INPATIENT INTERVENTIONAL RADIOLOGY PLAN - Phase: Pre-Procedure Orders

Similar documents
PHYSICIAN ORDERS Diagnosis

UMC Health System Patient Label Here PHYSICIAN ORDERS

PEDIATRIC SPINE SURGERY POST-OP PLAN - Phase:.

PEDIATRIC SPINE SURGERY POST-OP PLAN - Phase: Pediatric Spine Surgery General Orders

Pediatric Outpatient Surgery Plan - Diagnostic/Pre-Op Orders

PICU BRONCHIOLITIS PLAN

PICU Therapeutic Hypothermia Post Cardiac Arrest Re Warming Phase

Gabapentin Research Pain Study for Ortho Total Knee Replacement Post-Op Plan - PACU Ortho Phase

PICU ADMIT DKA PLAN - Phase: Begin Immediately

ORTHO TOTAL KNEE REPLACEMENT POST-OP PLAN - Phase: PACU Ortho Phase

EPIDURAL / INTRATHECAL POST-OP PLAN

Therapeutic Hypothermia for Post Cardiac Arrest Plan Initial Orders

UMC Health System Patient Label Here. PHYSICIAN ORDERS Diagnosis

GENERAL SURGERY POST-OP PLAN

PICU TRAUMA PLAN - Phase:.

PEDIATRIC PICU TRAUMA PLAN EKM - Phase: PICU Trauma Plan

PHYSICIAN SIGNATURE DATE TIME DRUG ALLERGIES WT: KG

UMC Health System Patient Label Here. PHYSICIAN ORDERS Diagnosis

UMC Health System Patient Label Here. PHYSICIAN ORDERS Diagnosis

ENT THYROIDECTOMY/PARATHYROIDECTOMY POST OP PLAN - Phase: Begin Immediately/PACU

THROMBOLYTIC THERAPY FOR PERIPHERAL OCCLUSION

OB/GYN ANTEPARTUM PLAN

IV Acetaminophen Pain Study for Neurosurgery Post Op Non ICU Admit Plan Begin Immediately/PACU

OB/GYN CESAREAN SECTION POST-OP PLAN - Phase: General Orders

Gabapentin Research Pain Study for Ortho Total Knee Replacement Post Op Plan PACU Ortho Phase

UMC Health System Patient Label Here PHYSICIAN ORDERS

OPEN AAA/MAJOR ABDOMINAL POST-OP PLAN - Phase:.

LYSIS OF ADHESIONS POST-OP PLAN - Phase: PACU Phase

ENT THYROIDECTOMY/PARATHYROIDECTOMY POST OP ADMIT PLAN - Phase: Begin Immediately/PACU

IR Central Venous Access [ ] Pre Procedure

OB/GYN POSTPARTUM VAGINAL DELIVERY PLAN

PHYSICIAN SIGNATURE DATE TIME DRUG ALLERGIES WT: KG

LIFEGIFT BRAIN DEATH PLAN

WHS POSTOPERATIVE POWERPLAN CHANGES

TRAUMA AND SURGICAL ICU PLAN

PEDIATRIC LIFEGIFT BRAIN DEATH PLAN

Physician Orders PEDIATRIC: : LEB ED Trauma (Major) Plan

CARD THORACOTOMY PRE-OP PLAN

GENERAL SURGERY PLAN - Phase:.

OB/GYN POSTPARTUM VAGINAL DELIVERY PLAN

ADMIT GENERAL MEDICINE PLAN - Phase: Begin Immediately

***SPECIAL CONSIDERATION:

UMC Health System Patient Label Here. PHYSICIAN ORDERS Diagnosis

GENERAL MEDICINE PLAN

PHYSICIAN SIGNATURE DATE TIME DRUG ALLERGIES WT: KG

PEDIATRIC ARGININE CLONIDINE STIMULATION TEST PLAN

DONATION AFTER CARDIAC DEATH PLAN

ADMIT DIABETIC KETOACIDOSIS (DKA) PLAN - Phase: Begin Immediately/Emergency Center

TRANSCATHETER AORTIC VALVE REPLACEMENT POST- OP ADMIT PLAN - Phase: Begin Immediately/PACU Phase

PHYSICIAN ORDERS Diagnosis

PHYSICIAN SIGNATURE DATE TIME DRUG ALLERGIES WT: KG

Zzbeacon,Zayna [MR ]

UMC Health System Patient Label Here. PHYSICIAN ORDERS Diagnosis

(31189) Hypothermia Initiation Phase One

RITUXIMAB RHEUMATOLOGY VASCULITIS

Sample. Affix patient label within this box.

NEUROSURGERY ICU PLAN

TRANSCATHETER AORTIC VALVE REPLACEMENT POST- OP PLAN - Phase:.

Emergency Department Chest Pain, Suspected Cardiac Adult Order Set

PEDIATRIC CYSTIC FIBROSIS PLAN - Phase:.

