Physician Order Sheet 2 Diabetes HTN 2022

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NULB113

PRINCESS MARGARET HOSPITAL LAB USE


ONLY
PHYSICIAN’S ORDERS
Diagnosis: DM, HTN 42yrs
Date & Time Orders and Signature

Consultant Dr. James


Room/Bed 2
Registration # 000-00002
Name Sally Sue Smith
Current date 20** Admit to Ward
Current time Condition: Very ill
Activity: Bed rest
Vitals: Q 4 hourly, Glucometer readings
Diet: NPO
Allergies: NKDA
Investigations : CXR, CBC, U&E, Urinalysis for C/S
Medications: Captopril 50mg po od
Augmentin 1.2g IV tds x 3/7 then 325mg po
tds
Gentamicin 80mg IV q8h
Insulin 10u sc ac
MVT i tab po od
Panadol ii tabs po q6h prn for headaches

Consultant ______________
Room/Bed ______________
Registration # ____________
Name __________________
IVF: Normal Saline @ 75mL/hr

Consultant ______________
Room/Bed ______________
Registration # ____________
Name __________________

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