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OP - Renal Biopsy - Pediatric - Postprocedure [4721]

OP - Renal Biopsy - Pediatric - Postprocedure [4721] - Clinical Hub, UW Health Clinical Tool Search, UW Health Clinical Tool Search, Order Sets, HOD, Diagnostics/Sedation


SmartSet: OP - RENAL BIOPSY - PEDIATRIC POSTPROCEDURE (ID:4721)
General Information
Display name: OP - Renal Biopsy - Pediatric - Postprocedure
Type: General
Merge priority: 0
Version comment:
Content source:
Synonyms: 1. Pediatric Liver Biopsy
2. .DIAGNOSTICS
3. .SEDATION
4. .DX
SmartSet notes:
Description:
Web information: Title URL
1.
Questionnaire:
Configuration
Patient Care Orders
Vital Signs
Vital Signs SEE COMMENTS, Starting S For Until specified,
Routine
Temperature Measurement Method:
Temperature Measurement Restrictions:
BP Source:
BP Location:
BP Position:
BP Restrictions:
Every 15 minutes times 4, then every 30 minutes
times 4, then every hour times 4, then every 2 hours
while awake for 12., Peds Diagnostic
Activity
Page 1 of 6
Printed by STRAKA, KEVIN F [KFS1] at 1/20/2017 1:57:19 PM
Copyright © 2017 University of Wisconsin Hospitals and Clinics Authority
Contact: Lee Vermeulen, CCKM@uwhealth.org Last Revised: 01/2017CCKM@uwhealth.org

Bedrest CONTINUOUS, Routine
AD LIB:
AMBULATE:
CHAIR:
DANGLE:
BEDREST: strict bedrest
RESTRICTIONS:
UPPER LEFT EXTREMITY WEIGHT BEARING:
UPPER RIGHT EXTREMITY WEIGHT BEARING:
LOWER LEFT EXTREMITY WEIGHT BEARING:
LOWER RIGHT EXTREMITY WEIGHT BEARING:
Peds Diagnostic
Bedrest with Bathroom Privileges CONTINUOUS For 24 Hours, Routine
AD LIB:
AMBULATE:
CHAIR:
DANGLE:
BEDREST: with bathroom privileges
RESTRICTIONS:
UPPER LEFT EXTREMITY WEIGHT BEARING:
UPPER RIGHT EXTREMITY WEIGHT BEARING:
LOWER LEFT EXTREMITY WEIGHT BEARING:
LOWER RIGHT EXTREMITY WEIGHT BEARING:
Peds Diagnostic
Elevate Head Of Bed Equal to (degrees):
Greater than (degrees):
Less than (degrees): 45
Other options:
Routine, CONTINUOUS, Peds Diagnostic
Nutrition
General Diet EFFECTIVE NOW, Starting S, Routine
Patient Type: Pediatric
Diet Type: General (no Modifications)
Bedside Meal Instructions:
Room Service Class:
NPO except medications for 4 hours post-biopsy until
hematocrit is back. Call Provider on-call for Diet
Order update., Peds Diagnostic
Intake and Output
Measure Intake And Output EVERY 8 HOURS, Routine, Peds Diagnostic
Non-Categorized Patient Care Orders
Collect Bloody Urine SEE COMMENTS, Collect each grossly bloody urine
output and label serially., Peds Diagnostic
Contingency Parameters for Patients Less than 7 Months of Age
Page 2 of 6
Printed by STRAKA, KEVIN F [KFS1] at 1/20/2017 1:57:19 PM
Copyright © 2017 University of Wisconsin Hospitals and Clinics Authority
Contact: Lee Vermeulen, CCKM@uwhealth.org Last Revised: 01/2017CCKM@uwhealth.org

Notify Provider Provider to Notify: Provider
If systolic blood pressure > (mmHg):
If systolic blood pressure < (mmHg):
If diastolic blood pressure > (mmHg):
If diastolic blood pressure < (mmHg):
If temperature > (C): 38
If temperature < (C):
If heart rate > (bpm):
If heart rate < (bpm):
If respiratory rate >:
If respiratory rate <:
If blood glucose > (mg/dL):
If blood glucose < (mg/dL):
If pain score >:
Pulse Oximetry < (%):
If urine output < (mL):
Other: Complains of abdominal or back pain
Peds Diagnostic
Contingency Parameters for Patients 7 Months to 3 Years of Age
Notify Provider Provider to Notify: Provider
If systolic blood pressure > (mmHg):
If systolic blood pressure < (mmHg):
If diastolic blood pressure > (mmHg):
If diastolic blood pressure < (mmHg):
If temperature > (C): 38
If temperature < (C):
If heart rate > (bpm):
If heart rate < (bpm):
If respiratory rate >:
If respiratory rate <:
If blood glucose > (mg/dL):
If blood glucose < (mg/dL):
If pain score >:
Pulse Oximetry < (%):
If urine output < (mL):
Other: Complains of abdominal or back pain
Peds Diagnostic
Contingency Parameters for Patients 3 to 7 Years of Age
Notify Provider Provider to Notify: Provider
If systolic blood pressure > (mmHg):
If systolic blood pressure < (mmHg):
If diastolic blood pressure > (mmHg):
If diastolic blood pressure < (mmHg):
If temperature > (C): 38
If temperature < (C):
If heart rate > (bpm):
If heart rate < (bpm):
If respiratory rate >:
If respiratory rate <:
If blood glucose > (mg/dL):
If blood glucose < (mg/dL):
If pain score >:
Pulse Oximetry < (%):
If urine output < (mL):
Other: Complains of abdominal or back pain
Peds Diagnostic
Contingency Parameters for Patients 7 to 11 Years of Age
Page 3 of 6
Printed by STRAKA, KEVIN F [KFS1] at 1/20/2017 1:57:19 PM
Copyright © 2017 University of Wisconsin Hospitals and Clinics Authority
Contact: Lee Vermeulen, CCKM@uwhealth.org Last Revised: 01/2017CCKM@uwhealth.org