BARIATRIC SURGERY POST-OP PLAN - Phase: PACU Phase

Physician Orders ADULT: Sickle Cell Inpatient Plan

Zzbeacon,Zayna [MR ]

Neurosurgery Pre-Op [1710] Patient Name MRN. General. Nursing. Case Request [ ] Case request operating room Scheduling/ADT, Scheduling/ADT [ ] Other

Admit Heart Failure Plan - Begin Immediately

Physician Orders ADULT: Kidney-Panc/PancTransplant Post Op Plan

Physician Orders PEDIATRIC: LEB Oral Maxillofacial Post Op Plan

Bariatric Surgery Post Op Plan PACU Phase

Physician Orders ADULT: Head and Neck Postoperative Plan

NEUROSURGERY ICU PLAN

ADMIT STROKE NEUROINTERVENTION PLAN - Phase: Begin Immediately

UMC Health System Patient Label Here. PHYSICIAN ORDERS Diagnosis

STROKE NEUROINTERVENTION PLAN - Phase:.

Physician Orders ADULT: ANES Enhanced Recovery After Surgery (ERAS) Plan

Physician Orders ADULT: PCI Post Procedure Plan

ADMIT CHEST PAIN PLAN - Phase: Begin Immediately

Physician Orders Pediatric: LEB ED Asthma Plan

CARD POST CARDIAC CATHETERIZATION PLAN

Routine, Every 2 hours, Starting today, If temperature greater than 38.5 C initiate Evaluation for Possible Sepsis Physician Order #829

Physician Orders LEB PICU Status Epilepticus Plan. [ ] No known allergies

ALL orders are active unless: 1. Order is manually lined through to inactivate 2. Orders with check boxes ( ) are unchecked DRUG AND TREATMENT ORDERS

ISCHEMIC STROKE/TIA PLAN

SEPSIS PLAN - Phase:.

PHYSICIAN ORDER SET : Patient: DOB: Gender: Patient Phone #: Height: Weight:

Drug Max dose approved for IVP Dilution Rate Monitoring Parameters. Dilution not necessary (Available in prefilled syringe)

(30689) PROT Pain PCA Adult Patient Controlled Analgesia

Physician Orders ADULT: Acute MI/Acute Coronary Syndrome Adult Plan

Analgesic-Sedatives Drug Dose Onset

Standard Precautions Droplet Precautions Standard Precautions Contact Precautions Droplet Precautions Standard Precautions Neutropenic Precautions

CBC with Differential. PHYSICIAN SIGNATURE DATE TIME DRUG ALLERGIES WT: KG

Physician Orders. LEB NICU Sepsis Plan [X or R] = will be ordered unless marked out.

DOWNTIME Physician Order CARD CHF Heart Failure

Physician s Order Form. Physician s Order Form. Telemetry/Progressive Care Orders. Continued on next page. >>>>>>> Continued on next page.

CARD POST CARDIAC CATHETERIZATION PLAN

PHYSICIAN SIGNATURE DATE TIME DRUG ALLERGIES WT: KG

CARD OPEN HEART PRE-OP PLAN

INFLIXIMAB RHEUMATOLOGY LOAD DOSE (SCHEDULE WEEKS 0, 2, 6)

PHYSICIAN SIGNATURE DATE TIME DRUG ALLERGIES WT: KG

Injectable Opioid Shortage: February 27, 2018

Transcription:

- Phase: Pre-Procedure Orders DETAILS Patient Care Obtain Consent If one is not present on chart today. Vital Signs Per Policy Insert Peripheral Line T;N, Start IV on right side If left radial access is needed POC by Nursing POC Chem 8 POC Blood Sugar Check POC Hemoglobin and Hematocrit POC PT with INR Communication Misc Patient Care Order IV Solutions NS IV, 20 ml/hr LR IV, 20 ml/hr Medications Medication sentences are per dose. You will need to calculate a total daily dose if needed. Antibiotics ceftriaxone 1 g, IVPush, inj, OCTOR Reconstitute with 10mL of sterile water. Administer IVPush over 3 minutes. cefazolin 1 g, IVPush, inj, OCTOR Reconstitute with 10mL of sterile water. Administer IVPush over 3 minutes. ampicillin-sulbactam 1.5 g, IVPB, ivpb, OCTOR, Infuse over 30 min clindamycin 900 mg, IVPB, ivpb, OCTOR Other Medications To be used as premeds for Transarterial Chemoembolization (TACE): diphenhydramine 50 mg, IVPush, inj, OCTOR Premed for Transarterial Chemoembolization (TACE) ondansetron 8 mg, IVPush, soln, OCTOR Premed for Transarterial Chemoembolization (TACE) 1

