bariatric surgery rounding orders

Create date: Nov-07 SIGN DATE AND TIME ALL ENTRIES
Review date: Sept-11
Revise date: Jan-12
ORDERS AND SIGNATURE
PROGRESS NOTES AND SIGNATURE
& TIME
Bariatric Surgery Rounding Orders
Bariatric Surgery POD #:_____Date: ___/___/___ 1.  CBC w/ differential, BMP  Mg  PO BP __________ HR __________ RR______SO2 _____ 2.  CXR:  PA View  Bedside in am Weight: __________ Urine Output:_____________ JP Output: ___________ G-tube Output:__________ JP Color:  Serosanguenous  Other:__________  Bariatric Clear Liquids 30 ml q___ minutes  Bariatric Full Liquids 30 ml q___ minutes  Please keep several 30 ml cups of water or ice  Tolerating regular diet  Tolerating Soft Diet Pain Control :  Good  Fair  Poor Nausea: None  Minimum  Moderate  Severe BM:  Positive  Negative 6.  Increase IV fluids to _______________  Decrease IV fluids to _______________ Consult Case Management for home healthcare  Rhonchi  Crackles Other: ________ CXR:  Atelectasis Other: __________________ UGI:  Good flow of contrast with no leak or  Hydrocodone/Acetaminophen (Lortab) Elixir  Other: ________________________________ Labs:  Dilaudid 1 mg IV q4hr prn breakthrough pain  Oxycodone 5mg po q4hr prn mild-moderate Acetaminophen/ 24hrs, not to exceed 1 day of therapy) DC all other Acetaminophen orders  Atelectasis: Encourage incentive spirometry; flutter hours(not to exceed 4000 mg Acetaminophen/ 24hrs, not to exceed 1 day of therapy) DC all other breakthrough nausea  6.25 mg  12.5 mg  Potassium chloride liquid po  40 mEq Patient seen by:  Dr Amjad Ali  Dr Rodolfo Arreola  Other: ______ One time dose  Daily  Jackie Smith PAC  Janet Kelley CRNP Date Time Physician Signature
Date Time Physician Signature
Physician Order Sheet
& Progress Note
Create date: Nov-07 SIGN DATE AND TIME ALL ENTRIES
Review date: Sept-11
Revise date: Jan-12
ORDERS AND SIGNATURE
PROGRESS NOTES AND SIGNATURE
& TIME
 Potassium chloride 10 mEq in 0.9% NaCl 100 ml with lidocaine 10 mg over 1 hr x _____  Potassium Phosphate 20mmol in 250ml 0.9%  Metoclopromide (Reglan) 10 mg IV TID  Sucralfate (Carafate) liquid 1gm (10 ml) bid  Magnesium Sulfate 2 gram IVPB over 1 hr x 1  Ondansetron (Zofran) 4 mg  IV TID  PO  Please place patient name labels on the  Dietician consult before discharge home  RN please show bariatric video  Please help patient watch online educational video on my-emmi.com on POD #2. (Instructions are on a separate sheet) Date Time Physician Signature
Physician Order Sheet
& Progress Note

Source: http://www.mylapsurgeon.com/catalog/rounding%20orders.pdf