/clinical/,/clinical/cckm-tools/,/clinical/cckm-tools/content/,/clinical/cckm-tools/content/beacon-protocols/,/clinical/cckm-tools/content/beacon-protocols/hem---leukemia/,

/clinical/cckm-tools/content/beacon-protocols/hem---leukemia/name-96827-en.cckm

201611320

page

100

UWHC,UWMF,

Clinical Hub,UW Health Clinical Tool Search,UW Health Clinical Tool Search,Beacon Protocols,Hem - Leukemia

CSC HEM Bosutinib(28D:1-28) VER 10-3-16 (HL 5111)

CSC HEM Bosutinib(28D:1-28) VER 10-3-16 (HL 5111) - Clinical Hub, UW Health Clinical Tool Search, UW Health Clinical Tool Search, Beacon Protocols, Hem - Leukemia


CSC HEM BOSUTINIB (28D:1-28) VER: 10-3-16 – Properties
Pre-Cycle – 11/8/2016 through 11/14/2016 (7 days), Planned
Day 1, Pre-Cycle – Planned for 11/8/2016
Treatment Plan Information
Treatment Plan Summary
DISEASE: Chronic Myeloid Leukemia (Chronic, Accelerated, or Blast); THERAPY: bosutinib 500 mg by mouth once daily
continuously; CYCLE LENGTH: 28 days; COURSE: 3 cycles followed by THERAPY: bosutinib 500 mg by mouth once daily
continuously; CYCLE LENGTH: 84 days; COURSE: until disease progression.
Consent
Verify Consent
Verify informed consent has been obtained.
Pre-Labs
CBC WITH DIFFERENTIAL
Expected-S Approximate, Expires-S+365, Routine
ELECTROLYTES
Expected-S Approximate, Expires-S+397, Routine
GLUCOSE
Expected-S Approximate, Expires-S+397, Routine
BUN
Expected-S Approximate, Expires-S+397, Routine
CREATININE
Expected-S Approximate, Expires-S+397, Routine
CALCIUM
Expected-S Approximate, Expires-S+397, Routine
ALBUMIN
Expected-S Approximate, Expires-S+397, Routine
PROTEIN, TOTAL
Expected-S Approximate, Expires-S+397, Routine
BILIRUBIN, TOTAL
Expected-S Approximate, Expires-S+397, Routine
AST/SGOT
Expected-S Approximate, Expires-S+397, Routine
ALT/SGPT
Expected-S Approximate, Expires-S+397, Routine
ALKALINE PHOSPHATASE
Expected-S Approximate, Expires-S+397, Routine
MAGNESIUM
Expected-S Approximate, Expires-S+365, Routine
Cycle 1 – 11/15/2016 through 12/12/2016 (28 days), Planned
Day 1, Cycle 1 – Planned for 11/15/2016
Treatment Plan Information
Reference Information (1)
CHRONIC MYELOID LEUKEMIA: Khoury HJ, et al. Blood 2012;119(15):3403-12.
Reference Information (2)
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ZZtestonc,Andrew [2428787]
11/15/2016 3:51:41 PM Page 1 of 9
Copyright © 201� University of Wisconsin Hospitals and Clinics Authority
Contact: Lee Vermeulen, CCKM@uwhealth.org Last Revised: 11/2016CCKM@uwhealth.org

