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/clinical/cckm-tools/content/order-sets/ambulatory/general-surgery/name-98579-en.cckm

201711317

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100

UWHC,UWMF,

Tools,

Clinical Hub,UW Health Clinical Tool Search,UW Health Clinical Tool Search,Order Sets,Ambulatory,General Surgery

OP - Endocrine Surgery - Adult - Postoperative [4558]

OP - Endocrine Surgery - Adult - Postoperative [4558] - Clinical Hub, UW Health Clinical Tool Search, UW Health Clinical Tool Search, Order Sets, Ambulatory, General Surgery


OP - Endocrine Surgery - Adult - Postoperative [4558]
Post-Op/Phase II
Analgesics - Acetaminophen - PRN [224796]
acetaMINOPHEN (TYLENOL) tab RANGE
[750000]
325-650 mg, Oral, EVERY 4 HOURS PRN For 1
Doses, pain/fever, mild to moderate pain, multimodal
therapy, or fever greater than 38.2 C, Post-Op/Phase
II
acetaMINOPHEN alcohol free (TYLENOL) oral
suspension [800005]
650 mg, Oral, EVERY 4 HOURS PRN For 1 Doses,
pain/fever, mild to moderate pain, multimodal therapy,
or fever greater than 38.2 C, Post-Op/Phase II
Analgesics - Opioids - Oral PRN [224797]
oxycodone-acetaminophen (PERCOCET) 5-325
mg per tab RANGE [750033]
1-2 tab, Oral, EVERY 4 HOURS PRN For 1 Doses,
pain, severe pain
No more than 4 grams acetaminophen per 24 hours
for adults or 15mg/kg per dose for peds <40kg
Post-Op/Phase II
hydrocodone-acetaMINOPHEN (NORCO) 5-325
mg per tab RANGE [750021]
1-2 tab, Oral, EVERY 4 HOURS PRN For 1 Doses,
pain, severe pain
No more than 4 grams acetaminophen per 24 hours
for adults or 15mg/kg per dose for peds <40kg
Post-Op/Phase II
oxycodone 5 MG/5ML soln RANGE [750031] 5-10 mg, Oral, EVERY 4 HOURS PRN For 1 Doses,
pain, severe pain, Post-Op/Phase II
traMADOL (ULTRAM) tab [720174] 25-50 mg, Oral, EVERY 6 HOURS PRN, pain, severe
pain
Analgesics - Opioids - Intravenous - PRN [224798]
HYDROmorphone PF (DILAUDID) injection
RANGE [750050]
0.2-0.5 mg, Intravenous, EVERY 2 HOURS PRN For
1 Doses, evere pain when patient unable to tolerate
oral medications, for 3 Minutes, Post-Op/Phase II
MORPHine PF injection RANGE [750057] 1-2 mg, Intravenous, EVERY 2 HOURS PRN For 1
Doses, pain, evere pain when patient unable to
tolerate oral medications, for 4 Minutes, Post-
Op/Phase II
Non-Categorized [224799]
naloxone (NARCAN) injection [800199] 0.1 mg, Intravenous, PRN, opioid overdose
Administer every 3 minutes times 4 doses as needed
for respiratory rate less than 8 breaths/minute. Notify
physician if administered.
Laboratory [122678]
PTH [HCPTHIN] STAT For 1 Occurrences, Routine
If add on test, what should lab do if unable to add test
to previous specimen?
If Conditional, What Condition?
Post-Op/Phase II
Outpatient Discharge Orders
Prior to Discharge [92767]
Patient Must Be Seen by Attending Prior to
Discharge [NURMON0083]
ONCE, Starting today For 1 Occurrences, Routine,
Post-Op/Phase II
Patient Must Be Seen by Resident Prior to
Discharge [NURMON0082]
ONCE, Starting today For 1 Occurrences, Routine,
Post-Op/Phase II
Wound Care (Single Response) [122682]
Page 1 of 5
Printed by STRAKA, KEVIN F [KFS1] at 10/23/2017 5:28:43 PM
Copyright © 2017 University of Wisconsin Hospitals and Clinics Authority
Contact: Lee Vermeulen, CCKM@uwhealth.org Last Revised:
 
