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/clinical/cckm-tools/content/order-sets/ambulatory/urology/name-98516-en.cckm

20180112

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UWHC,UWMF,

Tools,

Clinical Hub,UW Health Clinical Tool Search,UW Health Clinical Tool Search,Order Sets,Ambulatory,Urology

OP - Urologic Surgery - Adult - Postoperative [2964]

OP - Urologic Surgery - Adult - Postoperative [2964] - Clinical Hub, UW Health Clinical Tool Search, UW Health Clinical Tool Search, Order Sets, Ambulatory, Urology


OP - Urologic Surgery - Adult - Postoperative [2964]
for Adult Patients OnlyIntended
Post-Op/Phase II
Analgesics-Acetaminophen [240498]
acetaMINOPHEN (TYLENOL) tab [34149] 650 mg, Oral, EVERY 4 HOURS PRN, pain
See Pain Management Algorithm for the Selection of
As-needed Analgesic
No more than 4 grams acetaminophen per 24 hours
for adults
Post-Op/Phase II
Analgesics-Oral Opioids (Single Response) [240499]
hydrocodone-acetaMINOPHEN (NORCO) 5-325
mg per tab RANGE [750021]
1-2 tab, Oral, EVERY 4 HOURS PRN, pain
See Pain Management Algorithm for the Selection of
As-Needed Analgesic
No more than 4 grams of acetaminophen in 24 hours
Post-Op/Phase II
oxycodone-acetaminophen (PERCOCET) 5-325
mg per tab RANGE [750033]
1-2 tab, Oral, EVERY 4 HOURS PRN, pain
See Pain Management Algorithm for the Selection of
As-Needed Analgesic
No more than 4 grams of acetaminophen in 24 hours
Post-Op/Phase II
oxycodone tab RANGE [750032] 5-10 mg, Oral, EVERY 4 HOURS PRN, pain
See Pain Management Algorithm for the Selection of
As-Needed Analgesic
Post-Op/Phase II
Analgesics- Intravenous Opioids (Single Response) [91527]
HYDROmorphone PF (DILAUDID) injection
[750050]
0.5-1 mg, Intravenous, EVERY 2 HOURS PRN For 24
Hours, pain
See Pain Management Algorithm for the Selection of
As-needed Analgesic
for 3 Minutes, Post-Op/Phase II
MORPHine PF injection RANGE [750057] 1-4 mg, Intravenous, EVERY 2 HOURS PRN, pain
See Pain Management Algorithm for the Selection of
As-needed Analgesic
for 4 Minutes, Post-Op/Phase II
Medications - Anti-emetics [91526]
Adult - Standard - Anti-emetics [241839]
ondansetron (ZOFRAN ODT) disintegrating tab
[64224]
4 mg, Oral, EVERY 6 HOURS PRN,
nausea/vomiting
Use first line
Post-Op/Phase II
ondansetron (ZOFRAN) injection [800202] 4 mg, Intravenous, EVERY 6 HOURS PRN,
nausea/vomiting
Use first line if unable to take medications by mouth
or enteral tube OR if immediate effect is needed.
Post-Op/Phase II
prochlorperazine (COMPAZINE) tab [41372] 10 mg, Oral, EVERY 6 HOURS PRN,
nausea/vomiting
Use second line if there is inadequate response to
first line anti-emetic within 30 minutes. If there is no
response to second line therapy within 30 minutes,
notify provider
Post-Op/Phase II
Page 1 of 5
Printed by WILLIAMS, HEATHER R [HRS0] at 1/8/2018 8:40:50 AM
Copyright © 2018 University of Wisconsin Hospitals and Clinics Authority
Contact: Lee Vermeulen, CCKM@uwhealth.org Last Revised: 01/2018CCKM@uwhealth.org

