Pseudomonas aeruginosa
lt 5 yr except neonates 7.5 mg kg day IV IM q8h. 5-10 yr 6.0 mg kg day IV IM q8h. gt 10 yr 5.0 mg kg day IV IM q8h AND -Piperacillin Pipracil or ticarcillin Ticar 200-300 mg kg day IV IM q4-6h, max 24 gm day OR -Ceftazidime Fortaz 150 mg kg day IV IM q8h, max 12 gm day. Mycoplasma pneumoniae -Clarithromycin Biaxin 15-30 mg kg day PO q12h, max 1 gm day susp 125 mg 5 mL, 250 mg 5 mL tabs 250, 500 mg . -Erythromycin estolate Ilosone 30-50 mg kg day PO q8-12h, max 2 gm day caps 125, 250 mg drops...
EVentricular fibrillation and pulseless ventricular tachycardia
1. Apply cardiac monitor, administer oxygen, and ventilate. 2. Perform defibrillation using 2 J kg. Do not delay defibrillation. 3. If ventricular fibrillation persists, perform defibrillation using 4 J kg. 4. If ventricular fibrillation persists, perform defibrillation using 4 J kg. 5. If ventricular fibrillation persists, perform intubation, continue CPR, and obtain vascular access. Administer epinephrine, 0.1 mL kg of 1 10,000 IV or IO 0.01 mg kg or 0.1 mL kg of 1 1000 ET 0.1 mg kg . 6. If...
STSegment Elevation Myocardial Infarction
1. Admit to Coronary care unit 2. Diagnosis Rule out myocardial infarction 3 Condition 4. Vital Signs q1h. Call physician if pulse gt 90, lt 60 BP gt 150 90, lt 90 60 R gt 25, lt 12 T gt 38.5C. 5. Activity Bed rest with bedside commode. 7. Nursing Guaiac stools. If patient has chest pain, obtain 12-lead ECG and call physician. 8. Diet Cardiac diet, 1-2 gm sodium, low-fat, low-cholesterol diet. No caffeine or temperature extremes. 10. Special Medications -Oxygen 2-4 L min by NC. -Aspirin 325 mg...
Hepatitis B
6. Nursing Standard precautions. 8. IV Fluids Isotonic fluids at maintenance rate. 15 mg kg day IM PO PR q6-8h, max 100 mg dose if lt 13.6 kg or 200 mg dose if 13.6-41kg. caps 100, 250 mg inj 100 mg mL supp 100, 200 mg . -Diphenhydramine Benadryl 1 mg kg dose IV IM IO PO q6h prn pruritus or nausea, max 50 mg dose OR -Acetaminophen Tylenol 15 mg kg PO PR q4h prn temp gt 38 C or pain. -Meperidine Demerol 1 mg kg IV IM q2-3h prn pain. Post exposure prophylaxis for previously unimmunized persons...
Poisoning and Drug Overdose
-Gastric Lavage Place patient left side down, place nasogastric tube, and check position by injecting air and auscultating. Lavage with normal saline until clear fluid, then leave activated charcoal or other antidote. Gastric lavage is contraindicated for corrosives. -Magnesium citrate 6 solution 150-300 mL PO -Magnesium sulfate 10 solution 150-300 mL PO. -Activated Charcoal 50 gm PO first dose should be given using product containing sorbitol . Repeat q2-6h for large ingestions. -Hemodialysis...
BHormonal versus nonhormonal
1. Pelvic pain associated with severe dysmenorrhea and or pain at the time of ovulation is likely due to endometriosis or adenomyosis. Women with endometriosis report premenstrual spotting, dyspareunia, dyschezia, poor relief of symptoms with nonsteroidal anti-inflammatory drugs, progressively worsening symptoms, inability to attend work or school during menses, and the presence of pelvic pain unrelated to menses more often than women with primary dysmenorrhea. 2. Nonhormonally responsive...
V Dysrhythmias A Bradycardia
1. Bradycardia is the most common dysrhythmia in children. Initial management is ventilation and oxygenation. Chest compressions should be initiated if the heart rate is lt 60 bpm in a child or lt 80 bpm in an infant. 2. If these measures do not restore the heart rate, epinephrine is administered. Intravenous or intraosseous epinephrine is given in a dose of 0.1 mL kg of the 1 10,000 concentration 0.01 mg kg . Endotracheal tube epinephrine is given as a dose of 0.1 mL kg of the 1 1,000...
