Physician's Orders - Uncertain Etiology

CPER TRACK IV: Chest pain of uncertain etiology

1. Condition: Guarded.
2. Bedrest x3 hours, advance if pain free.
3. When meal service appropriate, may have Soft Diet as tolerated.
4. Rapid Assay Troponin-T
5. 12 Lead EKG on arrival, repeat for persistent pain, change in status or symptoms or when clinically indicated.
6. Cardiac monitoring. Document rhythm Q2H.
7. Nasal O2 at __________ L/min by cannula.
8. Check V.S. on arrival. If stable repeat in 1 hour, then if stable repeat Q2H. Record.
9. Tympanic temperature on arrival, then Q4H. Record.
10. Portable Chest X-Ray.
11. Initiate I.V. access with saline lock.
12. STAT CBC, FBS., Lytes, BUN, CR.
13. Myoglobin at 0, 2, and 4 hours.
14. CPK/MB at 0, 6, and 12 hours.
15. Schedule patient for initialed test based on consult with cardiologist/attending physician.

CPER TRACK I: Acute MI
CPER TRACK II: Probable Unstable Angina or Non-Q Wave Infarction
CPER TRACK III: Suspected Ischemia
CPER TRACK IV: Uncertain Etiology
CPER TRACK V: Non-Cardiac Chest Pain

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