CHRONIC MYELOID LEUKEMIA: Cortes JE, et al. Blood 2011;118(17):4567-76.
Treatment Plan Summary
DISEASE: Chronic Myeloid Leukemia (Chronic, Accelerated, or Blast); THERAPY: bosutinib 500 mg by mouth once daily
continuously; CYCLE LENGTH: 28 days; COURSE: 3 cycles followed by THERAPY: bosutinib 500 mg by mouth once daily
continuously; CYCLE LENGTH: 84 days; COURSE: until disease progression.
Consent
Verify Consent
Verify informed consent has been obtained.
IV Access
Insert and Maintain Peripheral IV
CONTINUOUS Starting when released Until Specified
Peripheral IV Size: RN Discretion
Additional PIV may be inserted as needed for repeat blood sampling or IV medication administration.
Treatment Conditions
Verify Labs
Verify pretreatment labs have been obtained: CBC with DIFF, AST, ALT, Total Bilirubin.
Treatment Parameters
Hold and notify authorizing prescriber for: ANC less than 1000/µL or Platelets less than 50K/µL or AST greater than 5 X ULN or ALT
greater than 5 X ULN (ALT greater than 3 X ULN and AST greater than 3 X ULN if in conjunction with Total Bilirubin greater than 2 X
ULN).
Nursing Procedure, Assessment and Monitoring
Flush Venous Access Device per Guidelines
Order details
sodium chloride flush 0.9% 10 mL injection
Flush, PRN Starting when released Until Discontinued, flush/line care
Flush per VAD guidelines.
heparin 10 UNIT/ML lock flush injection 1-150 units
1-150 units, Flush, PRN Starting when released Until Discontinued, flush/line care
Flush per VAD guidelines.
heparin 100 UNIT/ML lock flush injection 500 units
500 units, Flush, PRN Starting when released Until Discontinued, flush/line care
Implanted port use ONLY to be used when de-accessing port. Flush per VAD guidelines.
Treatment Medications
See Take Home Medication(s)
Refer to the take home medications section for the following treatment medication: bosutinib (dispensed Day 1 of Cycle 1 only -
subsequent refills will be ordered through the medication activity).
Take Home Medications
bosutinib (BOSULIF) 500 MG tab
Take 1 tab by mouth one time daily. Take with food. 30 tablets = 1 bottle., 500 mg, Disp-30 tab, R-0, 1 X DAILY starting S, Local
Printer
Follow-Up
DAY 8 FOLLOW-UP
LABS: CBC with DIFF.
DAY 15 FOLLOW-UP
LABS: CBC with DIFF.
DAY 22 FOLLOW-UP
LABS: CBC with DIFF.
DAY 29 FOLLOW-UP
RETURN TO CLINIC for appointment with provider; LABS: CBC with DIFF, Total Bilirubin, AST, ALT, Alkaline Phosphatase,
Magnesium, Potassium.
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ZZtestonc,Andrew [2428787]
11/15/2016 3:51:41 PM Page 2 of 9
Copyright © 201� University of Wisconsin Hospitals and Clinics Authority
Contact: Lee Vermeulen, CCKM@uwhealth.org Last Revised: 11/2016CCKM@uwhealth.org

Lab Only - Day 8 , Cycle 1 – Planned for 11/22/2016
Treatment Plan Information
Treatment Plan Summary
DISEASE: Chronic Myeloid Leukemia (Chronic, Accelerated, or Blast); THERAPY: bosutinib 500 mg by mouth once daily
continuously; CYCLE LENGTH: 28 days; COURSE: 3 cycles followed by THERAPY: bosutinib 500 mg by mouth once daily
continuously; CYCLE LENGTH: 84 days; COURSE: until disease progression.
IV Access
Insert and Maintain Peripheral IV
CONTINUOUS Starting when released Until Specified
Peripheral IV Size: RN Discretion
Additional PIV may be inserted as needed for repeat blood sampling or IV medication administration.
Pre-Labs
CBC WITH DIFFERENTIAL
Expected-S+7 Approximate, Expires-S+365, Routine
Follow-Up
VERIFY APPOINTMENTS
Verify next day appointment(s) have been scheduled. See follow-up section on Day 1.
Lab Only - Day 15, Cycle 1 – Planned for 11/29/2016
Treatment Plan Information
Treatment Plan Summary
DISEASE: Chronic Myeloid Leukemia (Chronic, Accelerated, or Blast); THERAPY: bosutinib 500 mg by mouth once daily
continuously; CYCLE LENGTH: 28 days; COURSE: 3 cycles followed by THERAPY: bosutinib 500 mg by mouth once daily
continuously; CYCLE LENGTH: 84 days; COURSE: until disease progression.
IV Access
Insert and Maintain Peripheral IV
CONTINUOUS Starting when released Until Specified
Peripheral IV Size: RN Discretion
Additional PIV may be inserted as needed for repeat blood sampling or IV medication administration.
Pre-Labs
CBC WITH DIFFERENTIAL
Expected-S+14 Approximate, Expires-S+365, Routine
Follow-Up
VERIFY APPOINTMENTS
Verify next day appointment(s) have been scheduled. See follow-up section on Day 1.
Lab Only - Day 22, Cycle 1 – Planned for 12/6/2016
Treatment Plan Information
Treatment Plan Summary
DISEASE: Chronic Myeloid Leukemia (Chronic, Accelerated, or Blast); THERAPY: bosutinib 500 mg by mouth once daily
continuously; CYCLE LENGTH: 28 days; COURSE: 3 cycles followed by THERAPY: bosutinib 500 mg by mouth once daily
continuously; CYCLE LENGTH: 84 days; COURSE: until disease progression.
IV Access
Insert and Maintain Peripheral IV
CONTINUOUS Starting when released Until Specified
Peripheral IV Size: RN Discretion
Additional PIV may be inserted as needed for repeat blood sampling or IV medication administration.
Pre-Labs
CBC WITH DIFFERENTIAL
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ZZtestonc,Andrew [2428787]
11/15/2016 3:51:41 PM Page 3 of 9
Copyright © 201� University of Wisconsin Hospitals and Clinics Authority
Contact: Lee Vermeulen, CCKM@uwhealth.org Last Revised: 11/2016CCKM@uwhealth.org