Syncope
4. Vital Signs q1h, postural BP and pulse q12h. Call physician if BP gt 160 90, lt 90 60 P gt 120, lt 50 R gt 25, lt 10 6. Nursing Fingerstick glucose. 8. IV Fluids Normal saline at TKO. 9. Special medications High-Grade AV Block with Syncope -Isoproterenol 0.5-1 mcg min initially, then slowly titrate to 10 mcg min IV infusion 1 mg in 250 mL NS . -Transthoracic pacing. Drug-Induced Syncope -Discontinue vasodilators, centrally acting hypotensive agents, tranquilizers, antidepressants, and...
Absence Seizure
-Divalproex Depakote 250-500 mg PO tid-qid 125, 250, 500 mg . -Clonazepam Klonopin 0.5-5 mg PO bid-qid 0.5, 1, 2 mg . -Lamotrigine Lamictal 50 mg PO qd, then increase to 50-250 mg PO bid 25, 100, 150, 200 mg adjunct therapy. 10. Extras MRI with and without gadolinium or CT with contrast EEG with photic stimulation, hyperventilation, sleep deprivation, awake and asleep tracings portable CXR, ECG. 11. Labs CBC, SMA 7, glucose, Mg, calcium, phosphate, liver panel, VDRL, anticonvulsant levels. UA,...
Status Epilepticus
2. Position the patient laterally with the head down. The head and extremities should be cushioned to prevent injury. 3. A bite block or other soft object may be inserted into the mouth to prevent injury to the tongue. 4. Give 100 O2 by mask. Obtain brief history and a fingerstick glucose. 5. Secure IV access and draw blood for glucose analysis. Give thiamine 100 mg IV push, then dextrose 50 50 mL IV push.
Discharge Summary
Patient's Name and Medical Record Number Attending or Ward Team Responsible for Patient Surgical Procedures, Diagnostic Tests, Invasive Procedures Brief History, Pertinent Physical Examination, and Laboratory Data Describe the course of the patient's disease up until the time that the patient came to the hospital, including physical exam and laboratory data. Hospital Course Describe the course of the patient's illness while in the hospital, including evaluation, treatment, medications, and...
Nephrolithiasis
4. Vital Signs q8h. Call physician if urine output lt 30 cc hr BP gt 160 90, lt 90 60 T gt 38.5 C. 6. Nursing Strain urine, measure inputs and outputs. Place Foley if no urine for 4 hours. 7. Diet Regular, push oral fluids. 8. IV Fluids IV D5 NS at 100-125 cc hr maintain urine output of 80 mL h . 9. Special Medications -Cefazolin Ancef 1-2 gm IV q8h -Meperidine Demerol 75-100 mg and hydroxyzine 25 mg IM IV q2-4h prn pain OR -Butorphanol Stadol 0.5-2 mg IV q3-4h. -Hydrocodone acetaminophen...
Hyperkalemia
4. Vital Signs q4h. Call physician if QRS complex gt 0.14 sec or BP gt 160 90, lt 90 60 P gt 120, lt 50 R gt 25, lt 10 T gt 38.5 C. 5. Activity Bed rest up in chair as tolerated. 6. Nursing Inputs and outputs. Chart QRS complex width q1h. 7. Diet Regular, no salt substitutes. -Discontinue ACE inhibitors, angiotensin II receptor blockers, beta-blockers, potassium sparing diuretics. -Calcium gluconate 10 solution 10-30 mL IV over 2-5 min second dose may be given in 5 min. Contraindicated if...
APap smear report
1. A description of specimen type. Conventional Pap smear, liquid based cytology, or other. 2. A description of specimen adequacy. 3. A general categorization optional . Negative, epithelial cell abnormality, or other see interpretation below . 4. An interpretation result. Either the specimen is negative for intraepithelial lesions and malignancy although organisms or reactive changes may be present or there is an epithelial cell abnormality or there is another finding. 5. A description of any...
Pleural Effusion
4. Vital Signs q shift. Call physician if BP gt 160 90, lt 90 60 P gt 120, lt 50 R gt 25, lt 10 T gt 38.5 C 8. Extras CXR PA and LAT, repeat after thoracentesis left and right lateral decubitus x-rays, ECG, ultrasound, PPD pulmonary consult. 9. Labs CBC, SMA 7 amp 12, protein, albumin, amylase, ANA, ESR, INR PTT, UA. Cryptococcal antigen, histoplasma antigen, fungal culture. Tube 1 LDH, protein, amylase, triglyceride, glucose 10 mL . Tube 2 Gram stain, C amp S, AFB, fungal C amp S 20-60 mL,...
