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IP - Anesthesiology - ICU - Adult - Postoperative [2952]

IP - Anesthesiology - ICU - Adult - Postoperative [2952] - Clinical Hub, UW Health Clinical Tool Search, UW Health Clinical Tool Search, Order Sets, Inpatient, Anesthesiology


IP - Anesthesiology - ICU - Adult - Postoperative [2952]
Patient Care Orders
Patient Monitoring - Glucose [148315]
Glucose, POC - Immediately Postoperatively
[IPGLUCOSE]
POST-OP, Routine, Glucose, POC should always be
ordered in conjunction with orders for hypoglycemia
management and monitoring as indicated in the
Hypoglycemia Management (Adult) panel.
If Conditional, What Condition?
Immediately Postoperatively
Glucose, POC - Prior to Discharge from PACU
[IPGLUCOSE]
POST-OP, Routine, Glucose, POC should always be
ordered in conjunction with orders for hypoglycemia
management and monitoring as indicated in the
Hypoglycemia Management (Adult) panel.
If Conditional, What Condition?
Prior to Discharge from PACU
GLUCOSE, WHOLE BLOOD [HCWBGLU] CONDITIONAL, STAT
If add on test, what should lab do if unable to add test
to previous specimen?
If Conditional, What Condition? If glucose point of care
results with <40 mg/dL or >400 mg/dL
Hypoglycemia Management (Adult) [191576]
Glucose, POC [IPGLUCOSE] AS NEEDED FOR SIGNS AND SYMPTOMS OF
HYPOGLYCEMIA, Starting today For Until specified,
Routine, Glucose, POC should always be ordered in
conjunction with orders for hypoglycemia
management and monitoring as indicated in the
Hypoglycemia Management (Adult) panel.
If Conditional, What Condition?
Glucose, POC [IPGLUCOSE] AFTER PROVIDING HYPOGLYCEMIA
TREATMENT, Starting today For Until specified,
Routine, Glucose, POC should always be ordered in
conjunction with orders for hypoglycemia
management and monitoring as indicated in the
Hypoglycemia Management (Adult) panel.
If Conditional, What Condition?
Per hypoglycemia treatment algorithm Recheck
glucose 15 minutes after providing treatment until
glucose is greater than or equal to 70 mg/dL. If
patient has been critically low (i.e., glucose less than
40 mg/dL), recheck glucose after 1 hour to ensure
glucose remains greater than or equal to 70mg/dL.
After resolution of mild hypoglycemia (i.e., glucose
40-69 mg/dL), consider rechecking after 1 hour if
patient has signs/symptoms of hypoglycemia or is at
risk for a subsequent hypoglycemic event (e.g.,
previously administered insulin still active, altered
renal status, altered mental status, NPO or
interrupted nutrition, or any other condition that
increases hypoglycemia risk)
Notify Provider [NURCOM0001] Provider to Notify: Provider
Notify based on: Blood Glucose,Other
If blood glucose > (mg/dL): 400
If blood glucose < (mg/dL): 40
Other: Nutritional status changes
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Hypoglycemia Treatment for blood glucose less
than 40 mg/dL and patient able to eat/swallow
safely [NURCOM0022]
CONDITIONAL, Starting today For Until specified
If Conditional, What Condition? If blood glucose less
than 40mg/dL and patient able to eat/swallow safely.
Give 30 grams of carbohydrate (8 oz. of fruit juice).
Repeat treatment until glucose is 70 mg/dL or
greater.
Hypoglycemia Treatment for blood glucose
between 40 to 69 mg/dL and patient able to
eat/swallow safely [NURCOM0022]
CONDITIONAL, Starting today For Until specified
If Conditional, What Condition? If glucose is 40-69
mg/dL and patient able to eat/swallow safely
Give 15 grams of carbohydrate (4 oz of fruit juice).
