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    Mariano Marcos State University: College of Health Sciences

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    Joshua Gonzales
    The doctor's order is for a patient admitted to the hospital with laryngitis. The order includes admitting the patient to a room of their choice, obtaining consent for care and management, monitoring vital signs, starting the patient on a soft diet, and performing diagnostic tests including a CBC, throat swab for culture and sensitivity, and neck ultrasound. Treatment ordered includes IV fluids, antibiotics, pain medication, and gargling with an antiseptic solution. The patient is also instructed to rest their voice, increase fluid intake, and avoid certain drinks.

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    Mariano Marcos State University: College of Health Sciences

    Uploaded by

    Joshua Gonzales
    94 views3 pages
    The doctor's order is for a patient admitted to the hospital with laryngitis. The order includes admitting the patient to a room of their choice, obtaining consent for care and management, monitoring vital signs, starting the patient on a soft diet, and performing diagnostic tests including a CBC, throat swab for culture and sensitivity, and neck ultrasound. Treatment ordered includes IV fluids, antibiotics, pain medication, and gargling with an antiseptic solution. The patient is also instructed to rest their voice, increase fluid intake, and avoid certain drinks.

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    Doctors Order

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    The doctor's order is for a patient admitted to the hospital with laryngitis. The order includes admitting the patient to a room of their choice, obtaining consent for care and management, monitoring vital signs, starting the patient on a soft diet, and performing diagnostic tests including a CBC, throat swab for culture and sensitivity, and neck ultrasound. Treatment ordered includes IV fluids, antibiotics, pain medication, and gargling with an antiseptic solution. The patient is also instructed to rest their voice, increase fluid intake, and avoid certain drinks.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Download as docx, pdf, or txt
    94 views3 pages

    Mariano Marcos State University: College of Health Sciences

    Uploaded by

    Joshua Gonzales
    The doctor's order is for a patient admitted to the hospital with laryngitis. The order includes admitting the patient to a room of their choice, obtaining consent for care and management, monitoring vital signs, starting the patient on a soft diet, and performing diagnostic tests including a CBC, throat swab for culture and sensitivity, and neck ultrasound. Treatment ordered includes IV fluids, antibiotics, pain medication, and gargling with an antiseptic solution. The patient is also instructed to rest their voice, increase fluid intake, and avoid certain drinks.

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    MARIANO MARCOS STATE UNIVERSITY

    College of Health Sciences

    DOCTOR’S ORDER

    SURNAME:____________________ AGE: ______ HOSP.NO.: _____________

    GIVEN: ________________________ MI: ______________ SEX: _________ WARD: ______

    PROGRESS NOTES ORDER ACTION TIME/SIG


    11/14/2021 8:00  Admit to room of choice
    AM  Secure consent to care and management
    Hoarseness of voice  TPR q shift and record
    almost 6 months  Soft diet
    Pain upon  Diagnostics:
    swallowing 3  CBC, ESR
    months ago  Throat swab for C/S
    BP: 110/70  Neck ultrasound
    PR: 80  For Laryngoscopy
    RR: 20  Treatment:
    BT: 36.8 C  Start IVF D5LR 1L for 10 hrs, TF : IVF
    D5NM1L for 12 hrs
    Dx: Laryngitis  Ampicillin 1000 mg IV q 6 hrs ANST
     MIbuprofen 500 mg p.o TID
     Bactidol 1 ml in a glass of water for
    gargle TID
     Rest voice as much as possible
     Increase fluid intake
     Avoid coffee and alcohol
     Daily weighing
     Report progress of symptoms
     Refer accordingly

    Dr. Galvez

    Name Age/ Sex Ward Rm. No.

    Nurses Action Legend:


    C – Carried A – Administered R – Requested E – Endorsed D – Discontinue

    DOCTOR’S ORDER
    MARIANO MARCOS STATE UNIVERSITY
    College of Health Sciences

    SURNAME:____________________ AGE: ______ HOSP.NO.: _____________

    GIVEN: ________________________ MI: ______________ SEX: _________ WARD: ______

    PROGRESS NOTES ORDER ACTION TIME/SIG


    11/14/2021 8:00  Admit to Room of choice
    AM  V/S q 15 mins until stable
    Nape pan  On low salt low fat diet
    Dizziness  I& O monitoring q shift
    BP: 160/100  CBR w/BPR s
    PR: 86  Diagnostics:
    RR: 18  CBC, UA
    BT: 37. C  Blood chem-FBS, BUN, Crea, Na, K
     lipid profile-total cholesterol,
    Dx: HTN, Stage 1 LDL,HDL
     ECG
     Treatment:
     IVF D5LR 1L for 6 hrs
     TF : IVF D5NM1L for 8 hrs
     Clonidine 150 mcg tab SL Now
     Spirinolactone 25mg tab OD AM
     Irbesartan 150 mg tab OD
     Amlodipine 10 mg tab HS
     Observe for any untoward manifestation
     Refer accordingly
    Dr. Dela Cruz

    Name Age/ Sex Ward Rm. No.

    Nurses Action Legend:


    C – Carried A – Administered R – Requested E – Endorsed D – Discontinue

    DOCTOR’S ORDER
    MARIANO MARCOS STATE UNIVERSITY
    College of Health Sciences

    SURNAME:____________________ AGE: ______ HOSP.NO.: _____________

    GIVEN: ________________________ MI: ______________ SEX: _________ WARD: ______

    PROGRESS NOTES ORDER ACTION TIME/SIG


    10/06/2021 8:00 AM -Please admit room of choice
    Difficuty swallowing -Secure consent for the admission R 8:05
    Dry cough -Diet: Soft diet R 8:05
    Sore throat -IVF: Start IVF D5LR 1L to run for 8 hrs R 8:05
    TF: IVF D5NM 1L for 6 hrs
    Meds: C 8:06
    Temp: 37.5oC -Ampicillin 500mg IV q 6 hrs
    PR: 76 bpm -Paracetamol 300 mg IV for body temperature 38.5 and up C 8:01
    RR: 22 breaths/min -Mefenamic Acid 250mg tab TID P.O for headache
    BP: 100/60mmHg A 8:02
    -Warm saline gargle TID A 8:03
    Dx: Pharyngitis -TSB PRN A 12:03
    -Watchout for progress of symptoms A 8:04
    -Monitor VS q 4 and record C 8:07
    -Refer accordingly C 8:07
    Dr. Baytec C 8:10

    Name Age/ Sex Ward Rm. No.

    Nurses Action Legend:


    C – Carried A – Administered R – Requested E – Endorsed D – Discontinue

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