Walden University
NRNP 6550- Adv Pract Care AAC Setting II
Admission Orders Template
Primary Diagnosis: Acute Pericarditis
Status/Condition (Critical, Guarded, Stable, etc.): Guarded
Code Status: Full Code
Allergies: Bactrim
Admit to Unit: Cardiac telemetry
Activity Level: Bedrest with bathroom privileges
Diet: Cardiac Low-Sodium
IV Fluids: Saline lock
• Critical Drips (If ordered, include type and rate. Do not defer to ICU protocol.):
, None
Respiratory: Oxygen (If ordered, include type and rate.), pulmonary toilet needs, ventilator
settings: Oxygen via nasal cannula, titrate up to 6 lpm to maintain oxygen saturation ≥ 94%
Medications (include ALL, tx of primary condition, underlying conditions, pain, comfort needs, etc., dose and
route):
1. clopidogrel 75mg PO daily
2. atorvastatin 80mg PO nightly
3. lisinopril 2.5mg PO daily
4. carvedilol 3.125mg PO nightly
5. pantoprazole 40mg PO daily
6. aspirin 650mg PO every 8 hours
7. colchicine 0.6mg PO BID (Chiabrando et al., 2020)
8. acetaminophen 650mg PO every 6 hours PRN fever ≥ 100.4 F or mild pain
9. hydrocodone/acetaminophen 5/325mg 1 tablet PO every 6 hours PRN pain greater than 5/10
10. ondansetron 4mg IVP every 4 hours PRN nausea
Nursing Orders (vital signs, skin care, toileting, ambulation, etc.):
1. Vital signs every 4 hours
2. Bedrest with bathroom privileges
3. Continuous cardiac monitor
4. Continuous pulse oximetry
5. Monitor IOs every shift
NRNP 6550- Adv Pract Care AAC Setting II
Admission Orders Template
Primary Diagnosis: Acute Pericarditis
Status/Condition (Critical, Guarded, Stable, etc.): Guarded
Code Status: Full Code
Allergies: Bactrim
Admit to Unit: Cardiac telemetry
Activity Level: Bedrest with bathroom privileges
Diet: Cardiac Low-Sodium
IV Fluids: Saline lock
• Critical Drips (If ordered, include type and rate. Do not defer to ICU protocol.):
, None
Respiratory: Oxygen (If ordered, include type and rate.), pulmonary toilet needs, ventilator
settings: Oxygen via nasal cannula, titrate up to 6 lpm to maintain oxygen saturation ≥ 94%
Medications (include ALL, tx of primary condition, underlying conditions, pain, comfort needs, etc., dose and
route):
1. clopidogrel 75mg PO daily
2. atorvastatin 80mg PO nightly
3. lisinopril 2.5mg PO daily
4. carvedilol 3.125mg PO nightly
5. pantoprazole 40mg PO daily
6. aspirin 650mg PO every 8 hours
7. colchicine 0.6mg PO BID (Chiabrando et al., 2020)
8. acetaminophen 650mg PO every 6 hours PRN fever ≥ 100.4 F or mild pain
9. hydrocodone/acetaminophen 5/325mg 1 tablet PO every 6 hours PRN pain greater than 5/10
10. ondansetron 4mg IVP every 4 hours PRN nausea
Nursing Orders (vital signs, skin care, toileting, ambulation, etc.):
1. Vital signs every 4 hours
2. Bedrest with bathroom privileges
3. Continuous cardiac monitor
4. Continuous pulse oximetry
5. Monitor IOs every shift