Repeat treatment until glucose is 70 mg/dL or
greater.
glucose-vitamin C chew tab [50690] 16 g, Oral, EVERY 15 MINUTES PRN,
hypoglycemia, Hypoglycemia, For blood glucose 40-
69 mg/dL
Use in patients able to safely eat/swallow but unable
to tolerate volume of fruit juice or per patient
preference. Repeat every 15 minutes until blood
glucose is 70 mg/dL or greater.
glucose-vitamin C chew tab [50690] 32 g, Oral, EVERY 15 MINUTES PRN,
hypoglycemia, Hypoglycemia, For blood glucose
less than 40 mg/dL
Use in patients able to safely eat/swallow but unable
to tolerate volume of fruit juice or per patient
preference. Repeat every 15 minutes until blood
glucose is 70 mg/dL or greater.
glucagon injection kit [107799] 1 mg, Subcutaneous, PRN, For blood glucose less
than 69 mg/dL and patient unable to eat/swallow
safely AND has NO IV access
Repeat every 15 minutes until blood glucose is 70
mg/dL or greater. See Adult Hypoglycemia Algorithm
dextrose injection [800233] 12.5 g, Intravenous, PRN, For blood glucose 40-69
mg/dL and patient unable to eat/swallow safely AND
has IV access
Repeat every 15 minutes until blood glucose is 70
mg/dL or greater. See Adult Hypoglycemia Algorithm
dextrose injection [800233] 25 g, Intravenous, PRN, For blood glucose less than
40 mg/dL and patient unable to eat/swallow safely
AND has IV access.
Repeat every 15 minutes until blood glucose is 70
mg/dL or greater. See Adult Hypoglycemia Algorithm
GLUCOSE, WHOLE BLOOD [HCWBGLU] CONDITIONAL, Starting today For 7 Days, STAT
If add on test, what should lab do if unable to add
test to previous specimen?
If Conditional, What Condition? Draw if blood
glucose is less than 40 mg/dL or greater than 400
mg/dL.
GLUCOSE, WHOLE BLOOD [HCWBGLU] CONDITIONAL, Starting 12/23/17 For 7 Days, STAT
If add on test, what should lab do if unable to add
test to previous specimen?
If Conditional, What Condition? Draw if blood
glucose is less than 40 mg/dL or greater than 400
mg/dL.
Respiratory [109856]
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Initiate Adult PACU Oxygen Titration Protocol
[NURTRT0082]
CONTINUOUS, Starting today, Routine
O2 Delivery Device: Nasal Cannula
FiO2 (%) Titrate to Keep Sats >/= to ___%:
Liter Flow:
Titrate oxygen to maintain O2 sat at (%):
Attempt to Wean Off Oxygen?
Post-Op/Phase II
CPAP Continuous [RT0009] Routine
PEEP (cmH2O):
FiO2 (%) Titrate to Keep Sats >/= to ___%:
Titrate oxygen to maintain O2 sat at (%):
Self Administered (Only RT may document in this box
after patient assessment): RT Approval Required
If patient brings own device, RT to evaluate., Post-
Op/Phase II
Biphasic Positive Airway Pressure (BIPAP)
[RT0004]
Routine
Mode:
IPAP (cm H2O):
EPAP (cm H2O):
FiO2 (%) Titrate to Keep Sats >/= to ___%:
Set Rate/Min:
Titrate oxygen to maintain O2 sat at (%):
Self Administered (Only RT may document in this box
after patient assessment): RT Approval Required
Post-Op/Phase II
Mechanical Ventilation - Adult [117146]
Provide Manual Resuscitator at Bedside
[RT0039]
CONTINUOUS, Routine
Mechanical Ventilation [RT0028] Routine, For ADULT patients order chlorihexidene
gluconate (PERIDEX) 0.12% soln 15 mL to swab
oral cavity 2x daily while on ventilation.
Is this a modification to a current vent order?
Ventilator Management:
Wean:
Set Rate/Min:
PEEP (cmH2O):
Mode:
Tidal Volume Multiplier: 6
FiO2 (%) Titrate to Keep Sats >/= to ___%:
Pressure Support:
Pressure Control:
P High (cmH20):
P Low (PEEP) (cmH20):
T High (sec):
T Low (T PEEP) (sec):
PS above P High (cmH2O):
PS above PEEP (cmH2O):
NAVA Level (µV):
chlorhexidine (PERIDEX) 0.12 % soln
MULTIDOSE [792004]
15 mL, Mouth/Throat, 2 X DAILY Starting today
Use to swab oral cavity. Discontinue when patient no
longer on ventilation.
