My post-op admit order notes

Post-op Admit Notes

Hemithyroid:

Drain: .cdldrain

           .cdldrainteach

HTN:

Change parameters for call if SBP >150

For BP > 150 treat pain rated > 5/10.  Perform bladder scan*.

Resume held ace-i

labetolol 10 mg - 20 mg slow IV push every 2 minutes for SBP > 150 (max 300 mg/24 hr), HOLD for HR < 60 or wheezing. [CI: RAD, bradycardia, 2 or 3 heart block, HF]

Hydralazine 10 mg - 20 mg slow IV push, repeat every 4 hrs for SBP > 150 (max 200 mg/24 hr). (“10 mg slow IV push x1. Re-check BP 20 minutes after the first dose and give 10 mg if SBP > 150 mmHg.  Re-check BP 20 minutes after 2nd dose and notify MD for SBP > 150 mmHg.)

Enalaprilat 1.25 mg IV over 5 minutes, with doses up to 5 mg every 6 hrs prn SBP > 150 (max 50 mg/24 hr).  (“Re-check BP 20 minutes after each dose, and if SBP > 150 mmHg, add another dose 1.25 mg more than the last up to 5 mg per dose.  Notify MD if SBP > 150 mmHg after 4th dose.”)

Bladder scan for SBP > 150 or for reported difficulty voiding.  If bladder volume < 350 mL, perform straight catheterization.  Notify MD for drained urine volume > 700 mL.

OSA:

Contiuous SaO2

RT consult

Order CPAP

.cdlOsaAvoidO2

Total or completion thyroid:

All of the hemithyroid orders plus:

Albumin, calcium, magnesium in PACU

Serial calcium (set iPhone alarms for t+90 min)

Nursing communication: .cdllowcaproto