Expected-S+21 Approximate, Expires-S+365, Routine
Follow-Up
VERIFY APPOINTMENTS
Verify next day appointment(s) have been scheduled. See follow-up section on Day 1.
Cycle 2 – 12/13/2016 through 1/9/2017 (28 days), Planned
Day 1, Cycle 2 – Planned for 12/13/2016
Treatment Plan Information
Treatment Plan Summary
DISEASE: Chronic Myeloid Leukemia (Chronic, Accelerated, or Blast); THERAPY: bosutinib 500 mg by mouth once daily
continuously; CYCLE LENGTH: 28 days; COURSE: 3 cycles followed by THERAPY: bosutinib 500 mg by mouth once daily
continuously; CYCLE LENGTH: 84 days; COURSE: until disease progression.
Consent
Verify Consent
Verify informed consent has been obtained.
IV Access
Insert and Maintain Peripheral IV
CONTINUOUS Starting when released Until Specified
Peripheral IV Size: RN Discretion
Additional PIV may be inserted as needed for repeat blood sampling or IV medication administration.
Pre-Labs
CBC WITH DIFFERENTIAL
Expected-S+28 Approximate, Expires-S+365, Routine
BILIRUBIN, TOTAL
Expected-S+28 Approximate, Expires-S+365, Routine
AST/SGOT
Expected-S+28 Approximate, Expires-S+365, Routine
ALT/SGPT
Expected-S+28 Approximate, Expires-S+365, Routine
ALKALINE PHOSPHATASE
Expected-S+28 Approximate, Expires-S+365, Routine
MAGNESIUM
Expected-S+28 Approximate, Expires-S+365, Routine
POTASSIUM
Expected-S+28 Approximate, Expires-S+365, Routine
Treatment Conditions
Verify Labs
Verify pretreatment labs have been obtained: CBC with DIFF, AST, ALT, Total Bilirubin.
Treatment Parameters
Hold and notify authorizing prescriber for: ANC less than 1000/µL or Platelets less than 50K/µL or AST greater than 5 X ULN or ALT
greater than 5 X ULN (ALT greater than 3 X ULN and AST greater than 3 X ULN if in conjunction with Total Bilirubin greater than 2 X
ULN).
Nursing Procedure, Assessment and Monitoring
Flush Venous Access Device per Guidelines
Order details
sodium chloride flush 0.9% 10 mL injection
Flush, PRN Starting when released Until Discontinued, flush/line care
Flush per VAD guidelines.
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ZZtestonc,Andrew [2428787]
11/15/2016 3:51:41 PM Page 4 of 9
Copyright © 201� University of Wisconsin Hospitals and Clinics Authority
Contact: Lee Vermeulen, CCKM@uwhealth.org Last Revised: 11/2016CCKM@uwhealth.org

