303 POST-OP ADMISSION ORDERS - CLEFT LIP AND PALATE page 1

Dr. Luis Cuadros 505.243.7670


Pt name: ________________________________________ DOB: _______________

CSN: _______________________________

Date: _______________________________

Allergies: ______________________

Weight: _______________________ Kg

 

Status: Admit Inpatient - Peds Unit 6th floor

Diet and Feeding Orders:

Today: clear liquids, mother’s breast milk, Pedialyte or Sweet-Ease

via syringe, spoon, or Zip-n-Squeeze

1st Day after surgery: full liquids or ½ strength formula

                   via syringe, spoon, or Zip-n-Squeeze, with clear liquid rinse

2nd Day after surgery: full liquids, full strength formula

                   via syringe, spoon, or Zip-n-Squeeze with clear liquid rinse

Elbow splints in PACU and post-procedure.

IV: D5-1/2NS @ ______________ cc/hr

Medications:

Kefzol mg __________ IV Q 8 hours

Morphine Sulfate __________ mg IV Q 1 Hour PRN Pain

Tylenol __________ mg PO/PR Q 4° PRN T > 101.5°F or PRN Pain

Tylenol with codeine elixir __________ cc PO Q 4° PRN Pain

      Toradol (0.5mg/kg)mg __________ Q8hr PRN pain

Zofran (0.1mg/kg) IV for patients weighing 40kg or less Q6hr PRN nausea or

      Zofran 4mg IV for patients weighing more than 40kg Q6hr PRN nausea

       For children under 2 years old, Mylicon oral drops 20mg/0.3ml PO QID PRN

For children over 2 years old, Mylicon oral drops 40mg/0.6ml PO QID PRN

Bacitracin ointment 1 oz tube

Cipro Ear Drops 3 gtts AU TID x 3 days beginning day of surgery

      Oral Viscous Lidocaine 2% – apply to gums with syringe, finger or Q-tip Q1-2 hrs PRN.

            Parents may apply.

Wound and lip care: (for cleft lip repairs only)

      Clean suture line with H2O2 Q4hr and PRN

      Apply Bacitracin ointment to wound.

      Apply Aquaphor to lips to keep moist. Parents may assist.

Pulse Oximeter

Blow-by O2 for O2 Sats below 95%

Suction nose or mouth PRN with pediatric suction


POST-OP ADMISSION ORDERS - CLEFT LIP AND PALATE page 2

 

 

IF IV FAILS:

If IV fails and PO intake is good, then, do not restart.

If IV fails, and is not re-inserted, then start Keflex Elixir 125mg PO TID

 

Other orders:

 

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PEDIATRIC DOSING CHART - DR. CUADROS

 

Weight

Kg

IV FLUIDS

D5½NS cc/hr

KEFZOL mg IV

25mg/kg q8h

MS mg IV

q1-2h

TYLENOL mg

q4h PRN

TYLENOL/codeine

cc q4h PRN

4

17

100

0.125

60

1-2cc

5

21

125

0.125

75

1-2cc

6

25

150

0.25

90

1-2cc

7

29

175

0.25

105

2cc

8

33

200

0.25

120

2cc

9

38

225

0.5

135

2cc

10

42

250

0.5

150

2-3cc

12

45

300

0.5

180

2-3cc

15

52

375

1.0

225

3cc

20

63

500

1.0

300

3cc

25

67

625

2.0

375

3-4cc

30

71

750

2.0

450

3-4cc

35

75

875

2.0

525

4cc

40

79

1000

2.5

600

5cc

 

Preoperative Diet orders: NPO solids 8 hours - Formula & Milk 6 hours - Breast Milk 4 hours - Clear Liquids 2 hours.

Acetominophen [TYLENOL] 10-15 mg/kg PO q4-6h prn; Max: 75 mg/kg/day

Ibuprofen [MOTRIN, ADVIL] 5-10 mg/kg PO q6-8h prn; Max: 40 mg/kg/day

Midazolam [VERSED] oral medication 0.5mg/kg in 5cc Tylenol elixir

Topical oral analgesia: Mix 10cc Viscous lidocaine 2% + 10cc Benadryl Elixir; 1-2cc PRN.

Codeine: 0.5 -1.0 mg/kg q4-6h; Elixir 5ml = 120mg acetaminophen + 12 mg codeine. 2.4mg codeine/cc;1mg/.416 cc

Ondansetron [ZOFRAN]: under 40kg give 0.1mg/kg. Over 40kg give 4mg

Promethazine [PHENERGAN]: not for under 2 years. Oral 0.2 mg/kg, Rectal 6.25-12.5 mg PR

Metoclopramide [REGLAN] (0.1-0.25 mg/kg)

Diphenhydramine [BENADRYL] (0.5-1 mg/kg)

Fentanyl: 1-2 mcg/kg Q1-4h, 0.5-1 mcg/kg/hr infusion

Naloxone [NARCAN]: (0.01mg/kg) repeat Q5min

Ketorlac [TORADOL]: .5mg/kg Q8h

Dexamethasone [DECADRON] 0.25 mg/kg