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Clinical Hub,UW Health Clinical Tool Search,UW Health Clinical Tool Search,Delegation/Practice Protocols,Ambulatory Delegation Protocols,Related

Cardiac Cath/EP - Study/Ablation - Adult - Preprocedure

Cardiac Cath/EP - Study/Ablation - Adult - Preprocedure - Clinical Hub, UW Health Clinical Tool Search, UW Health Clinical Tool Search, Delegation/Practice Protocols, Ambulatory Delegation Protocols, Related


Cardiac Cath/EP - Study/Ablation - Adult - Preprocedure [5181]
Intended for Adult Patients Only
Patient Care Orders
Vital Signs [139633]
Vital Signs [NURMON0013] ONCE, Starting today For 1 Occurrences, Routine
Temperature Measurement Method:
Temperature Measurement Restrictions:
BP Source:
BP Location: Bilateral Arms
BP Position:
BP Restrictions:
Obtain upon admission, Cardiac Cath/EP
Nutrition [139634]
Diet - NPO [NUT0001] EFFECTIVE NOW, Starting today, Routine
NPO (If patient receiving tube feeding see question 25): NPO
EXCEPT MEDICATIONS
Cardiac Cath/EP
Non-Categorized Patient Care Orders [146740]
Glucose, POC [IPGLUCOSE] STAT - RN COLLECT, Starting today For 1 Occurrences,
Routine
If Conditional, What Condition? Patients with Diabetes
Cardiac Cath/EP
Insert and Maintain Urinary Catheter [NURELM0013] CONTINUOUS, Starting today, Routine
Type: Indwelling Single Lumen
Indication for Placement:
Initiate Urinary Catheter Removal Protocol? (NP/PA Must
Select "No"): No: Urology or Gyn/Onc Patient/Other
Details: To Dependent Drainage
Irrigate With:
Irrigation Frequency:
Does this need to be inserted/placed?
To be placed by Electrophysiology Lab staff once patient is
sedated.
Urinary Catheter Removal Protocol does NOT apply to
Urology, Gynecology, spinal cord injured patients, patients
with catheters placed by Urology on prior admission, or to
patients with chronic foley catheters. Not appropriate for
Pediatric patients., Cardiac Cath/EP
Intravenous Therapy
Premedications for Needle Insertion [139592]
Use lidocaine topical dressing kit for stable patient, no lidocaine allergies, have at least 30 minutes time prior to needing
to use IV
Sodium chloride (bacteriostatic) 0.9% intradermal: Useful for patients requiring urgent IV access; onset is within 1 minute.
Choice of medication should be based on patient’s previous experience/preference, history of lidocaine allergy and ease
of access.
lidocaine (LMX) 4% topical dressing kit [66882] Topical, EVERY 1 HOUR PRN, peripheral line insertion - see
Admin Instructions
Do NOT apply to area greater than 200 square centimeters
(maximum 2.5 g/site; maximum 4 sites per hour, 6 times per
day). Do NOT leave on longer than 2 hours. Use for stable
patient, no allergies to lidocaine, with at least 30 minutes time
prior to IV use
Cardiac Cath/EP
lidocaine (XYLOCAINE) 1% injection [39034] 0.1-0.4 mL, Intradermal, PRN, peripheral line insertion - see
Admin Instructions
Use an insulin or TB syringe with a 25-30 gauge needle to
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Copyright © 2014 University of Wisconsin Hospital and Clinics Authority


inject solution and create a wheal. Wait 30 seconds to 1
minute then insert IV catheter into center of wheal. Use if IV
is needed within 30 minutes. Choice of medication should be
based on patient’s previous experience/preference, history of
lidocaine allergy and ease of access
Cardiac Cath/EP
sodium chloride (bacteriostatic) 0.9 % injection [50585] 0.05-0.1 mL, Intradermal, PRN, peripheral line insertion - see
Admin Instructions
Use an insulin or TB syringe with a 25-30 gauge needle to
inject solution and create a wheal. Wait 30 seconds to 1
minute then insert IV catheter into center of wheal. Use if IV
is needed within 30 minutes. Choice of medication should be
based on patient’s previous experience/preference, history of
lidocaine allergy and ease of access
Cardiac Cath/EP
Intravenous Fluids [139628]
Insert and Maintain Peripheral IV [NURVAD0013] CONTINUOUS, Starting today, Routine
Peripheral IV Device:
Peripheral IV Location:
Peripheral IV Size:
Peripheral IV Status:
Does this need to be inserted/placed?
Cardiac Cath/EP
sodium chloride 0.9 % infusion [64367] at 20 mL/hr, Intravenous, CONTINUOUS, Cardiac Cath/EP
Laboratory
On Arrival [139600]
ACTIVATED CLOTTING TIME, POC [HCACTPOC] STAT - RN COLLECT, Starting today For 1 Occurrences,
Routine
If Conditional, What Condition?
Cardiac Cath/EP
Laboratory [139601]
MAGNESIUM [MAG] STAT - RN COLLECT, Starting today For 1 Occurrences,
Routine
If add on test, what should lab do if unable to add test to
previous specimen?
If Conditional, What Condition?
Cardiac Cath/EP
ELECTROLYTES [LYTE] STAT - RN COLLECT, Starting today For 1 Occurrences,
Routine
If add on test, what should lab do if unable to add test to
previous specimen?
If Conditional, What Condition?
Cardiac Cath/EP
BUN [BUN] STAT - RN COLLECT, Starting today For 1 Occurrences,
Routine
If add on test, what should lab do if unable to add test to
previous specimen?
If Conditional, What Condition?
Cardiac Cath/EP
CREATININE [CRET] STAT - RN COLLECT, Starting today For 1 Occurrences,
Routine
If add on test, what should lab do if unable to add test to
previous specimen?
If Conditional, What Condition?
Cardiac Cath/EP
CBC WITHOUT DIFFERENTIAL [HEMO] STAT - RN COLLECT, Starting today For 1 Occurrences,
Routine
If add on test, what should lab do if unable to add test to
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Pr i nt ed by SPENCER, L I NDSEY M [LMS033] at 3/24/2014 2:45:10 PM
Copyright © 2014 University of Wisconsin Hospital and Clinics Authority


previous specimen?
If Conditional, What Condition?
Cardiac Cath/EP
Taking Warfarin [139603]
PROTHROMBIN TIME/INR [PT] STAT - RN COLLECT, Starting today For 1 Occurrences,
Routine
If Conditional, What Condition? For patients on warfarin
Cardiac Cath/EP
Blood Bank
Conditional-Patients with Atrial Fibrillation [139616]
TYPE AND SCREEN [HCTS] STAT - RN COLLECT, Starting today For 1 Occurrences,
Routine
As good clinical practice and for patient safety, the
Transfusion Service will automatically crossmatch 2 packed
RBC's on all patients with antibodies. Do you want to opt out
of this automatic order for this patient? No
Cardiac Cath/EP
Diagnostic Tests and Imaging
Diagnostic Tests and Imaging [139625]
ECG - 12 Lead [EKG0008] ONCE, Starting today For 1 Occurrences, Routine
Reason for exam:
Cardiac Cath/EP
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Pr i nt ed by SPENCER, L I NDSEY M [LMS033] at 3/24/2014 2:45:10 PM
Copyright © 2014 University of Wisconsin Hospital and Clinics Authority