Notify Provider Provider to Notify: Provider
If systolic blood pressure > (mmHg):
If systolic blood pressure < (mmHg):
If diastolic blood pressure > (mmHg):
If diastolic blood pressure < (mmHg):
If temperature > (C): 38
If temperature < (C):
If heart rate > (bpm):
If heart rate < (bpm):
If respiratory rate >:
If respiratory rate <:
If blood glucose > (mg/dL):
If blood glucose < (mg/dL):
If pain score >:
Pulse Oximetry < (%):
If urine output < (mL):
Other: Complains of abdominal or back pain
Peds Diagnostic
Contingency Parameters for Patients 11 Years of Age and Older
Notify Provider Provider to Notify: Provider
If systolic blood pressure > (mmHg):
If systolic blood pressure < (mmHg):
If diastolic blood pressure > (mmHg):
If diastolic blood pressure < (mmHg):
If temperature > (C): 38
If temperature < (C):
If heart rate > (bpm):
If heart rate < (bpm):
If respiratory rate >:
If respiratory rate <:
If blood glucose > (mg/dL):
If blood glucose < (mg/dL):
If pain score >:
Pulse Oximetry < (%):
If urine output < (mL):
Other: Complains of abdominal or back pain
Peds Diagnostic
Intravenous Therapy
IV Fluids
dextrose 5%-NaCl 0.45% infusion Intravenous, CONTINUOUS, Peds Diagnostic
Insert and Maintain Peripheral IV CONTINUOUS, Routine
Peripheral IV Size: RN Discretion
Does this need to be inserted/placed?
Discontinue IV fluids and cap line when adequate oral
intake., Peds Diagnostic
Medications
Page 4 of 6
Printed by STRAKA, KEVIN F [KFS1] at 1/20/2017 1:57:19 PM
Copyright © 2017 University of Wisconsin Hospitals and Clinics Authority
Contact: Lee Vermeulen, CCKM@uwhealth.org Last Revised: 01/2017CCKM@uwhealth.org

Analgesics
acetaMINOPHEN alcohol free (TYLENOL) oral
suspension - NOTE: Suggested dose 15
mg/kg/dose (Maximum 650 mg/dose)
15 mg/kg, Oral, EVERY 4 HOURS PRN, pain/fever
NOTE: Suggested dose 15 mg/kg/dose (Maximum
650 mg/dose)
Peds Diagnostic
acetaMINOPHEN (TYLENOL) tab - NOTE:
Suggested dose 15 mg/kg/dose (Maximum 650
mg/dose)
325 mg, Oral, EVERY 4 HOURS PRN, pain/fever
NOTE: Suggested dose 15 mg/kg/dose (Maximum
650 mg/dose)
Peds Diagnostic
acetaMINOPHEN (TYLENOL) tab - NOTE:
Suggested dose 15 mg/kg/dose (Maximum 650
mg/dose)
500 mg, Oral, EVERY 4 HOURS PRN, pain/fever
NOTE: Suggested dose 15 mg/kg/dose (Maximum
650 mg/dose)
Peds Diagnostic
acetaMINOPHEN (TYLENOL) tab - NOTE:
Suggested dose 15 mg/kg/dose (Maximum 650
mg/dose)
650 mg, Oral, EVERY 4 HOURS PRN, pain/fever
NOTE: Suggested dose 15 mg/kg/dose (Maximum
650 mg/dose)
Peds Diagnostic
Laboratory
Laboratory
HEMATOCRIT 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?
Peds Diagnostic
CREATININE 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?
Peds Diagnostic
Criteria
Suggestions:
Filter: UWHC W/ INPATIENT ENCOUNTER FOR POC[1344]
Restrict SmartSet:
Settings
Discontinue action:
Deselect sections for
Pended/Held orders:
Pended/Held orders
display:
Release date: Use System Definitions Setting
Page 5 of 6
Printed by STRAKA, KEVIN F [KFS1] at 1/20/2017 1:57:19 PM
Copyright © 2017 University of Wisconsin Hospitals and Clinics Authority
Contact: Lee Vermeulen, CCKM@uwhealth.org Last Revised: 01/2017CCKM@uwhealth.org

Disallow user override:
Page 6 of 6
Printed by STRAKA, KEVIN F [KFS1] at 1/20/2017 1:57:19 PM
Copyright © 2017 University of Wisconsin Hospitals and Clinics Authority
Contact: Lee Vermeulen, CCKM@uwhealth.org Last Revised: 01/2017CCKM@uwhealth.org