prochlorperazine (COMPAZINE) injection [41369] 10 mg, Intravenous, EVERY 6 HOURS PRN,
nausea/vomiting
Use second line. Use if there is inadequate
response to first line anti-emetic within 30 minutes
and if unable to take medications by mouth or
enteral tube OR if immediate effect is needed. If
there is no response to second line therapy within 30
minutes, notify provider
Post-Op/Phase II
Medications - Non-categorized [91695]
belladonna-opium (B&O SUPPRETTES) 16.2-30
MG rectal suppository [56903]
30 mg, Rectal, ONCE For 1 Doses, Post-Op/Phase II
belladonna-opium (B&O SUPPRETTES) 60 mg
rectal suppository [61073]
60 mg, Rectal, ONCE For 1 Doses, Post-Op/Phase II
Nursing Discharge Orders [91660]
Check Post Void Residual with Bladder Scan
[NURMON0060]
ONCE, Starting today For 1 Occurrences, Post-
Op/Phase II
Post-Op Care Orders [91661]
Strain All Urine, Save Fragments [NURELM0019] CONTINUOUS, Starting today, Routine
For:
If Present:
Post-Op/Phase II
Insert and Maintain Urinary Catheter
[NURELM0013]
CONTINUOUS, Starting today, Routine, To
discontinue this order, enter a new order for
"Discontinue Urinary Catheter".
To modify this order, enter a new order for "Maintain
Urinary Catheter" and make the necessary changes in
the new order.
Type: Indwelling Single Lumen
Indication for Placement:
Details: To Dependent Drainage
Does this need to be inserted/placed?
Post-Op/Phase II
Insert and Maintain Urinary Catheter for
Transuretheral Procedure [NURELM0013]
CONTINUOUS, Starting today, Routine, To
discontinue this order, enter a new order for
"Discontinue Urinary Catheter".
To modify this order, enter a new order for "Maintain
Urinary Catheter" and make the necessary changes in
the new order.
Type: Three-Way
Indication for Placement:
Details: To Dependent Drainage
Does this need to be inserted/placed?
Post-Op/Phase II
Other Post-Op Care Orders [NURCOM0022] ONCE, Starting today For 1 Occurrences, ***, Post-
Op/Phase II
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
Outpatient Discharge Orders
Medications - Prescriptions - Anti-infectives [91528]
cephalexin (KEFLEX) 250 mg cap - 2x/d [44593] 250 mg, starting 1/8/18, Normal, Phase II Discharge
Page 2 of 5
Printed by WILLIAMS, HEATHER R [HRS0] at 1/8/2018 8:40:50 AM
Copyright © 2018 University of Wisconsin Hospitals and Clinics Authority
Contact: Lee Vermeulen, CCKM@uwhealth.org Last Revised: 01/2018CCKM@uwhealth.org

cephalexin (KEFLEX) 250 MG cap - 3X/d [44593] 250 mg, starting 1/8/18, Normal
cephalexin (KEFLEX) 250 MG cap - 4x/d [44593] 250 mg, starting 1/8/18, Normal
cephalexin (KEFLEX) 500 MG cap - 2X/d [44594] 500 mg, starting 1/8/18, Normal
cephalexin (KEFLEX) 500 MG cap - 3X/day
[44594]
500 mg, starting 1/8/18, Normal
cephalexin (KEFLEX) 500 mg cap - 4x/d [44594] 500 mg, starting 1/8/18, Normal, Phase II Discharge
ciprofloxacin (CIPRO) 250 mg tab - 1x/d [61499] 250 mg, starting 1/8/18, Normal, Phase II Discharge
ciprofloxacin (CIPRO) 250 mg tab - 2x/d [61499] 500 mg, starting 1/8/18, Normal, Phase II Discharge
ciprofloxacin (CIPRO) 500 mg tab - 1x/d [61500] 500 mg, starting 1/8/18, Normal, Phase II Discharge
ciprofloxacin (CIPRO) 500 mg tab - 2x/d [61500] 500 mg, starting 1/8/18, Normal, Phase II Discharge
nitrofurantoin macrocrystals (MACRODANTIN) 50
mg cap - 1x/d [40272]
50 mg, starting 1/8/18, Normal, Phase II Discharge
nitrofurantoin macrocrystals (MACRODANTIN)
100 mg cap - 1x/d [40270]
100 mg, starting 1/8/18, Normal, Phase II Discharge
nitrofurantoin macrocrystals (MACRODANTIN)
100 mg cap - 2x/d [40270]
100 mg, starting 1/8/18, Normal, Phase II Discharge
sulfamethoxazole-trimethoprim (BACTRIM) 400-
80 mg per tab - 1x/d [42457]
1 tab, starting 1/8/18, Normal, Phase II Discharge
sulfamethoxazole-trimethoprim (BACTRIM) 400-
80 mg per tab - 2x/d [42457]
1 tab, starting 1/8/18, Normal, Phase II Discharge
sulfamethoxazole-trimethoprim (BACTRIM DS)
800-160 MG per tab - 2x/d [46804]
1 tab, starting 1/8/18, Normal
Medications - Prescriptions - Non-categorized [91529]
oxybutynin (DITROPAN) 5 mg tab - 3x/d [40666] 5 mg, starting 1/8/18, Normal, Phase II Discharge
tamsulosin (FLOMAX) 0.4 mg cap - 1x/d [140027] 0.4 mg, starting 1/8/18, Normal, Phase II Discharge
senna-docusate (SENOKOT-S) 8.6-50 mg per tab
- 2t 2x/d [60530]
2 tab, starting 1/8/18, Normal, Phase II Discharge
Medications - Prescriptions - Opioid - Analgesics - Oral (Single Response) [243299]
oxycodone-acetaminophen (PERCOCET) 5-325
mg per tab - 1-2t q4-6h prn [40668]
1-2 tab, 0, starting 1/8/18, Normal, Phase II Discharge
hydrocodone-acetaMINOPHEN (NORCO) 5-325
mg per tab - 1-2t q4-6h prn [71425]
1-2 tab, 0, starting 1/8/18, Normal, Phase II Discharge
oxycodone 5 MG tab [45976] 5 mg, starting 1/8/18, Normal, Phase II Discharge
Medication Instructions [135806]
Do not resume taking NSAIDs (i.e. ibuprofen,
naproxen), anti-inflammatory medications or
aspirin-like products until instructed
[NURCOM0071]
Please complete in PATIENT FRIENDLY terms. This
order will appear on the patient's After Hospital Care
Plan., Routine, Do not resume taking NSAIDs (i.e.
ibuprofen, naproxen), anti-inflammatory medications
or aspirin-like products until instructed
Do not resume taking herbal medications or
supplements until instructed [NURCOM0071]
Please complete in PATIENT FRIENDLY terms. This
order will appear on the patient's After Hospital Care
Plan., Routine, No herbal medications or supplements
for *** days.
Instructions on resuming blood thinners
[NURCOM0071]
Please complete in PATIENT FRIENDLY terms. This
order will appear on the patient's After Hospital Care
Plan., Routine, May resume {Blood Thinners:2000184}
in *** days.
Activity/Return to Work [91662]
Activity (No Restrictions) [NURACT0008] Routine
Discharge Activity: Up As Tolerated
Phase II Discharge
Page 3 of 5
Printed by WILLIAMS, HEATHER R [HRS0] at 1/8/2018 8:40:50 AM
Copyright © 2018 University of Wisconsin Hospitals and Clinics Authority
Contact: Lee Vermeulen, CCKM@uwhealth.org Last Revised: 01/2018CCKM@uwhealth.org

