Clonazepam Prescription

29. november 2011 at 10:01






























































Related article: 7.3. Post appointment dismissal and monitoring Following completion of the clinic/diagnostic appointment and after the attending staff (medical or dental) has determined that the client is stable, the client may return to his or her living area. Upon arrival at the living area, the nurse will evaluate the client and record Clonazepam Prescription the vital signs. The nurse should inform the physician/dentist of significant abnormal findings such as vomiting, labored respirations, cyanosis, aspiration, not arousable to verbal or tactile stimulation, blood pressure less than 90/60, pulse rate less than 60 or respiratory rate less than 12. Any clinic orders are reviewed and appropriate action taken. The client is monitored in accordance with facility protocol until the client has returned to baseline coordination and cognitive function. The client whose mental status was initially abnormal should have returned to his or her baseline. For example, the client should respond as usual to verbal and tactile stimulation. Since cognitive function and coordination may be impaired, a staff member should assist any client who has received any sedative medication until the effects are no longer noticeable. Such assistance would include aiding with ambulation, particularly in the transition from sitting or lying to standing and walking. 8. Prescribing Requirements The smallest dose required to achieve the desired level of relaxation Clonazepam Prescription should be prescribed. The dose may be titrated up as needed over subsequent clinic appointments provided minimal sedation levels and maximum doses are not exceeded. A table of approved medications that includes typical and maximum dosages is included in this policy. Typical doses are based on average healthy adults and should be adjusted accordingly to insure only minimal sedation is achieved. Whenever possible, the oral route Clonazepam Prescription should be selected as it is less invasive to the client. Combinations of these drugs should be used only after the single medications have proven to be ineffective in achieving minimal sedation appropriate for the clinical evaluation or procedure to be done. A physician/dentist may exceed the maximum recommended dose only with the clinical director�s approval. In these situations the prescribing physician must write a progress note justifying the higher dose and the record must reflect previous attempts at the maximum dose resulting in little or no sedative affect. The clinical director (or designee) must make a similar supporting progress note. Subsequent appointments for that client will not require additional notations. A physician/dentist may prescribe a medication not on the approved list only with the clinical director�s approval. In these situations the prescribing physician must write a progress note justifying the alternative medication and the record must reflect little or no sedative affects with the approved medications. The clinical director (or designee) must make a similar supporting progress note. Subsequent appointments for that client will not require additional notations. Table 1. Approved Sedative Medications Generic Name Route Typical Dose Maximum Dose ALPRAZolam (Xanax) PO 0.5 mg 2 mg Chloral Hydrate PO 500 mg 1000 mg ChlorproMAZINE PO 25 mg 50 mg Diazepam (Valium) PO 5 mg 20 mg Diphenhydramine PO 50 mg 100 mg Haloperidol (Haldol) PO or IM 5 mg 5 mg Haloperidol plus LORazepam (Ativan) IM 5 mg Haloperidol plus 2 mg Lorazepam 5 mg Haloperidol plus 4 mg Lorazepam HydrOXYzine (Vistaril) PO or IM 50 mg 100 mg LORazepam (Ativan) PO or IM 2 mg 4 mg Meperidine (Demerol) PO or IM 50 mg 50 mg Midazolam (Versed) IM 2 mg 5 mg Promethazine (Phenergan) PO or IM 25 mg 50 mg QUEtiapine (Seroquel) PO 50 mg 800 mg Ziprasidone (Geodon) IM
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