Non-Categorized Patient Care Orders [91029]
Discontinue all Post-Op Anesthesia Orders When
Patient Scores 9 or Higher on PACU Discharge
Criteria [NURCOM0022]
ONCE, Starting today For 1 Occurrences, Discontinue
all Post-Op Anesthesia Orders When Patient Scores 9
or Higher on PACU Discharge Criteria, Post-Op/Phase
II
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Urinary Catheterization-Intermittent
[NURELM0018]
PRN, Starting today For Until specified, Routine,
Perform a urinary bladder drainage straight cath, if
bladder volume via bladder scan meets PACU criteria,
Post-Op/Phase II
May Use Postoperative Regional Analgesia
Orders [NURCOM0022]
ONCE, Starting today For 1 Occurrences, May Use
Postoperative Regional Analgesia Orders, Post-
Op/Phase II
May Use Surgeon's Postoperative Patient
Controlled Analgesia (PCA) Orders
[NURCOM0022]
ONCE, Starting today For 1 Occurrences, May Use
Surgeon's Postoperative Patient Controlled Analgesia
(PCA) Orders, Post-Op/Phase II
Use Surgeon's Supplemental Insulin Orders
[NURCOM0022]
ONCE For 1 Occurrences, Post-Op/Phase II
Contingency Parameters [148316]
Cardiovascular and Respiratory Parameters to
Notify Anesthesiologist [NURCOM0022]
ONCE, Starting today For 1 Occurrences, Call
Anesthesiologist if HYPOtension: systolic BP below ***
or diastolic BP below ***
Call Anesthesiologist if HYPERtension: systolic BP
above *** or diastolic BP above ***
Call Anesthesiologist if Respiratory Distress. If
respiratory rate is above *** or if Oxygen Sat is below
***, Post-Op/Phase II
Intravenous Fluids
IV Fluids [92755]
sodium chloride 0.9% infusion [64367] at 125 mL/hr, Intravenous, CONTINUOUS, Post-
Op/Phase II
lactated ringers infusion [38890] at 125 mL/hr, Intravenous, CONTINUOUS, Post-
Op/Phase II
PLASMA-LYTE A infusion [41099] Intravenous, CONTINUOUS
Medications
Please review the patient's pain medication for the prior 24 hours before ordering as burn
patients may be tolerant to narcotics and require a higher narcotic dose that the guardrail
guidelines allow.
Respiratory/Airway [92756]
albuterol neb soln (3 mL) [800248] 2.5 mg, Nebulization, ONCE For 1 Doses, Post-
Op/Phase II
ipratropium (ATROVENT) neb soln [47883] 500 mcg, Nebulization, ONCE For 1 Doses, Post-
Op/Phase II
ipratropium-albuterol (DUO-NEB) 0.5-2.5 mg/3
mL neb soln [67220]
3 mL, Nebulization, ONCE For 1 Doses, Post-
Op/Phase II
racepinephrine 2.25 % neb soln [150812] 0.5 mL, Nebulization, ONCE For 1 Doses, Post-
Op/Phase II
Bradycardia [91036]
atropine injection [800178] 0.5 mg, Intravenous, ONCE PRN For 2 Hours,
bradycardia, see Admin instructions
Administer for symptomatic bradycardia and notify
anesthesiologist. Symptoms include decreased level
of consciousness, nausea, and decreased heart rate
less than 40 beats per minute
Post-Op/Phase II
Parenteral Opioid Analgesic - First Line Rescue Therapy (Single Response) [91031]
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MORPHine PF injection RANGE [750057] 1-4 mg, Intravenous, EVERY 6 MINUTES PRN For 2
Hours, pain
First Line Parenteral Analgesic Agent- Administer first
line if unable to tolerate oral opioids. Administer up to
a maximum of *** mg. If insufficient pain relief after
administration of maximum dose, give second line
parenteral therapy or notify provider if no second line
therapy is ordered. When bridging to oral opioid
analgesic, may administer single IV dose following
administration of initial oral opioid analgesic dose.
for 4 Minutes, Post-Op/Phase II
HYDROmorphone PF (DILAUDID) injection
[750050]
0.2-0.6 mg, Intravenous, EVERY 6 MINUTES PRN
For 2 Hours, pain
First Line Parenteral Analgesic Agent- Administer first
line if unable to tolerate oral opioids. Administer up to
a maximum of *** mg. If insufficient pain relief after
administration of maximum dose, give second line
parenteral therapy or notify provider if no second line
therapy is ordered. When bridging to oral opioid
analgesic, may administer single IV dose following
administration of initial oral opioid analgesic dose.
for 3 Minutes, Post-Op/Phase II
FENTanyl PF injection RANGE [750047] 25-50 mcg, Intravenous, EVERY 6 MINUTES PRN
For 2 Hours, pain
First Line Parenteral Analgesic Agent- Administer first
line if unable to tolerate oral opioids. Administer up to
a maximum of *** mcg. If insufficient pain relief after
administration of maximum dose, give second line
parenteral therapy or notify provider if no second line
therapy is ordered. When bridging to oral opioid
analgesic, may administer single IV dose following
administration of initial oral opioid analgesic dose.
for 1 Minutes, Post-Op/Phase II
Parenteral Opioid Analgesic - Second Line Therapy (Single Response) [145935]
MORPHine PF injection RANGE [750057] 1-4 mg, Intravenous, EVERY 6 MINUTES PRN For 2
Hours, pain
Second Line Parenteral Analgesic Agent - Administer
second line if unable to tolerate oral opioids.