Hypernatremia 1
6. Nursing Inputs and outputs, daily weights. If volume depleted or hypotensive, give NS 20-40 mL kg IV until adequate circulation, then give D5 NS IV to replace half of body water deficit over first 24h. Correct serum sodium slowly at 0.5-1 mEq L hr. Correct remaining deficit over next 48-72h. Body water deficit liter 0.6 x weight kg x serum Na -140 Hypernatremia with ECF Volume Excess -Furosemide Lasix 1 mg kg IV. -D5 1 4 NS to correct body water deficit. 10. Labs SMA 7, osmolality,...
Severe Gastroenteritis with Fever Gross Blood and Neutrophils in Stool E coli
-Ceftriaxone Rocephin 50-75 mg kg day IV IM q 12-24h, max 4 gm day OR -Cefixime Suprax 8 mg kg day PO bid-qd, max 400 mg day susp 100 mg 5 mL tabs 200, 400 mg OR -Trimethoprim Sulfamethoxazole Bactrim, Septra 10 mg of TMP component kg day PO bid x 5-7d, max 320 mg TMP day susp per 5 mL TMP 40 mg SMX 200 mg tab DS TMP 160 mg SMX 800 mg tab SS TMP 80mg SMX 400 mg . Salmonella treat infants and patients with septicemia -Ceftriaxone Rocephin 50-75 mg kg day IV IM q12-24h, max 4 gm day OR -Cefixime...
Crohns Disease
4. Vital Signs q8h. Call physician if BP gt 160 90, lt 90 60 P gt 120, lt 50 R gt 25, lt 10 T gt 38.5 C 6. Nursing Inputs and outputs. NG at low intermittent suction if obstruction . 7. Diet NPO except for ice chips and medications for 48h, then low residue or elemental diet, no milk products. 8. IV Fluids 1-2 L NS over 1-3h, then D5 NS with 40 mEq KCL L at 125 cc hr. -Mesalamine Asacol 400-800 mg PO tid or mesalamine Pentasa 1000 mg four 250 mg tabs PO qid OR -Sulfasalazine Azulfidine 0.5-1 gm...
Bronchiolitis
6. Nursing Pulse oximeter, peak flow rate. Respiratory isolation. -Oxygen, humidified 1-4 L min by NC or 40-60 by mask, keep sat gt 92 . -Albuterol Ventolin, Proventil 5 mg mL sln nebulized 0.2-0.5 mL in 2 mL NS 0.10-0.15 mg kg q1-4h prn. Treatment of Respiratory Syncytial Virus severe lung disease or underlying cardiopulmonary disease -Ribavirin Virazole therapy should be considered in high risk children lt 2 yrs with chronic lung disease or with history of premature birth less than 35 weeks...
Renal Failure
4. Vital Signs q8h. Call physician if QRS complex gt 0.14 sec urine output lt 20 cc hr BP gt 160 90, lt 90 60 P gt 120, lt 50 R gt 25, lt 10 T gt 38.5 C. 5. Allergies Avoid magnesium containing antacids, salt substitutes, NSAIDS. Discontinue phosphate or potassium supplements. 7. Nursing Daily weights, inputs and outputs, chart urine output. If no urine output for 4h, in-and-out catheterize. Guaiac stools. 8. Diet Renal diet of high biologic value protein of 0.6-0.8 g kg, sodium 2 g, potassium...
Pneumonia
4. Vital Signs q4-8h. Call physician if BP gt 160 90, lt 90 60 P gt 120, lt 50 R gt 25, lt 10 T gt 38.5 C or O2 saturation lt 90 . 5. Activity Up ad lib, bathroom privileges. 6. Nursing Pulse oximeter, inputs and outputs, nasotracheal suctioning prn, incentive spirometry. 8. IV Fluids IV D5 NS at 125 cc hr. -Oxygen by NC at 2-4 L min, or 24-50 by Ventimask, or 100 by non-rebreather reservoir to maintain O2 saturation gt 90 . Moderately Ill Patients Without Underlying Lung Disease From the...
