Pain in Older Adults

Oral Health/Oral Hygiene



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Appendix 1

Appendix 2

Appendix 3

Meadow Lane Nursing Facility

26 Meadow Lane, Sunnyvale, IA 5111

319-123-4567 | 319-456-7890 |


To: C. Smith, NP

From: College of Nursing

Fax: 319-562-9812

Phone: 319-562-9813

Re: Patient Status

Pages: 2

Date: 10.15.17

  • Urgent
  • For Review
  • Please comment
  • Please reply

Resident Name: Margaret Anderson

DOB: 06-15-1935

Physician/ARNP: C. Smith, NP, ARNP

Nurse: Scott

Allergies: NKA

Vitals: NA


  • Weight loss 6# in 2 weeks
  • Taking 20-30% general diet; fluids ok
  • Resistance to am cares

Recommendations/New Orders PCP:


Dietician to see for caloric needs

Calculate BMI

Will see next regular visit

Appendix 4

Prescriber Sig/Date : C. Smith, NP, ARNP

Date: 10.15.17

Prescriber Print Name: C. Smith NP, ARNP

Meadow Lane Nursing Facility

26 Meadow Lane, Sunnyvale, IA 5111

319-123-4567 | 319-456-7890 |

Resident Name: Margaret Anderson


  1. Oral care bid
  2. Schedule Dental Appointment
  3. No dentures until evaluation by dentist
  4. Soft foods, dietician to recommend protein supplement
  5. APAP 1 gm tid x 2 weeks, hold prn APAP x 2 week
  6. Tramadol 50 mg po, 1 tab 18h prn x 2 weeks, severe pain not relieved by APAP

Physician/ARNP: C. Smith, NP, ARNP

Date: 10.29.17

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