ID

16036

Description

AAFP: Diabetic Ketoacidosis Admission Order, Standardizes Admission Orders, Author: Robert M. Wiprud, MD The primary purpose of these Ordersets is to decrease unnecessary variability and to improve quality through standardized Admission Orders. Developed by the Scott & White Clinic at College Station, Texas. Copyright © 2006 American Academy of Family Physicians. Physicians may photocopy or adapt for use in their own practices; all other rights reserved. Wiprud RM. Providing consistent care with standardized admission orders. Fam Pract Manag. September 2006: 49-52 See http://www.aafp.org/fpm/2006/0900/p49.html This ODM Form includes the ninth section ("Diabetic Ketoacidosis Admission Order").

Lien

http://www.aafp.org/fpm/2006/0900/p49.html

Mots-clés

  1. 27/06/2016 27/06/2016 -
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27 juin 2016

DOI

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Licence

Creative Commons BY-NC 3.0

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AAFP: Diabetic Ketoacidosis Admission Order

AAFP: Diabetic Ketoacidosis Admission Order

Default Itemgroup
Description

Default Itemgroup

Name
Description

Name

Type de données

text

Age
Description

Age

Type de données

integer

Date of birth
Description

Date of Birth

Type de données

date

Medical record
Description

Medical record

Type de données

integer

Status
Description

Status

ICU
Description

Status

Type de données

boolean

Attending
Description

Attending

Name of attending physician
Description

Name

Type de données

text

Phone number of attending physician
Description

Phone

Type de données

integer

Admitting Diagnosis
Description

Admitting Diagnosis

Diabetic Ketoacidosis Contributing Diagnoses
Description

Admitting Diagnosis

Type de données

text

Condition
Description

Condition

Condition
Description

Condition

Type de données

text

Allergies
Description

Allergies

Allergies
Description

Allergies

Type de données

text

Diet
Description

Diet

NPO for 12 hrs, then CL as tolerated; progress to 2,000 calorie ADA as tolerated
Description

Diet

Type de données

boolean

Activity
Description

Activity

Bed rest with bathroom privileges ad lib, beginning tomorrow if stable
Description

Activity

Type de données

boolean

Nursing
Description

Nursing

BP
Description

Nursing

Type de données

boolean

Pulse and respiratory every 1 hr X6, every 2 hrs X3, then every 4 hrs if stable
Description

Nursing

Type de données

boolean

T every 4 hrs
Description

Nursing

Type de données

boolean

I&O every 1 X6, every 4 hrs X3, then daily
Description

Nursing

Type de données

boolean

Notify MD for: T > 39 C; P < 60 or > 130; BP < 90/60 or > 170/110; all lab results
Description

Nursing

Type de données

boolean

Medications
Description

Medications

Regular insulin (0.1 units/kg)___ units IV bolus, then regular insulin infusion (0.1 units/kg/hr)__units/hr
Description

Medications

Type de données

boolean

If regular insulin, please specify amount of units
Description

Specification of regular insulin

Type de données

integer

If regular insulin, please specify amount of regular insulin infusion units
Description

Specification of regular insulin infusion

Type de données

integer

Lantus insulin if takes @home___units SQ at bedtime
Description

Medications

Type de données

boolean

If Lantus insulin, please specify amount of units
Description

Specification of Lantus

Type de données

integer

Medications
Description

Other: consider additional KCl if K+ normal or low

Type de données

boolean

IV
Description

IV

1000mL normal saline at 1000ml/hr
Description

IV

Type de données

boolean

1000mL normal saline with 20 mEq KCl at 500 mL/hr (add KCl after patient voids)
Description

IV

Type de données

boolean

1000mL normal saline with 20 mEq KCl at 500 mL/hr
Description

IV

Type de données

boolean

1000mL 1/2 normal saline with 20 mEq KCl at 250 mL/hr
Description

IV

Type de données

boolean

Change IVF to 1000mL Dextrose 5% in 1/2 normal saline with 20 mEq KCl at 250 mL/hr when glucose < 250 mg/dl
Description

IV

Type de données

boolean

Lab
Description

Lab

Basal metabolic profile on admission and 4,8, and 12 hrs after admission
Description

Lab

Type de données

boolean

Serum ketones with first, second and third blood draw
Description

Lab

Type de données

boolean

Hemogram, UA, urine C&S
Description

Lab

Type de données

boolean

ABGs on admission
Description

Lab

Type de données

boolean

Serum osmolality, PO4, Mg and Ca at admission
Description

Lab

Type de données

boolean

Mg
Description

Mg

If Mg 1.4-1.8 mg/gl, apply 1g MgSO4 with IV Piggyback over 30 minutes
Description

Magnesium

Type de données

boolean

If Mg < 1.4 mg/dl apply 2 g MgSO4 with IV Piggyback Over 30-60 minutes
Description

Magnesium

Type de données

boolean

PO4
Description

PO4

With all IV PO4 supplementation, check calcium every 4 hrs
Description

PO4

Type de données

boolean

After all infusions, complete immediately, check PO4 level
Description

PO4

Type de données

boolean

If calcium supplementation necessary, do not give in same IV line as PO4
Description

PO4

Type de données

boolean

Other
Description

Other

If pH < 7.1, then add 1 amp (44mEq) of NA bicarbonate to bag
Description

Other

Type de données

boolean

Normal saline every 2 hrs until pH > 7.1 ABG every 4 hrs (if treating with bicarbonate)
Description

Other

Type de données

boolean

Consider DVT prophylaxis with Lovenox 40 mg sq daily
Description

Other

Type de données

boolean

If PO4 1.0-1.8 mg/dl supply orally, if possible with milk or neutral-phos
Description