- Phase: Pre-Procedure Orders DETAILS dexamethasone 10 mg, IVPush, inj, OCTOR Premed for Transarterial Chemoembolization (TACE) Used for Vascular Cases with Radial Arterial Access lidocaine-prilocaine topical (lidocaine-prilocaine 2.5%-2.5% topical cream) 1 app, topical, cream, OCTOR Used During Vascular Procedures with Radial Arterial Access verapamil 2.5 mg, IVPush, inj, OCTOR Used During Vascular Procedures with Radial Arterial Access heparin 3,000 units, intra-arterial push, inj, OCTOR Used During Vascular Procedures with Radial Arterial Access nitroglycerin 200 mcg, intra-arterial push, inj, OCTOR Used During Vascular Procedures with Radial Arterial Access Laboratory CBC with Differential STAT Prothrombin Time with INR (PT with INR) STAT Urine Beta hcg Urine, STAT Diagnostic Tests EKG-12 Lead STAT, Pre-Procedure Exam DX Chest Portable STAT, Pre-Procedure exam Respiratory Oxygen Therapy 2

- Phase: History and Physical Documentation Order Diagnosis Weight Allergies DETAILS Patient Care Sedation History and Physical Update T;N 3

- Phase: Intra-Procedure Orders DETAILS Patient Care Patient Position Lying on Left Side Lying on Right Side Prone Supine Other Sedation Medications at Bedside Medications Medication sentences are per dose. You will need to calculate a total daily dose if needed. Other Medications lidocaine (lidocaine 1% injectable solution) 10 ml, locally, inj, ONE TIME For port placement only: bupivacaine (bupivacaine 0.25% preservative-free injectable solution) 30 ml, locally, inj, ONE TIME lidocaine-epinephrine (lidocaine-epinephrine 1%-1:200,000 preservative-free injectable solution) 10 ml, locally, inj, ONE TIME mepivacaine (mepivacaine 1% injectable solution) 1 ml, locally, inj, ONE TIME gentamicin (gentamicin 80 mg/50 ml irrigation) 80 mg, irrigation, ivpb, ONE TIME Flush port pocket Reversal Agent flumazenil 0.2 mg, IVPush, inj, q1min, PRN excess sedation naloxone 0.2 mg, IVPush, inj, q2min, PRN bradypnea 4

- Phase: Post-Procedure Orders DETAILS Patient Care Patient Activity Up Ad Lib/Activity as Tolerated Bedrest Bedrest, Bed Position: HOB Flat Convert IV to INT POC by Nursing POC Blood Sugar Check Communication Confirm Line Placement - Cleared for Use (Cleared for Use - CVL) Notify Nurse (DO NOT USE FOR MEDS) Notify Nurse (DO NOT USE FOR MEDS) T;N, Okay to resume diet per primary team recommendation Notify Provider of VS Parameters (Notify Provider if VS) Diagnostic Tests DX Chest Portable STAT, Post-Procedure exam 5

- Phase: Medication Documentation DETAILS...Additional Orders 6

- Phase: SEDATION MEDICATION DOCUMENTATION PLAN DETAILS Communication Procedural Sedation Medications Guidelin (Procedural Sedation Medications Guidelines) Medications Medication sentences are per dose. You will need to calculate a total daily dose if needed. Analgesics: Opioids fentanyl 25 mcg, IVPush, inj, OCTOR 50 mcg, IVPush, inj, OCTOR 75 mcg, IVPush, inj, OCTOR 100 mcg, IVPush, inj, OCTOR HYDROmorphone 0.5 mg, IVPush, inj, OCTOR 1 mg, IVPush, inj, OCTOR 2 mg, IVPush, inj, OCTOR morphine 2 mg, IVPush, inj, OCTOR 4 mg, IVPush, inj, OCTOR 10 mg, IVPush, inj, OCTOR Sedatives LORazepam 0.5 mg, IVPush, inj, OCTOR 1 mg, IVPush, inj, OCTOR 2 mg, IVPush, inj, OCTOR midazolam 0.5 mg, IVPush, inj, OCTOR 2 mg, IVPush, inj, OCTOR 4 mg, IVPush, inj, OCTOR 5 mg, IVPush, inj, OCTOR 7

- Phase: SEDATION MEDICATION DOCUMENTATION PLAN DETAILS The Following Medications are for Deep Sedation Use Only dexmedetomidine (dexmedetomidine 20 mcg/10 ml) 25 mcg, Slow IVPush, inj, OCTOR 50 mcg, Slow IVPush, inj, OCTOR 100 mcg, Slow IVPush, inj, OCTOR etomidate 5 mg, IVPush, inj, OCTOR 10 mg, IVPush, inj, OCTOR 20 mg, IVPush, inj, OCTOR ketamine 50 mg, IVPush, inj, OCTOR 100 mg, IVPush, inj, OCTOR 200 mg, IVPush, inj, OCTOR propofol 10 mg, IVPush, inj, OCTOR 20 mg, IVPush, inj, OCTOR 50 mg, IVPush, inj, OCTOR 100 mg, IVPush, inj, OCTOR 8