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ICU Post-op Orders for Cardiac Surgery

This document outlines post-operative orders for a patient in the intensive care unit following cardiac surgery. The orders include monitoring vital signs frequently, urine output, chest tube drainage, cardiac output measurements, peripheral pulses, IV fluids and medications. Specific instructions are provided for ventilation settings, oxygen therapy, suctioning, physiotherapy, pacemaker checks, pain medications, antibiotics and vasoactive drugs to control blood pressure.

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profarmah
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185 views1 page

ICU Post-op Orders for Cardiac Surgery

This document outlines post-operative orders for a patient in the intensive care unit following cardiac surgery. The orders include monitoring vital signs frequently, urine output, chest tube drainage, cardiac output measurements, peripheral pulses, IV fluids and medications. Specific instructions are provided for ventilation settings, oxygen therapy, suctioning, physiotherapy, pacemaker checks, pain medications, antibiotics and vasoactive drugs to control blood pressure.

Uploaded by

profarmah
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd

Intensive Care Unit (ICU) Post-operative Orders for Cardiac Surgery

1. Vital signs q15min, then q1h when stable


2. Urine output q1h until extubation, then q2h
3. Chest tubes at -20 cm H 2 O suction. Record chest tube loss q15min x 1h, then q1h if
hemodynamically stable
4. Auto-transfuse chest drainage
5. Cardiac output calculations now and q6h
6. Check peripheral pulses q1h x 4 then q4h
7. Central line IV D5W TKVO
8. K+ replacement - to be decided depending on urine output and last K + value
9. Peripheral IV NS TKVO
10. 12 lead ECG now then daily x 3 days
11. Ventilation e.g. VT 700 mL, FiO 2 50%, Rate 12/min, Peep 5 cm/H 2O to keep PaCO 2 between 35-45
mmHg
12. Titrate FiO 2 to keep PO 2 > 90 mmHg or O 2 sat > 95%
13. Suction ETT prn and chest care as per assessment
14. Physiotherapy: assessment and treatment
15. Pacemaker connected and checked by MD
16. Morphine sulphate 1-6 mg IV q1h PRN
17. Indomethacin supp 50-100 mg pr q1h x 2 PRN (avoid if diabetic, renal failure, peptic ulcer disease, or
age > 75)
18. Gravol 25-50 mg IV/IM q4h PRN x 2 days
19. Cefazolin 1 g IV q8h in 50 cc D5W x 3 doses (Vancomycin 300 mg to 1 g IV q12h if pen-allergic)
20. Propofol 200 mg IV in 100 cc D5W PRN
21. Sodium nitroprusside 50 mg IV in 250 cc D5W to keep SBP < 140 mmHg
22. Nitroglycerin 100 mg IV in 250 cc D5W PRN
23. Dopamine 200 mg IV in 250 cc D5W PRN to keep SBP > 90 mmHg

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