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Clinical Hub,UW Health Clinical Tool Search,UW Health Clinical Tool Search,Order Sets,Ambulatory,Madison Surgery Center

MSC - Interventional Pain Management - Adult - Postoperative [5116]

MSC - Interventional Pain Management - Adult - Postoperative [5116] - Clinical Hub, UW Health Clinical Tool Search, UW Health Clinical Tool Search, Order Sets, Ambulatory, Madison Surgery Center


MSC - Interventional Pain Management - Adult - Postoperative [5116]
Post-Op/Phase II
Medications [137314]
ketOROLAC (TORADOL) injection - NOTE - Do not give
if asthma symptoms related to aspirin administration
[58693]
15 mg, Intravenous, ONCE For 1 Doses
NOTE - Do not give if asthma symptoms related to aspirin
administration
If ordered IV: push over 15-30 seconds,(Pediatrics: over 5
minutes).
Post-Op/Phase II
ketOROLAC (TORADOL) injection - NOTE - Do not give
if asthma symptoms related to aspirin administration
[58693]
30 mg, Intravenous, ONCE For 1 Doses
NOTE - Do not give if asthma symptoms related to aspirin
administration
If ordered IV: push over 15-30 seconds,(Pediatrics: over 5
minutes).
Post-Op/Phase II
ondansetron (ZOFRAN) injection [132824] 4 mg, Intravenous, ONCE PRN For 1 Doses, for 3 Minutes,
Post-Op/Phase II
lactated ringers BOLUS [730001] 1,000 mL, Intravenous, ONCE PRN For 1 Doses, Systolic
blood pressure < 100 mmHg
Systolic blood pressure < 100
Post-Op/Phase II
Vital Signs [137315]
Vital Signs [NURMON0013] SEE COMMENTS, Routine
Temperature Measurement Method:
Temperature Measurement Restrictions:
BP Source:
BP Location:
BP Position:
BP Restrictions:
Every 15 minutes times one and as needed thereafter.
NOTIFY MD if SBP < 90 mmHg, DBP > 100 mmHg, Temp >
102 F, Post-Op/Phase II
Activity [137317]
May apply ice pack to procedure site for pain relief
[NURCOM0022]
ONCE, Post-Op/Phase II
Non-Categorized Patient Care Orders [137318]
For Sympathetic Blocks: Record bilateral extremity
temperatures times one, then record on test extremity
side every five minutes until peak temperature is
reached (approximately 30 minutes [NURCOM0022]
ONCE, Post-Op/Phase II
Accucheck Glucose PRN [HCMGLUC] ONCE For 1 Occurrences, Routine
If Conditional, What Condition?
Per MSC protocol, Post-Op/Phase II
Send patient down to Radiology post Discogram CT
[NURCOM0022]
ONCE, Post-Op/Phase II
Prior to Discharge [137319]
Discharge from Phase II When Criteria Below Are Met:
[NURCOM0022]
ONCE, - Vital Signs stable and within baseline
- Patient's baseline neurological status has returned
- Strength of lower extremities assessed prior to ambulation
- Pain reassessed after patient ambulatory; document in chart
and report to Physician, Post-Op/Phase II
Patient to be discharged to home when deemed stable per MSC Discharge from Phase II Recovery to Home Policy
[135357]
Patient to be discharged to home when deemed stable
per MSC Discharge from Phase II Recovery to Home
Policy [NURCOM0022]
ONCE, Phase II Discharge
Outpatient Discharge Orders
Page 1 of 2
Printed by GUETZLAFF, SCOTT F [SFG091] at 1/14/2016 2:08:09 PM

Copyright © 2015 University of Wisconsin Hospital and Clinics Authority, University of Wisconsin Medical Foundation, Inc, UW-Madison
Contact: Lee Vermeulen, CCKM@uwhealth.org Last Revised:



















 
01/2016Lee Vermeulen, CCKM@uwhealth.org

Discharge Instructions [137320]
Pain Log and Questionnaire [NURCOM0022] Routine, You have been given a pain log and/or a
questionnaire today. Please complete and mail in as
instructed
Hand out Oswestry Back Pain Disability Questionnaire
[NURCOM0022]
Routine
Hand out Neck Pain Disability Questionnaire
[NURCOM0022]
Routine
Page 2 of 2
Printed by GUETZLAFF, SCOTT F [SFG091] at 1/14/2016 2:08:09 PM

Copyright © 2015 University of Wisconsin Hospital and Clinics Authority, University of Wisconsin Medical Foundation, Inc, UW-Madison
Contact: Lee Vermeulen, CCKM@uwhealth.org Last Revised:



















 
01/2016Lee Vermeulen, CCKM@uwhealth.org