Orders

Question 1

What are Admission Orders?

Answer 1

Initial written directives by the doctor for the care and treatment of the patient.

Question 2

What are common components of an admission order?

Answer 2

1. Admitting diagnosis (ex. Abd pain, NYD)
2. Diet order (ex. FF)
3. Activity order (ex. AAT)
4. Diagnostic tests/procedures order (ex. CBC)
5. Nursing Observation order (ex. RVS)
6. Medication order (ex. Advil 2 tabs q4h prn)
7. Treatment order (ex. change dressing bid)
8. Patient code status order (ex. DNR)
9. Miscellaneous order (ex. request for old records)

Question 3

What are Activity Orders?

Answer 3

Refers to the amount of walking, sitting and other motions that the patient may do in a given period during his or her hospital stay.

Question 4

CBR

Answer 4

complete bedrest

Question 5

BR c BRP

Answer 5

bedrest with bathroom privileges

Question 6

Dangle

Answer 6

The patient may sit and dangle their feet over the edge of the bed.

Question 7

Up in chair c assist

Answer 7

The patient may sit in a chair with the assitance of a member of the nursing staff.

Question 8

BRP when A & O

Answer 8

The patient may use the bathroom as desired when alert and oriented.

Question 9

Up in hall

Answer 9

The patient may walk the hall

Question 10

Up as tol

Answer 10

The patient may be out of bed as much as they can physically tolerate

Question 11

Up ad lib

Answer 11

The patient has no restrictions on activity

Question 12

OOB

Answer 12

The patient may be out of bed.

Question 13

Amb

Answer 13

The patient must ambulate (walk) for prescribed periods of time

Question 14

Walk c assistance

Answer 14

Physio or RN will assist patient to walk

Question 15

AAT

Answer 15

activty as tolerated

Question 16

What is the role of Nutrition Services?

Answer 16

1. To meet the therapeutic needs and dietary preferences of the patient.
2. Preparing and serving food for patients.
3. To aid in development and monitoring of special therapeutic diets.
4. Providing dietary information to patients.

Question 17

What are Diet Orders?

Answer 17

A doctor’s order that states the type and quantity of food and liquids the patient may receive.

Question 18

List the common dietary orders:

Answer 18

1. Regular / General
2. GI soft
3. Mechanical Soft
4. Pureed / Minced
5. No thin liquids / thick fluids only
6. Diabetic Diet
7. Renal Diet
8. Neutropenic
9. Lactose Controlled
10. Nothing by Mouth (NPO)
11. Clear Fluids (CF)
12. Full Fluids (FF)
13. Cardiac Diet
14. Controlled Sodium
15. Controlled Calorie
16. Tube Feed
17. Dysphagia / Thickened
18. DAT

Question 19

Regular / General Diet

Answer 19

For patients with no dietary restrictions.

Question 20

GI soft Diet

Answer 20

For patients with nausea and distention.

Question 21

Mechanical Soft Diet

Answer 21

For patients who have trouble chewing or swallowing.

Question 22

Pureed / Minced Diet

Answer 22

For patients with problems chewing and swallowing ex. no dentures

Question 23

No thin liquids / thick fluids only Diet

Answer 23

To prevent choking.

Question 24

Diabetic Diet

Answer 24

For patients who cannot produce enough insulin.

Question 25

Renal Diet

Answer 25

For patients with kidney disease.

Question 26

Neutropenic Diet

Answer 26

To reduce the number of bacteria entering the stomach for patients on chemotherapy or those with immune deficiency diseases.

Question 27

Lactose controlled Diet

Answer 27

For patients who experience stomach disturbances after consuming milk products.

Question 28

Nothing by mouth (NPO) Diet

Answer 28

For patients pre/post surgery, scheduled for procedures, or tests as indicated.

Question 29

Clear fluids Diet

Answer 29

For patients whose digestive systems should not, or cannot digest whole foods.

Question 30

Full fluids Diet

Answer 30

For patients who cannot eat solid foods.

Question 31

Cardiac Diet

Answer 31

Low sodium, no sugar, low cholesterol.

Question 32

Controlled sodium Diet

Answer 32

For patients with heart disease, high blood pressure, kidney disease, or may be using certain drugs.

Question 33

Controlled calorie Diet

Answer 33

Calorie reduced or restricted diet.

Question 34

Dysphagia / Thickened

Answer 34

Thickened fluids for patients with swallowing difficulites.

Question 35

DAT

Answer 35

Diet as tolerated - allows the nursing staff to advance patients diet as tolerated without phoning the Doctor for a new order.

Question 36

List 5 Miscellaneous Diet Orders

Answer 36

1. hold tray / early or late tray - for patients going to or returing from OR, tests or treatments. 2. fluid restrictions - for patients retaining fluids in tissues (edema) 3. push or force fluids - patients are dehydrated and require additional juices, tea etc. 4. natural laxatives - bran, fruitlax etc. 5. calorie count - a 24-hour calorie count record. RN records each item patient has eaten on the calorie count sheet.

Question 37

Who receives snacks between meals? Who receives a snack before bed?

Answer 37

Patients on special diets recieve a SNACK between meals which is delivered to the unit and given to the patient by the RN. Patients who are diabetic recieve a snack before bedtime.

Question 38

What food supplies does the NUC order?

Answer 38

Juice, bread, becel/butter, jell-o, ice cream, milk, sugar, cheese, crackers, ginger ale, popsicles, peanut butter, jam etc.