DrChrono Plastic Surgery | Surgeon's Pre-Operative / Post-Operative Orders Medical Form - Dec. 11, 2018, 3:40 p.m.

Surgeon's Pre-Operative Orders
Admit patient to facility	Nurse
Consent patient to procedure	Nurse
Start IV Fluids 150 ml per hour	Nurse
Lactated Ringers	Normal Saline
If Diabetic Patient: Check blood sugar on all diabetic patients. Record results on Pre-Anesthesia Evaluation (Ref Range: 70-110)
Blood Sugar Level	Nurse
If Female Patient: Check urine Hcg. Record results on Nursing Pre-op Checklist. (Reference Range: 1 Stripe = Negative; 2 Stripes
Nurse	HCG Lot Number/Expiration
HCG Notes
Complete Pre-Operative Nursing Checklist	Nurse
Verify Pre-operative work-up has been reviewed by Anesthesia Provider
Nurse
Sequential Compression Device to bilateral lower extremities (prior to intubation)
Nurse
Anesthesia Provider: Give 1 gram Ancef IV within 1 hour of surgery. Record in Anesthesia Record
Nurse
Anesthesia Provider: Give 5000 units Heparin SQ within 1 hour of surgery. Record in Anesthesia Record
Nurse
Surgeon's Post Operative Orders
General Orders
Transfer patient to Recovery Room
Nurse
Follow Post-Op Anesthesia Orders for Vital Signs Monitoring, Pain, Nausea, and IV Fluids
Nurse
Assess patient dressings. Report excessive or unusual drainage
Nurse
Clear liquids PO 30 ml every hour, or as tolerated
Nurse
Sequential compression devices to bilateral lower extremities until patient is ready for discharge
Nurse
Provide written and verbal Discharge Instructions (including Rx) to patient and family prior to discharge
Nurse
Discharge Patient per Anesthesia's Clearance/Orders
Nurse
Other
Compression Garmets
Nurse
Ice Packs
Nurse
Urine Catheter
Nurse
JP Drains
Nurse
Upper GI Contrast
Nurse
Additional Orders
Additional Orders
Nurse
Signatures
Surgeons Signature
Surgeon Signature
Nurse Signature
Nurse Signature

DrChrono Plastic Surgery | Surgeon's Pre-Operative / Post-Operative Orders Medical Form

Plastic Surgeon

DrChrono's surgeon's pre-operative/ post-operative orders form, customizable for your Plastic Surgery practice.

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Published: Dec. 11, 2018, 3:40 p.m.
Doctor: Dr. History Physical
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DrChrono Plastic Surgery | Surgeon's Pre-Operative / Post-Operative Orders Medical Form

Plastic Surgeon

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