heparin 10 UNIT/ML lock flush injection 1-150 units
1-150 units, Flush, PRN Starting when released Until Discontinued, flush/line care
Flush per VAD guidelines.
heparin 100 UNIT/ML lock flush injection 500 units
500 units, Flush, PRN Starting when released Until Discontinued, flush/line care
Implanted port use ONLY to be used when de-accessing port. Flush per VAD guidelines.
Treatment Medications
Oral Chemotherapy Order Management
For this regimen, bosutinib will be ordered through the medication activity after the initial order.
Follow-Up
DAY 29 FOLLOW-UP
RETURN TO CLINIC for appointment with provider; LABS: CBC with DIFF, Total Bilirubin, AST, ALT, Alkaline Phosphatase,
Magnesium, Potassium.
Cycle 3 – 1/10/2017 through 2/6/2017 (28 days), Planned
Day 1, Cycle 3 – Planned for 1/10/2017
Treatment Plan Information
Treatment Plan Summary
DISEASE: Chronic Myeloid Leukemia (Chronic, Accelerated, or Blast); THERAPY: bosutinib 500 mg by mouth once daily
continuously; CYCLE LENGTH: 28 days; COURSE: 3 cycles followed by THERAPY: bosutinib 500 mg by mouth once daily
continuously; CYCLE LENGTH: 84 days; COURSE: until disease progression.
Consent
Verify Consent
Verify informed consent has been obtained.
IV Access
Insert and Maintain Peripheral IV
CONTINUOUS Starting when released Until Specified
Peripheral IV Size: RN Discretion
Additional PIV may be inserted as needed for repeat blood sampling or IV medication administration.
Pre-Labs
CBC WITH DIFFERENTIAL
Expected-S+28 Approximate, Expires-S+365, Routine
BILIRUBIN, TOTAL
Expected-S+28 Approximate, Expires-S+365, Routine
AST/SGOT
Expected-S+28 Approximate, Expires-S+365, Routine
ALT/SGPT
Expected-S+28 Approximate, Expires-S+365, Routine
ALKALINE PHOSPHATASE
Expected-S+28 Approximate, Expires-S+365, Routine
MAGNESIUM
Expected-S+28 Approximate, Expires-S+365, Routine
POTASSIUM
Expected-S+28 Approximate, Expires-S+365, Routine
Treatment Conditions
Verify Labs
Verify pretreatment labs have been obtained: CBC with DIFF, AST, ALT, Total Bilirubin.
Treatment Parameters
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ZZtestonc,Andrew [2428787]
11/15/2016 3:51:41 PM Page 5 of 9
Copyright © 201� University of Wisconsin Hospitals and Clinics Authority
Contact: Lee Vermeulen, CCKM@uwhealth.org Last Revised: 11/2016CCKM@uwhealth.org

Hold and notify authorizing prescriber for: ANC less than 1000/µL or Platelets less than 50K/µL or AST greater than
5 X ULN or ALT greater than 5 X ULN (ALT greater than 3 X ULN and AST greater than 3 X ULN if in conjunction
with Total Bilirubin greater than 2 X ULN).
Nursing Procedure, Assessment and Monitoring
Flush Venous Access Device per Guidelines
Order details
sodium chloride flush 0.9% 10 mL injection
Flush, PRN Starting when released Until Discontinued, flush/line care
Flush per VAD guidelines.
heparin 10 UNIT/ML lock flush injection 1-150 units
1-150 units, Flush, PRN Starting when released Until Discontinued, flush/line care
Flush per VAD guidelines.
heparin 100 UNIT/ML lock flush injection 500 units
500 units, Flush, PRN Starting when released Until Discontinued, flush/line care
Implanted port use ONLY to be used when de-accessing port. Flush per VAD guidelines.
Treatment Medications
Oral Chemotherapy Order Management
For this regimen, bosutinib will be ordered through the medication activity after the initial order.
Follow-Up
DAY 29 FOLLOW-UP
RETURN TO CLINIC for appointment with provider; LABS: CBC with DIFF, Total Bilirubin, AST, ALT, Alkaline Phosphatase,
Magnesium, Potassium.
Cycle 4 – 2/7/2017 through 5/1/2017 (84 days), Planned
Day 1, Cycle 4 – Planned for 2/7/2017
Treatment Plan Information
Treatment Plan Summary
DISEASE: Chronic Myeloid Leukemia (Chronic, Accelerated, or Blast); THERAPY: bosutinib 500 mg by mouth once daily
continuously; CYCLE LENGTH: 28 days; COURSE: 3 cycles followed by THERAPY: bosutinib 500 mg by mouth once daily
continuously; CYCLE LENGTH: 84 days; COURSE: until disease progression.
Consent
Verify Consent
Verify informed consent has been obtained.
IV Access
Insert and Maintain Peripheral IV
CONTINUOUS Starting when released Until Specified
Peripheral IV Size: RN Discretion
Additional PIV may be inserted as needed for repeat blood sampling or IV medication administration.
Pre-Labs
CBC WITH DIFFERENTIAL
Expected-S+28 Approximate, Expires-S+365, Routine
BILIRUBIN, TOTAL
Expected-S+28 Approximate, Expires-S+365, Routine
AST/SGOT
Expected-S+28 Approximate, Expires-S+365, Routine
ALT/SGPT
Expected-S+28 Approximate, Expires-S+365, Routine
ALKALINE PHOSPHATASE
Expected-S+28 Approximate, Expires-S+365, Routine
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ZZtestonc,Andrew [2428787]
11/15/2016 3:51:41 PM Page 6 of 9
Copyright © 201� University of Wisconsin Hospitals and Clinics Authority
Contact: Lee Vermeulen, CCKM@uwhealth.org Last Revised: 11/2016CCKM@uwhealth.org

