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.
: 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).
Despite multiple haloperidol injections (5 mg IM q4h
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.