Acute Gastroenteritis
2. Diagnosis Acute Gastroenteritis 4. Vital Signs q6h call physician if BP gt 160 90, lt 80 60 P gt 120 R gt 25 T gt 38.5 C. 6. Nursing Daily weights, inputs and outputs. 7. Diet NPO except ice chips for 24h, then low residual elemental diet no milk products. 8. IV Fluids 1-2 L NS over 1-2 hours then D5 NS with 40 mEq KCL L at 125 cc h. Febrile or gross blood in stool or neutrophils on microscopic exam or prior travel -Ciprofloxacin Cipro 500 mg PO bid OR -Levofloxacin Levaquin 500 mg PO qd OR...
ACE Inhibitors
-Quinapril Accupril 5-10 mg PO qd x 1 dose, then 20-80 mg PO qd in 1 to 2 divided doses 5, 10, 20, 40 mg OR -Lisinopril Zestril, Prinivil 5-40 mg PO qd 5, 10, 20, 40 mg OR -Benazepril Lotensin 10-20 mg PO qd-bid, max 80 mg d 5, 10, 20, 40 mg OR -Fosinopril Monopril 10-40 mg PO qd, max 80 mg d 10, 20 mg OR -Ramipril Altace 2.5-10 mg PO qd, max 20 mg d 1.25, 2.5, 5, 10 mg . -Captopril Capoten 6.25-50 mg PO q8h 12.5, 25,50,100 mg OR -Enalapril Vasotec 1.25-5 mg slow IV push q6h or 2.5-20 mg PO bid...
Cellulitis
4. Vital Signs tid. Call physician if BP lt 90 60 T gt 38.5 C 6. Nursing Keep affected extremity elevated warm compresses prn. 7. Diet Regular, encourage fluids. 8. IV Fluids Heparin lock with flush q shift. 9. Special Medications Empiric Therapy Cellulitis -Nafcillin or oxacillin 1-2 gm IV q4-6h OR -Vancomycin 1 gm q12h 1 gm in 250 cc D5W over 1h OR -Dicloxacillin 500 mg PO qid may add penicillin VK, 500 mg PO qid, to increase coverage for streptococcus OR -Cephalexin Keflex 500 mg PO qid....
Enteral Nutrition
General Considerations Daily weights, inputs and outputs, naso-duodenal feeding tube. Head-of-bed at 30 while enteral feeding and 2 hours after completion. Enteral Bolus Feeding Give 50-100 mL of enteral solution Pulmocare, Jevity, Vivonex, Osmolite, Vital HN q3h. Increase amount in 50 mL steps to max of 250-300 mL q3-4h 30 kcal of nonprotein calories kg d and 1.5 gm protein kg d. Before each feeding, measure residual volume, and delay feeding by 1h if gt 100 mL. Flush tube with 100 cc of water...
Chronic Obstructive Pulmonary Disease
2. Diagnosis Exacerbation of COPD 4. Vital Signs q4h. Call physician if P gt 130 R gt 30, lt 10 T gt 38.5 C O2 saturation lt 90 . 5. Activity Up as tolerated bedside commode. 6. Nursing Pulse oximeter. Measure peak flow with portable peak flow meter bid and chart with vital signs. No sedatives. 7. Diet No added salt, no caffeine. Push fluids. 8. IV Fluids D5 1 2 NS with 20 mEq KCL L at 125 cc h. -Oxygen 1-2 L min by NC or 24-35 by Venturi mask, keep O2 saturation 90-91 . Beta-Agonists, Acute...
Refractory Pharyngitis
-Amoxicillin clavulanate Augmentin 40 mg kg day of amoxicillin PO q8h x 7-10d, max 500 mg dose susp 125 mg 5 mL, 250 mg 5 mL tabs 250, 500 mg tabs, chew 125, 250 mg OR -Dicloxacillin Dycill, Dynapen, Pathocil 50 mg kg day PO qid, max 2 gm day caps 125, 250, 500 elixir 62.5 mg 5 mL OR -Cephalexin Keflex 50 mg kg day PO qid-tid, max 4 gm day caps 250, 500 mg drops 100 mg mL susp 125 mg 5 mL, Prophylaxis 5 strep infections in 6 months -Penicillin V Potassium Pen Vee K 40 mg kg day PO bid, max 3 gm...
Dehydration
6. Nursing Inputs and outputs, daily weights. Urine specific gravity q void. 8. IV Fluids Maintenance Fluids 10-20 kg 1000 mL plus 50 mL kg 24h for each kg gt 10 kg gt 20 kg 1500 mL plus 20 mL kg 24h for each kg gt 20 kg. Glucose 5-10 gm 100 mL water required D5W - D10W Normal to orthostatic, gt 10 mm Hg change Not visible except with supraclavic-ular pressure Not visible even with supraclavicular pressure Delayed capillary refill, 2-4 sec decreased turgor Very delayed capillary refill gt 4 sec...
