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Recommendations moving forward include a change in physicians' standard orders to make the default vital sign order While Awake rather than Q4H. Making this change may reduce the number of patients who are awakened unnecessarily for vital signs.
Pending the results of serologic testing, the bird was prescribed 0.12% prednisolone acetate ophthalmic drops (1 drop OU q4h for 7 days).
After 3 days, his orders were changed to include Fragmin (dalteparin) of 12,500 units subcutaneous daily, Percocet (oxycodone/acetaminophen) of 5- to 325-mg tablet q4h pm; Unasyn (ampicillin-sulbactam) IVPB of 3 g q6h, and Lovenox (enoxaparin) injection of 70 mg subcutaneous daily.
Autologous serum q3h, ofloxacin 3% q6h, preservative-free dexamethasone q4h were started and tapered gradually for 20 days.
Q4h: I selected a 7 25, 3.04, 0.841 specific learning path, because ...
Nimodipine was commenced (60 mg po q4h) as prophylaxis against secondary vasospasm and antihypertensive agents were added to maintain normal blood pressure (systolic blood pressure <120 mmHg).
Intravenous cefotaxime (2 g q4h) was commenced at admission.
The bird was hospitalized and treated with meloxicam (0.5 mg/kg PO q24h) and assisted feeding (30 mL PO q4h; mixture of 4 parts of water, 3 parts of Emeraid Omnivore Care, and 2 parts of Emeraid Herbivore Care [Emeraid Critical Care Nutrition, Lafeber Company, Cornell, IL, USA]).
No other analgesics or NSAIDs were allowed for 48 h Postoperatively, visual analogue scale(VAS) score was determined q1h for 4 h then q4h for 48 h.
Orders are received for serial assessment of acetaminophen levels, routine ICU observation and nursing care, oxygen at 3 L per nasal cannula, an IV infusion of D5-1/2NS at 60 mL/hr, Mucomyst 385 mg q4h x 17 doses, and a formal gastroenterology consultation.
* 1 dose IV antibs Pre-operative Planning OR & blood consents Patient Education Pre-op teaching: * surg procedure * npo, IV, pre-op holding area, vs, neuro checks, pacu, sicu (prn), ward Discharge Planning Transportation home Care Elements Same Day Admission, Day of Surgery Setting * Pre-op holding area * PACU * SICU or surgical ward Comfort Pain meals Diagnostic Tests Post-op monitoring in PACU/SICU prn) Assessments * VS q4h after pacu * neuro cks * wound cks for hematoma Activities * OOB to chair * Walk in room/hall Diet Clear liquids in eve Medications ECASA Pre-operative Planning Patient Education Review/repeat pre-op teaching, Discharge Planning Confirm discharge transportation Care Elements Post-Op Day One Discharge Home Setting Surgical ward Comfort P.O.