Other

Type de données

boolean

If 1.0-1.8 mg/dl please specify solution
Description

Specification of PO4 1.0-1.8 mg/dl

Type de données

text

Unités de mesure
  • ln
ln
If 1.0-1.8 mg/dl please specify duration
Description

Specification of PO4 1.0-1.8 mg/dl

Type de données

integer

Unités de mesure
  • hrs
hrs
If PO4 0.5-1.0 mg/dl supply IV with 0.08 mM/Kg KPO4 in 250 cc NS for 4 hrs
Description

Other

Type de données

boolean

If PO4 < 0.5 mg/dl supply IV with 0.16 mM/Kg KPO4 in 250 cc NS for 4 hrs
Description

Other

Type de données

boolean

Signature
Description

Signature

Type de données

text

Print Name
Description

Print Name

Type de données

text

Date and Time
Description

Date and Time

Type de données

datetime

Similar models

AAFP: Diabetic Ketoacidosis Admission Order

Name
Type
Description | Question | Decode (Coded Value)
Type de données
Alias
Name
Item
Name
text
Age
Item
Age
integer
Date of Birth
Item
Date of birth
date
Medical record
Item
Medical record
integer
Item Group
Status
Status
Item
ICU
boolean
Item Group
Attending
Name
Item
Name of attending physician
text
Phone
Item
Phone number of attending physician
integer
Item Group
Admitting Diagnosis
Admitting Diagnosis
Item
Diabetic Ketoacidosis Contributing Diagnoses
text
Item Group
Condition
Item
Condition
text
Code List
Condition
CL Item
Stable (1)
CL Item
Fair (2)
CL Item
Serious (3)
CL Item
Critical (4)
Item Group
Allergies
Allergies
Item
Allergies
text
Item Group
Diet
Diet
Item
NPO for 12 hrs, then CL as tolerated; progress to 2,000 calorie ADA as tolerated
boolean
Item Group
Activity
Activity
Item
Bed rest with bathroom privileges ad lib, beginning tomorrow if stable
boolean
Item Group
Nursing
Nursing
Item
BP
boolean
Nursing
Item
Pulse and respiratory every 1 hr X6, every 2 hrs X3, then every 4 hrs if stable
boolean
Nursing
Item
T every 4 hrs
boolean
Nursing
Item
I&O every 1 X6, every 4 hrs X3, then daily
boolean
Nursing
Item
Notify MD for: T > 39 C; P < 60 or > 130; BP < 90/60 or > 170/110; all lab results
boolean
Item Group
Medications
Medications
Item
Regular insulin (0.1 units/kg)___ units IV bolus, then regular insulin infusion (0.1 units/kg/hr)__units/hr
boolean
Specification of regular insulin
Item
If regular insulin, please specify amount of units
integer
Specification of regular insulin infusion
Item
If regular insulin, please specify amount of regular insulin infusion units
integer
Medications
Item
Lantus insulin if takes @home___units SQ at bedtime
boolean
Specification of Lantus
Item
If Lantus insulin, please specify amount of units
integer
Medications
Item
boolean
Item Group
IV
IV
Item
1000mL normal saline at 1000ml/hr
boolean
IV
Item
1000mL normal saline with 20 mEq KCl at 500 mL/hr (add KCl after patient voids)
boolean
IV
Item
1000mL normal saline with 20 mEq KCl at 500 mL/hr
boolean
IV
Item
1000mL 1/2 normal saline with 20 mEq KCl at 250 mL/hr
boolean
IV
Item
Change IVF to 1000mL Dextrose 5% in 1/2 normal saline with 20 mEq KCl at 250 mL/hr when glucose < 250 mg/dl
boolean
Item Group
Lab
Lab
Item
Basal metabolic profile on admission and 4,8, and 12 hrs after admission
boolean
Lab
Item
Serum ketones with first, second and third blood draw
boolean
Lab
Item
Hemogram, UA, urine C&S
boolean
Lab
Item
ABGs on admission
boolean
Lab
Item
Serum osmolality, PO4, Mg and Ca at admission
boolean
Item Group
Mg
Magnesium
Item
If Mg 1.4-1.8 mg/gl, apply 1g MgSO4 with IV Piggyback over 30 minutes
boolean
Magnesium
Item
If Mg < 1.4 mg/dl apply 2 g MgSO4 with IV Piggyback Over 30-60 minutes
boolean
Item Group
PO4
PO4
Item
With all IV PO4 supplementation, check calcium every 4 hrs
boolean
PO4
Item
After all infusions, complete immediately, check PO4 level
boolean
PO4
Item
If calcium supplementation necessary, do not give in same IV line as PO4
boolean
Item Group
Other
Other
Item
If pH < 7.1, then add 1 amp (44mEq) of NA bicarbonate to bag
boolean
Other
Item
Normal saline every 2 hrs until pH > 7.1 ABG every 4 hrs (if treating with bicarbonate)
boolean
Other
Item
Consider DVT prophylaxis with Lovenox 40 mg sq daily
boolean
Other
Item
If PO4 1.0-1.8 mg/dl supply orally, if possible with milk or neutral-phos
boolean
Specification of PO4 1.0-1.8 mg/dl
Item
If 1.0-1.8 mg/dl please specify solution
text
Specification of PO4 1.0-1.8 mg/dl
Item
If 1.0-1.8 mg/dl please specify duration
integer
Other
Item
If PO4 0.5-1.0 mg/dl supply IV with 0.08 mM/Kg KPO4 in 250 cc NS for 4 hrs
boolean
Other
Item
If PO4 < 0.5 mg/dl supply IV with 0.16 mM/Kg KPO4 in 250 cc NS for 4 hrs
boolean
Signature
Item
Signature
text
Print Name
Item
Print Name
text
Date and Time
Item
Date and Time
datetime

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