Admission Orders Template Primary Diagnosis: UTI / Septic shock Status/Condition Guarded Code

Admission Orders Template

Primary Diagnosis: UTI / Septic shock

Status/Condition Guarded

Code Status: Full Code

Allergies: NKA

Admit to Unit: Stepdown Telemetry

Diet: Diabetic diet

IV Fluids: Sodium Chloride 0.9 % 1,000 ml IV continuous 100 ml / hr

Critical Drips : No critical drips at this time

Respiratory: 2L nasal cannula to maintain O2 above 94% continuous Oxymetry


Rocephin 1 g, 100 ml/h Every 24 hours IV push

Metoprolol 25 mg PO daily – Do not administer if Systolic Blood pressure below 110 and Diastolic below 70

Insulin Lispro subcutaneously as per sliding scale – before meals

Lantus 10 Units subcutaneously daily before bed

Aspiring 81 mg oral daily

Nursing Orders : Vital Signs every 4 hours, Pulse Oximetry continuous, Weigh patient once upon admission, reorient PRN, Intake and Output every shift, Assess IV site every shift, Cardiac monitoring in telemetry floor for 24 hours and re- assess, Consent for treatment as needed, notify provider if there is any change in cardiac rhythm, bleeding precautions, fall precautions, bathroom privileges with assistance times 1.

Follow-Up Lab Tests:

Diagnostic testing : 12 Lead ekg ( to assess myocardial function ), CBC ( to assess WBC and potential Anemia) , BMP – for electrolytes and possible DKA , Urinalysis for UTI, Chest X-ray for potential infection, Blood cultures, Urine cultures

Consults: Infection Disease for antibiotic management, Nephrology for Renal function, Physical therapy, Endocrinologist for diabetes management.

Patient Education and Health Promotion (address age-appropriate patient education. if applicable): Diabetes education

Discharge Planning and Required Follow-Up Care: Primary care Provider within one week after discharge

References (minimum of three timely references that prove this plan follows current standards of care):