11/2017CCKM@uwhealth.org

Wound Care - Closure With Removable Suture
[NURWND0015]
Routine, Your wound is closed with sutures (that need
to be removed), tape, and a clear dressing. The
dressing is waterproof, so it is OK to shower or get it
wet. Small pieces of tape are used to reinforce the
incision. The pieces of tape should remain in place
until your next appointment (6-8 days). If the edges
curl up prior to your next appointment, it is ok to trim
them with a small scissors. The tape over your incision
may be covered with a clear dressing. If a clear
dressing is present, it may be removed in 2 days. No
swimming or soaking in water for 14 days after
surgery. Do NOT use ointments, powders, or creams
on the wound.
Wound Care - Closure With Dermabond
[NURWND0015]
Routine, Your wound is closed with glue and tape. The
glue is waterproof, so it is OK to shower or get it wet.
The glue and tape will start to peel off in 10-14 days. If
the edges curl up prior to your next appointement, it is
OK to trim them with a small scissors. You will have
pieces of tape over the glue, leave them on until your
next appointment (10-14 days). No swimming or
soaking in water for 14 days after surgery. Do NOT
use ointments, powders, or creams on the wound.
Activity/Return to Work [122681]
Activity [NURACT0011] Routine, Most people return to work within one week.
Avoid straining or extreme bending of your neck. Do
not lift more than 20 pounds for the first week. Avoid
strenuous activity for one week. Do NOT drive or
operate any machinery until you are no longer taking
opiod pain pills and can turn your head to the side 90
degrees with ease.
Nutrition (Single Response) [126677]
Diet [NUT8888] Routine
General: General (No Modifications)
Diet Modifications:
Other Diet Modifications:
Non-categorized Patient Care Orders [122680]
Provide Patient Education appropriate HFFY (e.g.
Thyroid Surgery, Minimally Invasive Parathyroid
Surgery) prior to discharge. [NURCOM0025]
ONCE For 1 Occurrences, Routine, Please provide
patient with appropriate HFFY (e.g. Thyroid Surgery,
Minimally Invasive Parathyroid Surgery) prior to
discharge., Post-Op/Phase II
Medications - Prescriptions - Analgesics [122827]
oxycodone 5 MG tab - 1-2t q4h prn [45976] 5-10 mg, 20 tab, 0, starting 10/23/17, Normal, Phase II
Discharge
oxycodone-acetaminophen (PERCOCET) 5-325
mg per tab - 1-2t q4h prn [40668]
1-2 tab, 20 tab, 0, starting 10/23/17, Normal, Phase II
Discharge
hydrocodone-acetaMINOPHEN (NORCO) 5-325
mg per tab - 1-2t q4h prn [71425]
1-2 tab, 20 tab, 0, starting 10/23/17, Normal, Phase II
Discharge
oxycodone 5 MG/5ML soln [45975] 5-10 mg, 100 mL, 0, starting 10/23/17, Normal, Phase
II Discharge
traMADOL (ULTRAM) 50 MG tab [50258] 25-50 mg, 20 tab, 0, starting 10/23/17, Normal, Phase
II Discharge
acetaMINOPHEN (TYLENOL) 325 MG tab
[34149]
325-650 mg, 20 tab, 0, starting 10/23/17, Normal,
Phase II Discharge
Medications - Prescriptions - Analgesics - NOTE: Order for Parathyroid Patients [224800]
oxycodone-acetaminophen (PERCOCET) 5-325
mg per tab - 1-2t q4h prn [40668]
1-2 tab, 20 tab, 0, starting 10/23/17, Normal, Phase II
Discharge
Page 2 of 5
Printed by STRAKA, KEVIN F [KFS1] at 10/23/2017 5:28:43 PM
Copyright © 2017 University of Wisconsin Hospitals and Clinics Authority
Contact: Lee Vermeulen, CCKM@uwhealth.org Last Revised:
 
