Pt Name:Derick Shepherd
French National Health Care Coverage 
MR # 000-000-000-7 
Allergies: None
DOB 07/04/1973
Code Status: Full Code

Medications - Scheduled
Time Time: Now Next Day PM Next Day AM 2 hr later Admission
PenVK 500 mg. bid by mouth Done Done Done   Done

Metoprolol 12.5 mg. bid by mouth

 Done Done Done   Done

Zantac 150 mg po daily

 Done   Done   Done

Protonix drip 40 mg in 100 ml at 8ml/hr for 24 hr

  D/Ced     Done Done

Synthroid 50 mcg po  daily

 Done   Done   Done
Lisinopril 40 mg. daily by mouth Done   Done   Done

Humalog (insulin lispro) Insulin sliding scale (moderate dose),  0-12 units q 6H hs, <70 initiate hypoglycemia protocol
70-140 = 0 units
141 – 180 = 2 units
181- 220 = 4 units
221 – 260 = 6 units
261 – 300 = 8 units
301 – 340 = 10 units

>340 = 12 units and call MD

     6 units   10 units
PRNs Below
Time Time: Now Next day pm Next day am 2 hr later Admission
Oxycodone 5 mg. q 4 hrs. by mouth prn  D/Ced Done Done Done Done
Glucose (Dextrose 50% injection 50ml) 25 gm push,prn, use if blood glucose is less than 70 mg/dl IV          
Medications - IV Soulutions
Time Time: Now Next day pm Next day am 2 hr later Admission
NS at 125 ml/hr IV D/Ced Done Done Done Done
           
VS H and P Meds Labs Plans For Discharge