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Cardiac Cath/EP – Cardiac Transplant Biopsy – Pre/Postprocedure [4769]

Cardiac Cath/EP – Cardiac Transplant Biopsy – Pre/Postprocedure [4769] - Clinical Hub, UW Health Clinical Tool Search, UW Health Clinical Tool Search, Order Sets, HOD, Cardiac Cath and Electrophysiology Labs


Cardiac Cath/Ep - Cardiac Transplant Biopsy - Pre/Postprocedure [4769]
PreProcedure
Vital Signs [140755]
Vital Signs [NURMON0013] ONCE, Starting today For 1 Occurrences, Routine
Temperature Measurement Method:
Temperature Measurement Restrictions:
BP Source:
BP Location:
BP Position:
BP Restrictions:
Once upon admission., Cardiac Cath/EP
Patient Monitoring [139466]
Measure Weight [NURMON0015] ONCE For 1 Occurrences, Routine
Weigh With?
Weigh when?
Upon admission, Cardiac Cath/EP
Medications [139467]
Patients may self-administer medications after
lab draw. [NURCOM0022]
ONCE, Patients may self-administer medications after
lab draw., Cardiac Cath/EP
Non-Categorized Patient Care Orders [142426]
Please instruct patient to wear PCM 2000
(duckbill) mask when transferring outside of the
Cardiac Catheterization Lab. [NURCOM0022]
ONCE For 1 Occurrences, Please instruct patient to
wear PCM 2000 (duckbill) mask when transferring
outside of the Cardiac Catheterization Lab., Cardiac
Cath/EP
IntraOp
Biopsy [215228]
SURGICAL PATHOLOGY [HCPATHS] NEXT AM For 1 Occurrences, Routine, This order is
to be used for fresh or formalin-fixed (for gross and
micro evaluation) tissues.
Slides and/or paraffin-embedded blocks coming from
outside institutions needing second opinion pathology
review should be ordered as Surgical Pathology
Consult [HCPATHSP].
Specimen Source Description: Endomyocardial
Biopsy
Number of containers:
Clinical Diagnosis: Status post heart transplant Z94.1
Reason for procedure: Routine Rejection Screening
Other pertinent information:
Frozen section call back number:
Type of procedure:
If add on test, what should lab do if unable to add test
to previous specimen?
If Conditional, What Condition?
Cardiac Cath/EP
Laboratory [139940]
Page 1 of 5
Printed by LIND, JANNA S [JSL237] at 12/8/2016 10:41:42 AM
Copyright © 201� University of Wisconsin Hospitals and Clinics Authority
Contact: Lee Vermeulen, CCKM@uwhealth.org Last Revised: 12/2016CCKM@uwhealth.org

LIPID PANEL [LIPID] STAT - RN COLLECT For 1 Occurrences, Routine,
Test includes Cholesterol, Total; HDL Cholesterol;
Triglyceride; LDL cholesterol, calculated; and non-
HDL cholesterol.
Patient must fast for 12-14 hours and be heparin free
for 48 hours prior to specimen collection. The patient
can only have water or black coffee during the fasting
period.
If add on test, what should lab do if unable to add test
to previous specimen?
If Conditional, What Condition?
Patients must have completed a 10 hour fast prior to
draw., Cardiac Cath/EP
ELECTROLYTES [LYTE] STAT - RN COLLECT 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
GLUCOSE [GLU] STAT - RN COLLECT 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 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 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
CALCIUM [CA] STAT - RN COLLECT 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
ALBUMIN [ALB] STAT - RN COLLECT 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
PROTEIN, TOTAL [TP] STAT - RN COLLECT 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
BILIRUBIN, TOTAL [TBIL] STAT - RN COLLECT 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
Page 2 of 5
Printed by LIND, JANNA S [JSL237] at 12/8/2016 10:41:42 AM
Copyright © 201� University of Wisconsin Hospitals and Clinics Authority
Contact: Lee Vermeulen, CCKM@uwhealth.org Last Revised: 12/2016CCKM@uwhealth.org

ALT/SGPT [ALT] STAT - RN COLLECT 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
AST/SGOT [AST] STAT - RN COLLECT 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
ALKALINE PHOSPHATASE [ALKP] STAT - RN COLLECT 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 WITH DIFFERENTIAL [CBC] STAT - RN COLLECT 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
MAGNESIUM [MAG] STAT - RN COLLECT 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
LD, TOTAL [LDH] STAT - RN COLLECT 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
PHOSPHATE [PHOS] STAT - RN COLLECT 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
CK, TOTAL [CPK] STAT - RN COLLECT 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
CMV QUANTITATIVE BY PCR [HCCMVDNA] STAT - RN COLLECT 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
TACROLIMUS LEVEL [HCTAC] STAT - RN COLLECT 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
SIROLIMUS [HCSIRO] STAT - RN COLLECT 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
Page 3 of 5
Printed by LIND, JANNA S [JSL237] at 12/8/2016 10:41:42 AM
Copyright © 201� University of Wisconsin Hospitals and Clinics Authority
Contact: Lee Vermeulen, CCKM@uwhealth.org Last Revised: 12/2016CCKM@uwhealth.org