11/2017CCKM@uwhealth.org

hydrocodone-acetaMINOPHEN (NORCO) 5-325
mg per tab - 1-2t q4h prn [71425]
1-2 tab, 20 tab, 0, starting 10/23/17, Normal, Phase II
Discharge
traMADOL (ULTRAM) 50 MG tab [50258] 25-50 mg, 20 tab, 0, starting 10/23/17, Normal, Phase
II Discharge
Medications - Levothyroxine [152701]
For MALIGNANT disease: Suggested dose is 2 mcg/kg.
For BENIGN disease: Suggested dose is based on patient's BMI (see below). BMI can be found
in the Outpatient chart (Snapshot/Ambulatory Vitals) or the Inpatient Doc Flowsheet.
levothyroxine (SYNTHROID) 25 MCG tab [39001] 25 mcg, 30 tab, 2, starting 10/23/17, Normal, Phase II
Discharge
levothyroxine (SYNTHROID) 50 MCG tab [39002] 50 mcg, 30 tab, 2, starting 10/23/17, Normal, Phase II
Discharge
levothyroxine (SYNTHROID) 75 MCG tab [39003] 75 mcg, 30 tab, 2, starting 10/23/17, Normal, Phase II
Discharge
levothyroxine (SYNTHROID) 88 MCG tab [45544] 88 mcg, 30 tab, 2, starting 10/23/17, Normal, Phase II
Discharge
levothyroxine (SYNTHROID) 100 MCG tab
[39004]
100 mcg, 30 tab, 2, starting 10/23/17, Normal, Phase
II Discharge
levothyroxine (SYNTHROID) 112 MCG tab
[45545]
112 mcg, 30 tab, 2, starting 10/23/17, Normal, Phase
II Discharge
levothyroxine (SYNTHROID) 125 MCG tab
[39005]
125 mcg, 30 tab, 2, starting 10/23/17, Normal, Phase
II Discharge
levothyroxine (SYNTHROID) 137 MCG tab
[45546]
137 mcg, 30 tab, 2, starting 10/23/17, Normal, Phase
II Discharge
levothyroxine (SYNTHROID) 150 MCG tab
[39006]
150 mcg, 30 tab, 2, starting 10/23/17, Normal, Phase
II Discharge
levothyroxine (SYNTHROID) 175 MCG tab
[45547]
175 mcg, 30 tab, 2, starting 10/23/17, Normal, Phase
II Discharge
levothyroxine (SYNTHROID) 200 MCG tab
[39007]
200 mcg, 30 tab, 2, starting 10/23/17, Normal, Phase
II Discharge
Medications - Calcitriol and Calcium Carbonate [152702]
All parathyroid patients: Order calcium carbonate 1000 mg, 2 X Daily.
For total thyroid patients:
If PACU PTH>20, no scheduled calcium carbonate unless patient has Graves' disease.
If PACU PTH is 10 - 20 or for patients with Graves' disease, order calcium carbonate 1000 mg, 3
X daily.
If PACU PTH is 2 - 9 give calcitriol 0.25 mcg, 2 X daily and calcium carbonate 1000 mg, 3X daily.
If PACU PTH is <2, order calcitriol 0.5 mcg, 2 X daily and calcium carbonate 1000 mg 3X daily.
All total thyroid and parathyroid patients need an order for PRN calcium carbonate.
BMI mcg/kg
Male Female
Less than 21 2.1 1.8
22-26 1.9 1.7
27-32 1.7 1.6
33-40 1.5 1.4
Greater than
40
1.3 1.2
Page 3 of 5
Printed by STRAKA, KEVIN F [KFS1] at 10/23/2017 5:28:43 PM
Copyright © 2017 University of Wisconsin Hospitals and Clinics Authority
Contact: Lee Vermeulen, CCKM@uwhealth.org Last Revised:
 