Hepatic Encephalopathy
2. Diagnosis Hepatic encephalopathy 4. Vital Signs q1-4h, neurochecks q4h. Call physician if BP gt 160 90, lt 90 60 P gt 120, lt 50 R gt 25, lt 10 T gt 38.5 C. 5. Allergies Avoid sedatives, NSAIDS or hepatotoxic drugs. 7. Nursing Keep head-of-bed at 40 degrees, guaiac stools turn patient q2h while awake, chart stools. Seizure precautions, egg crate mattress, soft restraints prn. Record inputs and outputs. Foley to closed drainage. 8. Diet NPO for 8 hours, then low-protein nasogastric enteral...
Septic Arthritis
5. Activity Up in chair as tolerated. Bedside commode with assistance. 6. Nursing Warm compresses prn, keep joint immobilized. Passive range of motion exercises of the affected joint bid. Empiric Therapy for Adults without Gonorrhea Contact -Nafcillin or oxacillin 2 gm IV q4h AND Ceftizoxime Cefizox 1 gm IV q8h or ceftazidime 1 gm IV q8h or ciprofloxacin 400 mg IV q12h if Gram stain indicates presence of Gram negative organisms. Empiric Therapy for Adults with Gonorrhea -Ceftriaxone Rocephin 1...
Infective Endocarditis
2. Diagnosis Infective endocarditis 4. Vital Signs q4h. Call physician if BP systolic gt 160 90, lt 90 60 P gt 120, lt 50 R gt 25, lt 10 T gt 38.5 C 5. Activity Up ad lib, bathroom privileges. 7. IV Fluids Heparin lock with flush q shift. Subacute Bacterial Endocarditis Empiric Therapy -Penicillin G 3-5 million U IV q4h or ampicillin 2 gm IV q4h AND Gentamicin 1-1.5 mg kg IV q8h. Acute Bacterial Endocarditis Empiric Therapy -Gentamicin 2 mg kg IV then 1-1.5 mg kg IV q8h AND Nafcillin or...
Torsades de Pointes Ventricular Tachycardia
-Correct underlying causes, including hypomagnesemia, and hypokalemia, and consider discontinuing quinidine, procain-amide, disopyramide, moricizine, amiodarone, sotalol, ibutilide, phenothiazine, haloperidol, tricyclic and tetracyclic antidepres-sants, ketoconazole, itraconazole, bepridil. -Magnesium sulfate 1-4 gm in IV bolus over 5-15 min, or infuse 3-20 mg min for 7-48h until QTc interval lt 440 msec. -Isoproterenol Isuprel , 2-20 mcg min 2 mg in 500 mL D5W, 4 mcg mL . -Consider ventricular...
NonST Segment Elevation Myocardial Infarction NSTEMI and Unstable Angina
1. Admit to Coronary care unit 2. Diagnosis Acute coronary syndrome 4. Vital Signs q1h. Call physician if pulse gt 90, lt 60 BP gt 150 90, lt 90 60 R gt 25, lt 12 T gt 38.5C. 5. Activity Bed rest with bedside commode. 7. Nursing Guaiac stools. If patient has chest pain, obtain 12-lead ECG and call physician. 8. Diet Cardiac diet, 1-2 gm sodium, low fat, low cholesterol. No caffeine or temperature extremes. 10. Special Medications -Oxygen 2-4 L min by NC. -Aspirin 325 mg PO, chew and swallow...
Tetanus
History of One or Two Primary Immunizations or Unknown Low risk wound - Tetanus toxoid 0.5 mL IM. Tetanus prone - Tetanus toxoid 0.5 mL IM, plus tetanus immunoglobulin TIG 250 U IM. Three Primary Immunizations and 10 yrs or more Since Last Low risk wound - Tetanus toxoid, 0.5 mL IM. Tetanus prone - Tetanus toxoid, 0.5 mL IM. Three Primary Immunizations and 5-10 yrs Since Last Booster Low risk wound - None Tetanus prone - Tetanus toxoid 0.5 mL IM. Three Primary Immunizations and lt 5 yrs Since...