Administer up to a maximum of *** mg. If insufficient
pain relief after administration of maximum dose,
notify the provider. If bridging to oral opioid analgesic,
may administer single IV dose following administration
of initial oral opioid analgesic dose.
for 4 Minutes, Post-Op/Phase II
HYDROmorphone PF (DILAUDID) injection
[750050]
0.2-0.6 mg, Intravenous, EVERY 6 MINUTES PRN
For 2 Hours, pain
Second Line Parenteral Analgesic Agent - Administer
second line if unable to tolerate oral opioids.
Administer up to a maximum of *** mg. If insufficient
pain relief after administration of maximum dose,
notify the provider. If bridging to oral opioid analgesic,
may administer single IV dose following administration
of initial oral opioid analgesic dose.
for 3 Minutes, Post-Op/Phase II
Page 5 of 12
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FENTanyl PF injection RANGE [750047] 25-50 mcg, Intravenous, EVERY 6 MINUTES PRN
For 2 Hours, pain
Second Line Parenteral Analgesic Agent - Administer
second line if unable to tolerate oral opioids.
Administer up to a maximum of *** mcg. If insufficient
pain relief after administration of maximum dose,
notify the provider. If bridging to oral opioid analgesic,
may administer single IV dose following administration
of initial oral opioid analgesic dose.
for 1 Minutes, Post-Op/Phase II
Parenteral Opioid Antishivering - Meperidine [148314]
meperidine (DEMEROL) injection [800195] 12.5 mg, Intravenous, EVERY 5 MINUTES PRN For 2
Doses, rigors, shivering
If shivering/rigors persist after second dose notify
provider
Parenteral Analgesic - Ketamine [205492]
ketAMINE injection [800191] Intravenous, ONCE For 1 Doses, Post-Op/Phase II
ketAMINE (KETALAR) 100 mg in sodium chloride
0.9 % 50 mL infusion syringe [700932]
Intravenous, CONTINUOUS, Post-Op/Phase II
Sedatives (Single Response) [205493]
diazepam (VALIUM) injection [36675] 5 mg, Intravenous, ONCE For 1 Doses
midazolam (VERSED) injection [800197] 2 mg, Intravenous, ONCE For 1 Doses
Antiemetics - First Line Rescue Therapy [91032]
diphenhydramine (BENADRYL) injection [800106] Intravenous, ONCE PRN For 2 Hours,
nausea/vomiting
First Line Agent. If two - three first line agents are
ordered, these should be considered as concurrent
administration orders.
Post-Op/Phase II
metoclopramide (REGLAN) injection [800059] Intravenous, ONCE PRN For 2 Hours,
nausea/vomiting
First Line Agent. If two - three first line agents are
ordered, these should be considered as concurrent
administration orders
Post-Op/Phase II
ondansetron (ZOFRAN) injection [800202] 4 mg, Intravenous, ONCE PRN For 2 Hours,
nausea/vomiting
First Line Agent. If two - three first line agents are
ordered, these should be considered as concurrent
administration orders.
Post-Op/Phase II
prochlorperazine (COMPAZINE) injection [41369] Intravenous, ONCE PRN For 2 Hours,
nausea/vomiting
First Line Agent. If two - three first line agents are
ordered, these should be considered as concurrent
administration orders
If ordered IV: push slowly, max rate 5 mg/minute.