11/2017CCKM@uwhealth.org

calcitriol (ROCALTROL) 0.25 MCG cap [44439] 0.25 mcg, 60 cap, 3, starting 10/23/17, Normal, Phase
II Discharge
calcitriol (ROCALTROL) 0.5 MCG cap [44440] 0.5 mcg, 60 cap, 3, starting 10/23/17, Normal, Phase
II Discharge
Calcium Carbonate 1000mg two times daily
[52229]
1,000 mg, 60 tab, 3, starting 10/23/17, Normal, Phase
II Discharge
Calcium Carbonate 1000mg three times daily
[52229]
1,000 mg, 60 tab, 3, starting 10/23/17, Normal, Phase
II Discharge
Calcium Carbonate 2000mg PRN [52229] 60 tab, 3, starting 10/23/17, Normal, Phase II
Discharge
Medications - Calcitriol and Calcium Carbonate - NOTE: Order for Total Thyroid and Parathyroid
Patients [224801]
All parathyroid patients: Order calcium carbonate 1000 mg, 2 X Daily.
For total thyroid patients:
If PACU PTH>20, no scheduled calcium carbonate unless patient has Graves' disease.
If PACU PTH is 10 - 20 or for patients with Graves' disease, order calcium carbonate 1000 mg, 3
X daily.
If PACU PTH is 2 - 9 give calcitriol 0.25 mcg, 2 X daily and calcium carbonate 1000 mg, 3X daily.
If PACU PTH is <2, order calcitriol 0.5 mcg, 2 X daily and calcium carbonate 1000 mg 3X daily.
All total thyroid and parathyroid patients need an order for PRN calcium carbonate.
Calcium Carbonate 2000mg PRN [52229] 2,000 mg, 60 tab, 3, starting 10/23/17, Normal, Phase
II Discharge
Medications - Prescriptions - Non-Categorized [122830]
senna-docusate (SENOKOT S) 8.6-50 MG per
tab [60530]
2 tab, 20 tab, 0, starting 10/23/17, Normal, Phase II
Discharge
Medication Instructions [122683]
Medication Instructions [NURCOM0022] Routine, If you develop numbess and tingling in your
face, lips, fingertips, or toes take four 500 mg tablets
of calcium carbonate (TUMS). The symptoms should
go away in 15-30 minutes. If the symptoms persist, at
30 minutes you can repeat this. If the syptoms do still
do not go away, call your doctor.
Contingency Parameters [122684]
Contingency Parameters [NURTRT0048] Routine, Call doctor for nausea or vomiting lasting
more than 24 hours; if you have not had a bowel
movement in 3 days; temperatue above 100.4F by
mouth, for 2 readings taken 4 hours apart; excess
swelling or bleeding; increased redness and/or warmth
at the incision site; pus-like drainage; pain not relieved
by pain pills; rapid or excess bruising (some bruising is
normal); sudden shortness of breath or cough;
cramping/swelling to leg; dark urine; and/or numbness
and/or tingling of your fingertips, face, lips or toes that
does not resolve with calcium supplements (TUMS).
This is rare, but if you are panicked due to trouble
breathing, sudden swelling in your throat, or are
unable to swallow, Call 911.
Follow-Up Orders [122685]
Patient to Schedule Appointment [NURCOM0056] Routine
Purpose:
With whom:
For when: 2 weeks after surgery
Page 4 of 5
Printed by STRAKA, KEVIN F [KFS1] at 10/23/2017 5:28:43 PM
Copyright © 2017 University of Wisconsin Hospitals and Clinics Authority
Contact: Lee Vermeulen, CCKM@uwhealth.org Last Revised:
 
11/2017CCKM@uwhealth.org

Verify Patient's Scheduled Appointment
[NURCOM0026]
Routine
Reason for Hospital Follow Up Appointment: post
discharge
Which Provider: Patient's Specific PCP/Care Team
When do you want appointment:
Which Clinic or Specialty:
Patient to Schedule Appointment [NURCOM0056] Routine
Purpose: Follow-up Appointment
With whom: Endocrine Surgery
For when: 1-2 weeks after surgery
Page 5 of 5
Printed by STRAKA, KEVIN F [KFS1] at 10/23/2017 5:28:43 PM
Copyright © 2017 University of Wisconsin Hospitals and Clinics Authority
Contact: Lee Vermeulen, CCKM@uwhealth.org Last Revised:
 
11/2017CCKM@uwhealth.org