Download Order Set: ED Lumbar Puncture Procedure Orders

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Physician Orders ADULT
Order Set: ED Lumbar Puncture Procedure Orders
[R] = will be ordered
T= Today; N = Now (date and time ordered)
Height: ___________cm Weight: __________kg
[ ] No known allergies
Allergies:
[ ]Medication allergy(s):_____________________________________________________________________
[ ] Latex allergy
[ ]Other:__________________________________________________________________
Patient Care
Consent
Signed
For
T;N,
Procedure:
Lumbar Puncture
[ ]
T;N, Lumbar Puncture tray setup to bedside
[ ] Nursing Communication
T;N,Stat,q4day
[ ] Intermittent Needle Therapy
Insert/Site (INT Insert/Site Care)
T;N, keep patient supine for 1 hr post lumbar puncture
[ ] Nursing Communication
NOTE: If patient is known diabetic, place bedside glucose order below
[ ] Whole Blood Glucose Nsg (Bedside T;N, Stat, once
Glucose Nsg)
Continuous Infusions
500 mL, IV Piggyback, once, STAT, 1,000 mL/hr
[ ] Sodium Chloride 0.9% (Sodium
Chloride 0.9% Bolus)
Sodium
Chloride 0.9%
1,000 mL, IV, STAT, 75 mL/hr
[ ]
1,000 mL,IV,STAT,T;N,75 mL/hr
[ ] Sodium Chloride 0.45%
1,000 mL,IV,STAT,T;N,75 mL/hr
[ ] Dextrose 5% with 0.45% NaCl
(Sodium chloride 0.45% with D5W)
Medications
1 mg,Injection,IV Push,once,STAT,T;N
[ ] LORazepam
p
1 mg,Injection,IV
g, j
, Push,once,STAT,T;N
,
,
, ;
[ ] HYDROmorphone
morPHINE
2
mg,Injection,IV
Push,once,STAT,T;N
[ ]
4 mg,Injection,IV Push,once,STAT,T;N
[ ] ondansetron
[ ] ED Sedation Procedure Orders
Laboratory
STAT, T;N, once, Type: CSF, Nurse Collect, Collection Comment: tube 1
[ ] Cell Count & Diff CSF (CSF Cell
Count & Diff)
STAT, T;N, once, Type: CSF, Nurse Collect, Collection Comment: tube 2
[ ] Glucose CSF
STAT, T;N, once, Type: CSF, Nurse Collect, Collection Comment: tube 2
[ ] Protein CSF
STAT, T;N, Specimen Source: Cerebrospinal Fluid(CSF), Nurse Collect, Collection
[ ] CSF Culture and Gram Stain
Comment: tube 3
Consults/Notifications
Hold
Specimen
(Specimen
Hold)
STAT,
T;N,
once, Type: CSF, Nurse Collect, Collection Comment: Tube 4-hold for
[ ]
spec. study
__________________
__________________
Date
Time
_________________________________________________
Physician's Signature
__________________
MD Number
*111*
ED Lumbar Puncture Procedure-20521-QM0808-Ver7 071211
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