standard peds admit orders

View
Edit

Title: *

Parent:

The parent that this page belongs in.

Resident:

Body: *

Diabetic Ketoacidosis 1. Admit to: (consider PICU) 2. Diagnosis: Diabetic ketoacidosis. 3. Condition: . 4. Vital signs: Call MD if: 5. Activity: 6. Nursing: consider ECG monitoring, Accuchecks q1-2h until glucose level is &lt;200 mg/dL, daily weights, strict inputs and outputs. O2 at 2-4 L/min by NC if needed. 7. Diet: NPO 8. IV Fluids: 0.9% saline 10-20 mL/kg over 1h, then repeat until blood pressure and pulse are normal. Then give 0.45% saline, and replace 1/2 of calculated deficit plus insensible loss over 8h, replace remaining 1/2 of deficit plus insensible losses over 16-24h. Keep urine output &gt;1.0 mL/kg/hour. Add KCL when potassium is &lt;6.0 mEq/dL
<table align="left" border="2">
<tbody>
<tr>
<td>Serum K+</td>
<td>IV KCl (mEq/L)</td>
</tr>
<tr>
<td>&lt;3</td>
<td>40-60</td>
</tr>
<tr>
<td>3-4</td>
<td>30</td>
</tr>
<tr>
<td>4-5</td>
<td>20</td>
</tr>
<tr>
<td>5-6</td>
<td>10</td>
</tr>
<tr>
<td>&gt;6</td>
<td>0</td>
</tr>
</tbody>
</table>
 Rate: 0.25-1 mEq KCL/kg/hr, maximum 1 mEq/kg/h or 20 mEq/h. 9. Medications: -Regular insulin (Humulin) 0.05-0.1 U/kg/hr (50 U in 500 mL NS) continuous IV infusion. Adjust to decrease glucose by 50-100 mg/dL/hr. -If glucose decreases at less than 50 mg/dL/hr, increase insulin to 0.14-0.2 U/kg/hr. If glucose decreases faster than 100 mg/dL/hr, continue insulin at 0.05-0.1 U/kg/h and add D5W to IV fluids. -When glucose approaches 250-300 mg/dL, add D5W to IV. Change to subcutaneous insulin (lispro or regular) when bicarbonate is &gt;15, and patient is tolerating PO food; do not discontinue insulin drip until one hour after subcutaneous dose of insulin. 10. Extras and X-rays: consider CXR, ECG. Consider Endocrine and dietary consults.
11. Labs:
<ul>
<li>Dextrostixs q1-2h until glucose &lt;200 mg/dL, then q4-6h. </li>
<li>BMP, phosphate, Mg q3-4h; </li>
<li>consider serum acetone, ABG</li>
<li>CBC. UA, urine culture and sensitivity.</li>
<li>consider blood  cultures +- starting Abx </li>
</ul>
<hr />
 
Dehydration -Admit to -diagnosis: -etc.
Newborn fever
RSV
Asthma exacerbation
cellulitis
ALTE cellulitis pneumonia fever RSV diarrhea jaundice child abuse

Input format

Filtered HTML

Web page addresses and e-mail addresses turn into links automatically.
Lines and paragraphs break automatically.

Rich-text editing

Lines and paragraphs break automatically.
Web page addresses and e-mail addresses turn into links automatically.

More information about formatting options

Weight:

Pages at a given level are ordered first by weight and then by title.

Log message:

An explanation of the additions or updates being made to help other authors understand your motivations.

Authoring information

Authored by:

Leave blank for Anonymous.

Authored on:

Format: 2008-06-24 21:01:43 -0600. Leave blank to use the time of form submission.

Publishing options

Published

Promoted to front page

Sticky at top of lists

Create new revision

Sun	Mon	Tue	Wed	Thu	Fri	Sat
1	2	3	4	5	6	7
8	9	10	11	12	13	14
15	16	17	18	19	20	21
22	23	24	25	26	27	28
29	30	31

lsumedpeds.com:

User login

Navigation

standard peds admit orders

Events

Who's online