Download physician`s orders - Providence Hospital

PROVIDENCE HOSPITAL
6801 Airport Boulevard, Mobile AL 36608,
251/633−1000
PHYSICIAN’S ORDERS
DATE
Page 1 of 1
INTRAVENOUS PCA PUMP ORDERS
meperidine (DEMEROL)
HOUR
To run concurrently with maintenance fluids.
meperidine (DEMEROL) 10 mg per mL in 0.9% NaCl
For PCA Dosing, patient activates dosing (Physician select one)
Mode of operation: PCA only
[meperidine (DEMEROL) 10 mg per mL in 0.9% NaCl concentration]
meperidine (DEMEROL) = PCA dose of 4 mg per dose
Low Dose
Delay (lockout time) = 6 minutes
One hour limit (maximum PCA dose per hour) = 40 mg per H
Standard Dose [meperidine (DEMEROL) 10 mg per mL in 0.9% NaCl concentration]
meperidine (DEMEROL) = PCA dose of 8 mg per dose
Delay (lockout time) = 6 minutes
One hour limit (maximum PCA dose per hour) = 80 mg per H
2. Nausea/Vomiting: (Physician select)
promethazine (PHENERGAN) 12.5 mg to 25 mg IV Q 4 H PRN nausea
ondansetron (ZOFRAN) 4 mg IV x 1 for severe nausea and vomiting
Other:____________________________________________________________
3. If patient has a fentanyl patch (DURAGESIC) in place, remove before starting PCA pump dosing.
4. While PCA pump is in operation, HOLD other analgesia, barbiturates, tranquilizers, and sedatives
unless ordered/approved by the physician ordering the intravenous pain management.
5. Instruct the family that only the patient should press the PCA button.
6. Call MD for: Difficulty arousing (sedation level of 3 to 4)
Respiratory impairment/obstruction
Inadequate analgesia
Nausea and vomiting uncontrolled by PRN medications
7.
For respiratory rate equal to or less than 8 per minute, STOP PUMP. Give naloxone (NARCAN)
0.4 mg per mL. Dilute 0.4 mg in 9 mL 0.9% NaCl. Give 2 mL IV slowly every 2 minutes until
respiratory rate greater than 10 per minute. Notify MD STAT. Initiate artificial ventilations per
Bag−Valve Mask as needed.
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Signature
Date
Developed: August 2000
Revised:
May 2005
November 2005
PH−PCA3−1105PH PHY00113