PLACE LABEL HERE
TURP
(Transurethral Resection of the Prostate)
POST-OP ORDERS
The following orders will be implemented. Orders with a “” are choices and are NOT implemented unless checked.
Initial all handwritten order modifications and the bottom of each page when indicated (multipage).
1. Do you expect that the patient’s condition will require a hospital stay that will cross two midnights (includes the time spent in outpatient- ED, surgery, OBS) and the patient has medical necessity for an inpatient admission?
Yes, admit as inpatient, proceed to # 2 No, place in observation No, outpatient, DC home
2. If admitted as inpatient, Inpatient Physician Certification:
Diagnosis: ________________________________________________________________________
Level of Care: Critical Intermediate Acute Care Location/Specialty Unit Preference_______
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Telemetry: If patient Medical/Surgical, must complete form # 36084
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Isolation: Contact Droplet Airborne For: _________________
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Vital signs per unit routine
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Diagnostics: H&H at 2100 tonight H&H in am Chem 7 in am
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Foley to bedside bag
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Continuous bladder irrigation with NS, titrate to keep pink to clear. Do not interrupt irrigation while transporting patient.
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Irrigate Foley with normal saline to prevent clot retention prn
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Incentive spirometry q 2 hrs while awake
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Diet: Regular Cardiac Diabetic______ calories Renal
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Oral Nutrition Supplement Standing Order (form # 31417), initiate if patient meets criteria
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Bedrest x 4 hrs then OOB to chair Other: _______________________________________________
SCHEDULED MEDIATIONS:
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IVF: NS LR D5NS D5 ½ NS with 20 KCl at __________ ml/hr
Discontinue IVF when tolerating PO fluids
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Antibiotic: Post-op antibiotic will be automatically stopped within 24 hrs unless indication is documented
Cipro (ciprofloxacin) 500 mg po bid x 2 doses
or continue > 24 hrs for _______________________ (Reason REQUIRED)
or Bactrim (sulfamethoxazole 800 mg/Trimethoprim 160mg) DS, 2 tabs po bid x 2 doses
or continue > 24 hrs for _______________________ (Reason REQUIRED)
The following orders will be implemented. Orders with a “” are choices and are NOT implemented unless checked.
Initial all handwritten order modifications and the bottom of each page when indicated (multipage).
PRN MEDICATIONS: See policy 520-06 for range orders and pain intensity guidelines.
Prior to administering pain medications, assess for difficulties with continuous bladder irrigation.
16. Spasms: B&O (Belladonna & Opium) suppository 1 per rectum q 6 hrs prn
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Electrolyte Replacement Protocol (form # 21340)
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Mild Pain, Temp >100.5F, HA: Tylenol (acetaminophen) 650 mg po or PR q 4 hrs prn
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Moderate Pain:
Norco (HYDROcodone/acetaminophen) 5/325 mg or 10/325mg 1 tab po q 4 hrs prn. DC if Percocet ordered.
or If patient cannot take tablet, Hycet elixir (HYDROcodone/acetaminophen 7.5/325 mg/15 ml) 15 ml po q 4 hrs prn instead of Norco. DC if Percocet ordered.
or Percocet (oxyCODONE/acetaminophen) 5/325 mg or 10/325 mg 1 tab po q 4 hrs prn. DC if Norco ordered.
and/or Toradol (ketorolac) 30 mg IV (or IM if no IV access) q 6 hrs prn (15 mg if CrCl 31-50, > 65 y/o old or < 50 kg) or 10 mg po q 6 hrs prn (max combined duration of IV and po ketorolac is 5 days). DC if CrCl < 30.
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Severe Pain (Begin when Epidural or PCA has been discontinued)
Morphine 1-2 mg IV q 3 hrs prn, DC if CrCl < 30. Hold for excessive sedation. DC if Dilaudid ordered.
or Dilaudid (HYDROmorphone) 0.25-0.5 mg IV q 3 hrs prn. If CrCl < 30, dose at 0.25 mg. Hold for excessive sedation. DC if Morphine ordered.
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Nausea/Vomiting: Zofran (ondansetron) 4 mg IV or po q 6 hrs prn
If N/V persists, add Reglan (metoclopramide) 10 mg IV q 6 hrs prn (5 mg if > 65 y/o)
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Sleep: Ambien (zolpidem) 5 mg (female or males ≥ 65 y/o) or 5-10 mg (male < 65 y/o) po at HS prn
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Indigestion: Maalox XS (aluminum/magnesium/simethicone) 30 ml po four times daily prn
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Stool Softener: Colace (docusate) 100 mg po bid prn; if patient has not had a bowel movement
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Constipation: Milk of Magnesia (MOM) 30 ml po daily prn
If no BM after 48 hrs, Dulcolax (biscodyl) 10 mg per rectum daily prn
and/or Senokot-S (docusate/senna) 2 tablets po at bedtime nightly
26. Cough: Robitussin (guaifenesin) 15 ml po q 4 hrs prn
27. Sore Throat: Chloraseptic (phenol/sodium phenolate) throat spray q 2 hrs prn
ADDITIONAL ORDERS:
________________________________________________________________________________________
________________________________________________________________________________________
______________ ________________ _________________________________ ___________
Date Time Physician Signature PID Number
Copy to pharmacy Order writer’s initials _______
*3-18191* FORM 3-18191 REV. 07/2015 Page 1 of 2
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