjusted.pmd

Nutritional and Animal Welfare Implications to Lameness Jan K. Shearer1 Department of Veterinary Diagnostic and Production Animal Medicine Abstract metalloproteinase enzymes and peripartumhormones, such as estrogen and relaxin. Theimplications of this are that in addition to feedingfermentive disorders occurring secondary to theand nutrition, dairy farmers must pay particularconsu