Active Pulmonary Tuberculosis
2. Diagnosis Active Pulmonary Tuberculosis 5. Activity Up ad lib in room. 6. Nursing Respiratory isolation. -Isoniazid 300 mg PO qd 5 mg kg d, max 300 mg d AND Rifampin 600 mg PO qd 10 mg kg d, 600 mg d max AND Pyrazinamide 500 mg PO bid-tid 15-30 mg kg d, max 2.5 gm AND Ethambutol 400 mg PO bid-tid 15-25 mg kg d, 2.5 gm d max . -Empiric treatment consists of a 4-drug combination of isoniazid INH , rifampin, pyrazinamide PZA , and either ethambutol or streptomycin. A modified regimen is...
New Onset Diabetes
2.Diagnosis New Onset Diabetes Mellitus 6.Nursing Record labs on a flow sheet. Fingerstick glucose at 0700, 1200, 1700, 2100, 0200 diabetic and dietetic teaching. 7.Diet Diabetic diet with 1000 kcal 100 kcal year of age. 3 meals and 3 snacks between each meal and qhs. 8.IV Fluids Hep-lock with flush q shift. 9.Special Medications -Goal is preprandial glucose of 100-200 mg dL -Divide 2 3 before breakfast and 1 3 before dinner. Give 2 3 of total insulin requirement as NPH and give 1 3 as lispro...
Hypocalcemia
4. Vital Signs q4h. Call physician if BP gt 160 90, lt 90 60 P gt 120, lt 50 R gt 25, lt 10 T gt 38.5 C or any abnormal mental status. -Calcium chloride, 10 270 mg calcium 10 mL vial , give 5-10 mL slowly over 10 min or dilute in 50-100 mL of D5W and infuse over 20 min, repeat q20-30 min if symptomatic, or hourly if asymptomatic. Correct hyperphosphatemia before hypocalcemia OR -Calcium gluconate, 20 mL of 10 solution IV 2 vials 90 mg elemental calcium 10 mL vial infused over 10-15 min,...
Pelvic Inflammatory Disease
2. Diagnosis Pelvic Inflammatory Disease PID -Ofloxacin Floxin, 400 mg PO twice daily or levofloxacin Levaquin, 500 mg once daily with or without metronidazole Flagyl, 500 mg twice daily for 14 days. OR -Ceftriaxone Rocephin, 250 mg IM , cefoxitin Mefoxin, 2 g IM plus probenecid 1 g orally , or another parenteral third-generation cephalosporin, followed by doxycycline 100 mg orally twice daily with or without metronidazole for 14 days. Quinolones are not recommended to treat gonorrhea acquired...
Anaphylaxis
4. Vital Signs q1-4h call physician if BP systolic gt 160, lt 90 diastolic gt 90, lt 60 P gt 120, lt 50 R gt 25, lt 10 T gt 38.5 C 6. Nursing O2 at 6 L min by NC or mask. Keep patient in Trendelenburg's position, No. 4 or 5 endotracheal tube at bedside. Foley to closed drainage. 8. IV Fluids 2 IV lines. Normal saline or LR 1 L over 1-2h, then D5 NS at 125 cc h. -Gastric lavage with normal saline until clear fluid if indicated for recent oral ingestion. -Activated charcoal 50-100 gm, followed by...
Viral Laryngotracheitis Croup
6. Nursing Pulse oximeter, laryngoscope and endotracheal tube at bedside. Respiratory isolation, inputs and outputs. -Oxygen, cool mist, 1-2 L min by NC or 40-60 by mask, keep sat gt 92 . -Racemic epinephrine 2.25 sln 0.05 mL kg dose max 0.5 mL in 2-3 mL saline nebulized q1-6h. -Dexamethasone Decadron 0.25-0.5 mg kg dose IM IV q6h prn, max dose 10 mg OR -Prednisone 1-2 mg kg day PO q12-24h x 3-5 days syr 1mg mL, tabs 1, 2.5, 5, 10, 20, 50 mg -Prednisolone 1-2 mg kg day PO q12-24h x 3-5 days 5...
Osteomyelitis
4. Vital Signs qid. Call physician if BP lt 90 60 T gt 38.5 C. 5. Activity Bed rest with bathroom privileges. 6. Nursing Keep involved extremity elevated. Range of motion exercises tid. 8. IV Fluids Heparin lock with flush q shift. 9. Special Medications Adult Empiric Therapy -Nafcillin or oxacillin 2 gm IV q4h OR -Cefazolin Ancef 1-2 gm IV q8h OR -Vancomycin 1 gm IV q12h 1 gm in 250 cc D5W over 1h . -Add 3rd generation cephalosporin if gram negative bacilli on Gram stain. Treat for 4-6 weeks....