MAGNESIUM
Expected-S+28 Approximate, Expires-S+365, Routine
POTASSIUM
Expected-S+28 Approximate, Expires-S+365, Routine
Treatment Conditions
Verify Labs
Verify pretreatment labs have been obtained: CBC with DIFF, AST, ALT, Total Bilirubin.
Treatment Parameters
Hold and notify authorizing prescriber for: ANC less than 1000/µL or Platelets less than 50K/µL or AST greater than 5 X ULN or ALT
greater than 5 X ULN (ALT greater than 3 X ULN and AST greater than 3 X ULN if in conjunction with Total Bilirubin greater than 2 X
ULN).
Nursing Procedure, Assessment and Monitoring
Flush Venous Access Device per Guidelines
Order details
sodium chloride flush 0.9% 10 mL injection
Flush, PRN Starting when released Until Discontinued, flush/line care
Flush per VAD guidelines.
heparin 10 UNIT/ML lock flush injection 1-150 units
1-150 units, Flush, PRN Starting when released Until Discontinued, flush/line care
Flush per VAD guidelines.
heparin 100 UNIT/ML lock flush injection 500 units
500 units, Flush, PRN Starting when released Until Discontinued, flush/line care
Implanted port use ONLY to be used when de-accessing port. Flush per VAD guidelines.
Treatment Medications
Oral Chemotherapy Order Management
For this regimen, bosutinib will be ordered through the medication activity after the initial order.
Follow-Up
DAY 85 FOLLOW-UP
RETURN TO CLINIC for appointment with provider; LABS: CBC with DIFF, Total Bilirubin, AST, ALT, Alkaline Phosphatase,
Magnesium, Potassium.
Cycle 5 – 5/2/2017 through 7/24/2017 (84 days), Planned
Day 1, Cycle 5 – Planned for 5/2/2017
Treatment Plan Information
Treatment Plan Summary
DISEASE: Chronic Myeloid Leukemia (Chronic, Accelerated, or Blast); THERAPY: bosutinib 500 mg by mouth once daily
continuously; CYCLE LENGTH: 28 days; COURSE: 3 cycles followed by THERAPY: bosutinib 500 mg by mouth once daily
continuously; CYCLE LENGTH: 84 days; COURSE: until disease progression.
Consent
Verify Consent
Verify informed consent has been obtained.
IV Access
Insert and Maintain Peripheral IV
CONTINUOUS Starting when released Until Specified
Peripheral IV Size: RN Discretion
Additional PIV may be inserted as needed for repeat blood sampling or IV medication administration.
Pre-Labs
CBC WITH DIFFERENTIAL
Expected-S+84 Approximate, Expires-S+365, Routine
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ZZtestonc,Andrew [2428787]
11/15/2016 3:51:41 PM Page 7 of 9
Copyright © 201� University of Wisconsin Hospitals and Clinics Authority
Contact: Lee Vermeulen, CCKM@uwhealth.org Last Revised: 11/2016CCKM@uwhealth.org

