Doctor’s Order Day 1

SURNAME AGE HOSPITAL

Sarmiento 10 months old NO.
GIVEN SEX 1/2/3/5/7/
NAME [/] M   [] F
Benjie  WARD NO.
DOCTORS’ ORDER/ NURSES COMPLIANCE SHEET
(Authenticate all orders)
C – Carried                   A – Administered                  R – Request Made
           E – Endorsed                                    D - Discontinue

ORDER C A R E D Time 
Date Posted
Time Signature
● Please admit to COVID ward----------------- / / MPC

● Secure consent to care------------------------- / / MPC

● D5LR 1L to run @ 40cc/hr------------------- / / / MPC

● NPO temporarily------------------------------- / / MPC

● CBC with BT----------------------------------- / / / MPC

● Serum electrolyte-------------------------------
● ABG----------------------------------------------
● Blood gs/cs--------------------------------------
● UA------------------------------------------------
● CXR – APL stat--------------------------------
● CXR – decubitus-------------------------------
● HGT----------------------------------------------
● RT-PCR------------------------------------------
● Ceftriaxone 750 mg + 30cc diluent IVTT / / / MPC
q24------------------------------------------------
● Gentamicin 35mg IVTT Q24-----------------
● Paracetamol 70mg IVTT Q4 prn for fever--
● Omeprazole 10mg IVTT OD-----------------

● Refer to surgery for possible CTT----------- / / MPC

● For gastric aspirate----------------------------- / / / MPC

● VS q hourly--------------------------------- / / MPC
● I&O q shift----------------------------------
● Hook to O2 @ 3-5 lpm via FM--------------- / / / MPC

● Refer--------------------------------------------- / / MPC

Dr. Riego
Chua, Marielle P./Delos Reyes, E.
NDU BSN 2 NDU CI
04/05/2021 7:30AM