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/clinical/cckm-tools/content/order-sets/ambulatory/cardiologyct-surgery/name-111583-en.cckm

20170110

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OP - Antiarrhythmic Management Delegation Protocol - Adult - Ambulatory [6260]

OP - Antiarrhythmic Management Delegation Protocol - Adult - Ambulatory [6260] - Clinical Hub, UW Health Clinical Tool Search, UW Health Clinical Tool Search, Order Sets, Ambulatory, Cardiology/CT Surgery


OP - ANTIARRHYTHMIC MANAGEMENT DELEGATION PROTOCOL - ADULT
[6260]
Antiarrhythmic Management Delegation Protocol URL: https://uconnect.wisc.edu/clinical/cckm-
tools/content/delegationpractice-
protocols/ambulatory-delegation-protocols/name-
110096-en.cckm
Documentation
Documentation [104911]
Blank Progress Note BLANK PROGRESS NOTE
Orders
flecainide (TAMBOCOR) [214806]
ECG - 12 Lead [EKG0008] Status: Future, Expires: 1/9/18, Normal, Routine,
Reason for exam: Routine monitoring for flecainide
therapy.
Creatinine [CRET] Status: Standing, Expires:1/9/18 Manual,Count:1,
Normal, Routine
propafenone (RYTHMOL) [214807]
ECG - 12 Lead [EKG0008] Status: Future, Expires: 1/9/18, Normal, Routine,
Reason for exam: Routine monitoring for propafenone
therapy
dofetilife (TIKOSYN) [214809]
ECG - 12 Lead [EKG0008] Status: Future, Expires: 1/9/18, Normal, Routine,
Reason for exam: Routine monitoring for dofetilide
therapy.
Creatinine [CRET] Status: Standing, Expires:1/9/18 Manual,Count:1,
Normal, Routine
Potassium [K] Status: Standing, Expires:1/9/18 Manual,Count:1,
Normal, Routine
Magnesium [MAG] Status: Standing, Expires:1/9/18 Manual,Count:1,
Normal, Routine
sotalol (BETAPACE AF) [214810]
ECG - 12 Lead [EKG0008] Status: Future, Expires: 1/9/18, Normal, Routine,
Reason for exam: Routine monitoring for sotalol
therapy.
CREATININE [CRET] Status: Standing, Expires:1/9/18 Manual,Count:1,
Normal, Routine
POTASSIUM [K] Status: Standing, Expires:1/9/18 Manual,Count:1,
Normal, Routine
MAGNESIUM [MAG] Status: Standing, Expires:1/9/18 Manual,Count:1,
Normal, Routine
dronedarone (MULTAQ) [214811]
ECG - 12 Lead [EKG0008] Status: Future, Expires: 1/9/18, Normal, Routine,
Reason for exam: Routine monitoring for
dronedarone therapy.
Potassium [K] Status: Standing, Expires:1/9/18 Manual,Count:1,
Normal, Routine
AST/SGOT [AST] Status: Standing, Expires:1/9/18 Manual,Count:1,
Normal, Routine
ALT/SGPT [ALT] Status: Standing, Expires:1/9/18 Manual,Count:1,
Normal, Routine
BILIRUBIN, TOTAL [TBIL] Status: Future, Expires: 1/9/18, Normal, Routine
amiodarone (CORDARONE) [214812]
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Copyright © 2017 University of Wisconsin Hospitals and Clinics Authority

ECG - 12 Lead [EKG0008] Status: Future, Expires: 1/9/18, Normal, Routine,
Reason for monitoring: Routine monitoring for
amiodarone therapy
X-Ray Chest PA & LAT Views [R71020] Status: Future, Expires: 1/9/18, Normal, Routine
Pulmonary Lab Testing [999992] Routine
Reason for Exam: Routine monitoring for amiodarone
therapy
Specify Test: Spirometry, Lung Volumes, Diffusing
Capacity
Specify location (if desired):
PFT Breathing Capacity Test [94010] Status: Future, Expires: 1/9/18, Normal, Routine,
Qty-1
TSH [TSH] Status: Future, Expires: 1/9/18, Normal, Routine
AST/SGOT [AST] Status: Future, Expires: 1/9/18, Normal, Routine
ALT/SGPT [ALT] Status: Future, Expires: 1/9/18, Normal, Routine
Diagnosis
DX - Medication Monitoring [214813]
Medication management [471669] Encounter for other specified aftercare
Page 2 of 2
Printed by DUNHAM, DEBORAH B [DBD0] at 1/9/2017 3:03:30 PM
Copyright © 2017 University of Wisconsin Hospitals and Clinics Authority