CYCLOSPORINE [XCYCA] STAT - RN COLLECT 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
HLA CLASS I DONOR SPECIFIC AB BY
LUMINEX [HCDSA1B]
STAT - RN COLLECT, Starting today For 1
Occurrences, Routine
Indicate organ for transplant:
If add on test, what should lab do if unable to add test
to previous specimen?
If Conditional, What Condition?
Cardiac Cath/EP
HLA CLASS II DONOR SPECIFIC AB BY
LUMINEX [HCDSA2B]
STAT - RN COLLECT, Starting today For 1
Occurrences, Routine
Indicate organ for transplant:
If add on test, what should lab do if unable to add test
to previous specimen?
If Conditional, What Condition?
Cardiac Cath/EP
CDC Increased Risk Labs [142668]
HIV-1 RNA, Quantitative (Viral Load) [XHIV1] STAT - RN COLLECT For 1 Occurrences, Routine,
This test is not used for the diagnosis of HIV-1
infection. This test is used to determine viral burden
in known HIV-1 positive patients.
If add on test, what should lab do if unable to add test
to previous specimen?
If Conditional, What Condition?
Cardiac Cath/EP
Hepatitis C RNA, Quantitative, PCR [XHCVRQ] STAT - RN COLLECT 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
Hepatitis B DNA, Ultra Quantitative, PCR
[XHBVD]
STAT - RN COLLECT 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
Hepatitis B Surface Ag [HBSAG] STAT - RN COLLECT 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
Hepatitis B Core Ab, Total [HBCAB] STAT - RN COLLECT 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
PostProcedure - Groin Biopsy Patients
Vitals [142368]
Page 4 of 5
Printed by LIND, JANNA S [JSL237] at 12/8/2016 10:41:42 AM
Copyright © 201� University of Wisconsin Hospitals and Clinics Authority
Contact: Lee Vermeulen, CCKM@uwhealth.org Last Revised: 12/2016CCKM@uwhealth.org

Vital Signs [NURMON0013] SEE COMMENTS, Routine
Temperature Measurement Method:
Temperature Measurement Restrictions:
BP Source:
BP Location:
BP Position:
BP Restrictions:
ONCE upon return to postprocedure area and then
EVERY 60 minutes., Cardiac Cath/EP
Diet [139934]
NPO Except Medications [NUT9999] EFFECTIVE NOW, Starting today, Routine
Patient Type: Adult
Diet Type: NPO
NPO: NPO except Medications
Bedside Meal Instructions:
Room Service Class:
Cardiac Cath/EP
General Diet [NUT9999] EFFECTIVE NOW, Starting today, Routine
Patient Type: Adult
Diet Type: General (no Modifications)
Bedside Meal Instructions:
Room Service Class:
Cardiac Cath/EP
Diabetes Meal Plan [NUT9999] EFFECTIVE NOW, Starting today, Routine
Patient Type: Adult
Diet Type: Diet Modifications
Diet Modifications: Diabetes
Bedside Meal Instructions:
Room Service Class:
Cardiac Cath/EP
Activity [139935]
Activity - Bedrest for 4 hours [NURACT0008] CONTINUOUS, Routine
AD LIB:
AMBULATE:
CHAIR:
DANGLE:
BEDREST: other (comment)
RESTRICTIONS:
UPPER LEFT EXTREMITY WEIGHT BEARING:
UPPER RIGHT EXTREMITY WEIGHT BEARING:
LOWER LEFT EXTREMITY WEIGHT BEARING:
LOWER RIGHT EXTREMITY WEIGHT BEARING:
Bedrest for 4 hours, Cardiac Cath/EP
Elevate Head Of Bed [NURACT0002] Equal to (degrees):
Greater than (degrees):
Less than (degrees):
Other options:
Routine, CONTINUOUS, Elevate Head of Bed 30
minutes after beginning bedrest., Cardiac Cath/EP
Wound/Procedure Site Care [139936]
Wound/Procedure Site Care - Groin Approach
[NURMON0036]
SEE COMMENTS, Routine, Check groin every 15
minutes times 1 hour then every 30 minutes times 3
hours, Cardiac Cath/EP
Page 5 of 5
Printed by LIND, JANNA S [JSL237] at 12/8/2016 10:41:42 AM
Copyright © 201� University of Wisconsin Hospitals and Clinics Authority
Contact: Lee Vermeulen, CCKM@uwhealth.org Last Revised: 12/2016CCKM@uwhealth.org