Lifting Restrictions [NURACT0008] Routine
Discharge Activity:
No lifting greater than *** pounds for ***., Phase II
Discharge
No Sexual Activity For: [NURACT0008] Routine
Discharge Activity: Other (Comment)
No sexual activity for ***., Phase II Discharge
Bathing Restrictions [NURACT0008] Routine
Discharge Activity: Other (Comment)
No tub baths for *** weeks.
May shower.
May sponge bathe., Phase II Discharge
Work Restrictions [NURACT0008] Routine
Discharge Activity:
May return to work in ***., Phase II Discharge
Other Activity Restrictions [NURACT0011] Routine, ***
Driving Restrictions [NURACT0008] Routine
Discharge Activity:
No driving while taking pain medications., Phase II
Discharge
Strain All Urine, Save Any Fragments
[NURCOM0071]
Please complete in PATIENT FRIENDLY terms. This
order will appear on the patient's After Hospital Care
Plan., Routine
Nutrition [135805]
General Diet (No Modifications) [NUT8888] Routine
General: General (No Modifications)
Diet Modifications:
Other Diet Modifications:
Nursing Communication - Diet [NURDIE0013] Routine, Resume general diet
Wound Care [91664]
May Remove Dressing [NURWND0018] Routine, May remove dressing in *** days.
Wear Scrotal Support [NURWND0018] Routine, Wear scrotal support for *** days.
Wear Tight Fitting Briefs [NURWND0018] Routine, Wear tight fitting briefs for *** days.
Wound Care [NURWND0015] Routine, ***
Follow-Up Diagnostic Tests and Imaging [91668]
X-RAY ABDOMEN SINGLE VIEW [R74018] Status: Future, Expires: 3/8/2019, Normal, Routine
US ABDOMEN LIMITED - RENAL/BLADDER
[R76705]
Status: Future, Expires: 3/8/2019, Normal, Routine
Follow-Up Appointments [91670]
Patient to Schedule Appointment (With MD)
[NURCOM0056]
Routine
Purpose:
With whom: Urology MD
For when:
Patient to Schedule Appointment (With NP/PA)
[NURCOM0056]
Routine
Purpose:
With whom: Urology NP/PA
For when:
Discharge Instructions [135810]
Page 4 of 5
Printed by WILLIAMS, HEATHER R [HRS0] at 1/8/2018 8:40:50 AM
Copyright © 2018 University of Wisconsin Hospitals and Clinics Authority
Contact: Lee Vermeulen, CCKM@uwhealth.org Last Revised: 01/2018CCKM@uwhealth.org

When to Call Your Doctor [NURCOM0079] Please complete in PATIENT FRIENDLY terms. This
order will appear on the patient's After Hospital Care
Plan.
You should include specific instructions on when and
who to call.
You should include actual provider names (i.e. not
'PCP').
You should NOT include the discharging unit as a
contact., Routine, For questions or problems, call 608-
263-4757 during business hours. After hours or on
weekends, ask to speak to the urology resident on
call.
Page 5 of 5
Printed by WILLIAMS, HEATHER R [HRS0] at 1/8/2018 8:40:50 AM
Copyright © 2018 University of Wisconsin Hospitals and Clinics Authority
Contact: Lee Vermeulen, CCKM@uwhealth.org Last Revised: 01/2018CCKM@uwhealth.org