Expiry Date Sep 01, 2018 11:59 PM EDT
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CLOCK MANAGEMENT AND SEQUENCING
| Exam: | Focused physical examination (as mentioned in "Scoring") |
|---|---|
| Order: | Urinary or serum qualitative beta-HCG |
| Clock: | Advance clock to next available resultNote: HCG result (positive) |
| Location: | Transfer patient to the ward |
| Order: | NPO, vital Q1 hr, IV access, IV Normal saline 0.9%, complete bedrest, quantitative serum beta-HCG, transvaginal ultrasonography, type and cross matching, blood group and Rh, CBC with diff., PT/ PTT , BMP, LFTs, cervical gonococcal and chlamydial cultures The above orders should be placed as “stat”. |
| Clock: | Advance clock to obtain results of TVS and quantitative HCGNote: TVS confirms the diagnosis of ectopic pregnancyNote: quantitative HCG 2000 mIU/mLNote: Rh+ (no need for RhoGAM) |
| Order: | OB/GYN consult, MTX, morphine |
| Clock: | Advance to obtain Ob/gyn recommendations |
| Order: | Cancel: NPO, vitals, IV access, NSS, and complete bedrestOrder rest at homeCounseling (as mentioned in the approach to the case) |
| Location: | Change location to home |
| Clock: | Appointment in 4 daysCase ends |
| Final Orders: | None |
| Primary diagnosis: | Ectopic pregnancy |
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