BILIRUBIN, TOTAL
Expected-S+84 Approximate, Expires-S+365, Routine
AST/SGOT
Expected-S+84 Approximate, Expires-S+365, Routine
ALT/SGPT
Expected-S+84 Approximate, Expires-S+365, Routine
ALKALINE PHOSPHATASE
Expected-S+84 Approximate, Expires-S+365, Routine
MAGNESIUM
Expected-S+84 Approximate, Expires-S+365, Routine
POTASSIUM
Expected-S+84 Approximate, Expires-S+365, Routine
Treatment Conditions
Verify Labs
Verify pretreatment labs have been obtained: CBC with DIFF, AST, ALT, Total Bilirubin.
Treatment Parameters
Hold and notify authorizing prescriber for: ANC less than 1000/µL or Platelets less than 50K/µL or AST greater than 5 X ULN or ALT
greater than 5 X ULN (ALT greater than 3 X ULN and AST greater than 3 X ULN if in conjunction with Total Bilirubin greater than 2 X
ULN).
Nursing Procedure, Assessment and Monitoring
Flush Venous Access Device per Guidelines
Order details
sodium chloride flush 0.9% 10 mL injection
Flush, PRN Starting when released Until Discontinued, flush/line care
Flush per VAD guidelines.
heparin 10 UNIT/ML lock flush injection 1-150 units
1-150 units, Flush, PRN Starting when released Until Discontinued, flush/line care
Flush per VAD guidelines.
heparin 100 UNIT/ML lock flush injection 500 units
500 units, Flush, PRN Starting when released Until Discontinued, flush/line care
Implanted port use ONLY to be used when de-accessing port. Flush per VAD guidelines.
Treatment Medications
Oral Chemotherapy Order Management
For this regimen, bosutinib will be ordered through the medication activity after the initial order.
Follow-Up
DAY 85 FOLLOW-UP
RETURN TO CLINIC for appointment with provider; LABS: CBC with DIFF, Total Bilirubin, AST, ALT, Alkaline Phosphatase,
Magnesium, Potassium.
Cycle 6 – 7/25/2017 through 10/16/2017 (84 days), Planned
Day 1, Cycle 6 – Planned for 7/25/2017
Treatment Plan Information
Treatment Plan Summary
DISEASE: Chronic Myeloid Leukemia (Chronic, Accelerated, or Blast); THERAPY: bosutinib 500 mg by mouth once daily
continuously; CYCLE LENGTH: 28 days; COURSE: 3 cycles followed by THERAPY: bosutinib 500 mg by mouth once daily
continuously; CYCLE LENGTH: 84 days; COURSE: until disease progression.
Consent
Verify Consent
Verify informed consent has been obtained.
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ZZtestonc,Andrew [2428787]
11/15/2016 3:51:41 PM Page 8 of 9
Copyright © 201� University of Wisconsin Hospitals and Clinics Authority
Contact: Lee Vermeulen, CCKM@uwhealth.org Last Revised: 11/2016CCKM@uwhealth.org

IV Access
Insert and Maintain Peripheral IV
CONTINUOUS Starting when released Until Specified
Peripheral IV Size: RN Discretion
Additional PIV may be inserted as needed for repeat blood sampling or IV medication administration.
Pre-Labs
CBC WITH DIFFERENTIAL
Expected-S+84 Approximate, Expires-S+365, Routine
BILIRUBIN, TOTAL
Expected-S+84 Approximate, Expires-S+365, Routine
AST/SGOT
Expected-S+84 Approximate, Expires-S+365, Routine
ALT/SGPT
Expected-S+84 Approximate, Expires-S+365, Routine
ALKALINE PHOSPHATASE
Expected-S+84 Approximate, Expires-S+365, Routine
MAGNESIUM
Expected-S+84 Approximate, Expires-S+365, Routine
POTASSIUM
Expected-S+84 Approximate, Expires-S+365, Routine
Treatment Conditions
Verify Labs
Verify pretreatment labs have been obtained: CBC with DIFF, AST, ALT, Total Bilirubin.
Treatment Parameters
Hold and notify authorizing prescriber for: ANC less than 1000/µL or Platelets less than 50K/µL or AST greater than 5 X ULN or ALT
greater than 5 X ULN (ALT greater than 3 X ULN and AST greater than 3 X ULN if in conjunction with Total Bilirubin greater than 2 X
ULN).
Nursing Procedure, Assessment and Monitoring
Flush Venous Access Device per Guidelines
Order details
sodium chloride flush 0.9% 10 mL injection
Flush, PRN Starting when released Until Discontinued, flush/line care
Flush per VAD guidelines.
heparin 10 UNIT/ML lock flush injection 1-150 units
1-150 units, Flush, PRN Starting when released Until Discontinued, flush/line care
Flush per VAD guidelines.
heparin 100 UNIT/ML lock flush injection 500 units
500 units, Flush, PRN Starting when released Until Discontinued, flush/line care
Implanted port use ONLY to be used when de-accessing port. Flush per VAD guidelines.
Treatment Medications
Oral Chemotherapy Order Management
For this regimen, bosutinib will be ordered through the medication activity after the initial order.
Follow-Up
DAY 85 FOLLOW-UP
RETURN TO CLINIC for appointment with provider; LABS: CBC with DIFF, Total Bilirubin, AST, ALT, Alkaline Phosphatase,
Magnesium, Potassium.
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ZZtestonc,Andrew [2428787]
11/15/2016 3:51:41 PM Page 9 of 9
Copyright © 201� University of Wisconsin Hospitals and Clinics Authority
Contact: Lee Vermeulen, CCKM@uwhealth.org Last Revised: 11/2016CCKM@uwhealth.org