Percutaneous Cecostomy Insertion - Post-Procedure Orders

PERCUTANEOUS CECOSTOMY INSERTION - Post-Procedure Doctors Orders -

HOSPITAL NO. ___________________	NURSING UNIT ___________________	REGISTRATION NO. ___________________

PATIENT NAME (LAST) ___________________	(FIRST) ___________________	SEX ___________________

BIRTH DATE [ yyyy \| mm \| dd ]	ADMIT DATE [ yyyy \| mm \| dd ]	REFERRING DOCTOR ___________________

ALLERGIES ___________________ ___________________ ___________________ ___________________ ___________________	SYMPTOMS OF ALLERGIES ___________________ ___________________ ___________________ ___________________ ___________________	Date of wt. ___________________ Patients wt. _________________kg Signature ___________________

ALL MEDICATION ORDERS ARE PROCESSED IN ACCORDANCE WITH APPROVED HOSPITAL POLICIES-SEE FORMULARY FOR DETAILS

POST-PROCEDURAL ORDERS FOR PERCUTANEOUS CECOSTOMY

Record vital signs q5m x2, q30m x2, q2h x2 Maintain intravenous to keep vein open a) Morphine IV ______________ mg (0.05mg/kg) q4h prn x 24 hours, then b) Acetaminophen po ______________ mg (15mg/kg) q4h prn. a) Metronidazole IV ______________ mg (10mg/kg) q8h x 2 days or until discharged. b) Gentamicin IV ______________ mg (2.5mg/kg) q8h x 2 days or until discharged. c) Ampicillin IV ______________ mg (20mg/kg) q6h x 2 days or until discharged. Instill 10 mL water in cecostomy tube bid. Ambulate as tolerated. Keep dressing intact for 24 hours then change daily for 2 days or until discharged. Clear fluids progressing to diet as tolerated when bowel sounds present or passage of flatus or feces. Book appointment for C-tube change in 6 weeks with Interventional Radiology.


________________ Date	________________ Time	______________________MD Signature

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