Name
Item
Name of attending physician
text
Phone
Item
Phone number of attending physician
integer
Admitting Diagnosis
Item
Please specify Deep Vein Thrombosis___lower extremity
text
Admitting Diagnosis
Item
Deep Vein Thrombosis ___lower extremity Associated Diagnoses
text
Activity
Item
Bed rest with bathroom privileges; elevate affected leg while in bed
boolean
Nursing
Item
Vital signs: every 4 hrs X2, then every shift
boolean
Nursing
Item
Notify MD for: T > 101 PO; P < 55 or > 120 bpm; systolic BP < 90 or > 180; diastolic BP > 120
boolean
Nursing
Item
Admission weight
boolean
Nursing
Item
Assess size, color, temp and pulses of lower extremities each shift
boolean
Nursing
Item
Notify MD of changes from baseline
boolean
Medications
Item
Enoxaparin (Levonox) 1 mg/kg body weight subcutaneously now and BID
boolean
Medications
Item
Coumadin 5 mg PO now and then daily
boolean
Medications
Item
Tylenol 325 mg 1-2 PO every 4-6 hrs prn pain or fever
boolean
Medications
Item
MOM 15-30 mL every 12 hrs prn constipation
boolean
Medications
Item
No NSAIDS, ASA or IM injunctions
boolean
Medications
Item
Other Medications
boolean
Medications
Item
If Other, please specify
text
IV
Item
IV lock; flush per routine
boolean
IV
Item
If Other, please specify
text
Lab
Item
PT/INR, PTT, CBC, basal metabolic profile on admission if not already done
boolean
Lab
Item
PT/INR every morning
boolean