Post-Op/Phase II
olanzapine (ZYPREXA) tab [57140] Oral, ONCE PRN For 2 Hours, nausea
First Line Agent. If two - three first line agents are
ordered, these should be considered as concurrent
administration orders
Post-Op/Phase II
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olanzapine (ZYPREXA ZYDIS) disintegrating tab
[64700]
Oral, ONCE PRN For 2 Hours, nausea
First Line Agent. If two - three first line agents are
ordered, these should be considered as concurrent
administration orders
Post-Op/Phase II
Antiemetics - Second Line Rescue Therapy [145936]
procedure, select an the patient received a single prophylactic antiemetic agent during the If
therapy in the anesthesia recovery period agent with a different mechanism of action for rescue
three -prophylactically, rescue with prochlorperazine). If two (e.g., if ondansetron was given
as ordered within a 1st, 2nd, or 3rd Line Panel, these should be considered agents are
concurrent administration orders.
diphenhydramine (BENADRYL) injection [800106] Intravenous, ONCE PRN For 2 Hours,
nausea/vomiting
Second Line Agent - Give if patient fails to respond to
first line agent after 30 minutes. If two - three second
line agents are ordered, these should be considered
as concurrent administration order. If response is
insufficient within 30 minutes, notify provider.
Post-Op/Phase II
metoclopramide (REGLAN) injection [800059] Intravenous, ONCE PRN For 2 Hours,
nausea/vomiting
Second Line Agent - Give if patient fails to respond to
first line agent after 30 minutes. If two - three second
line agents are ordered, these should be considered
as concurrent administration order. If response is
insufficient within 30 minutes, notify provider.
Post-Op/Phase II
ondansetron (ZOFRAN) injection [800202] 4 mg, Intravenous, ONCE PRN For 2 Hours,
nausea/vomiting
Second Line Agent - Give if patient fails to respond to
first line agent after 30 minutes. If two - three second
line agents are ordered, these should be considered
as concurrent administration order. If response is
insufficient within 30 minutes, notify provider.
Post-Op/Phase II
prochlorperazine (COMPAZINE) injection [41369] Intravenous, ONCE PRN For 2 Hours,
nausea/vomiting
Second Line Agent - Give if patient fails to respond to
first line agent after 30 minutes. If two - three second
line agents are ordered, these should be considered
as concurrent administration order. If response is
insufficient within 30 minutes, notify provider.
If ordered IV: push slowly, max rate 5 mg/minute.
Post-Op/Phase II
olanzapine (ZYPREXA) tab [57140] Oral, ONCE PRN For 2 Hours, nausea
Second Line Agent - Give if patient fails to respond to
first line agent after 30 minutes. If two - three second
line agents are ordered, these should be considered
as concurrent administration order. If response is
insufficient within 30 minutes, notify provider.
Post-Op/Phase II
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olanzapine (ZYPREXA ZYDIS) disintegrating tab
[64700]
Oral, ONCE PRN For 2 Hours, nausea
Second Line Agent - Give if patient fails to respond to
first line agent after 30 minutes. If two - three second
line agents are ordered, these should be considered
as concurrent administration order. If response is
insufficient within 30 minutes, notify provider.
Post-Op/Phase II
Anti-hypotensives [91033]
sodium chloride 0.9% BOLUS [730003] 500 mL, Intravenous, ONCE PRN For 2 Hours,
hypotension - see Admin Instructions
Administer for systolic blood pressure less than *** Hg.
If two - three hypotension therapies are ordered,
these should be considered to be concurrent
administration orders. If blood pressure increase is
insufficient within *** minutes of administration, notify
provider.
Post-Op/Phase II
lactated ringers BOLUS [730001] 500 mL, Intravenous, ONCE PRN For 2 Hours,
hypotension - see Admin Instructions
Administer for systolic blood pressure less than *** Hg.
If two - three hypotension therapies are ordered,
these should be considered to be concurrent
administration orders. If blood pressure increase is
insufficient within *** minutes of administration, notify
provider.
Post-Op/Phase II
albumin human 5% infusion [44038] 12.5 g, Intravenous, ONCE PRN For 2 Hours,
hypotension - see Admin Instructions
Administer for systolic blood pressure less than *** Hg.
If two - three hypotension therapies are ordered,
these should be considered to be concurrent
administration orders. If blood pressure increase is
insufficient within *** minutes of administration, notify
provider. Hang to gravity. Albumin tubing needed.
Post-Op/Phase II
epHEDRINE in sodium chloride 0.9% 5MG/ML
injection [755112]
5-10 mg, Intravenous, EVERY 10 MINUTES PRN For
2 Hours, hypotension - see Admin Instructions
Administer for systolic blood pressure less than *** Hg.
If two - three hypotension therapies are ordered,
these should be considered to be concurrent
administration orders. If blood pressure increase is
insufficient within *** minutes of administration, notify
provider. Maximum of 3 total doses of epHEDRINE.
Post-Op/Phase II
phenylEPHRINE in sodium chloride 0.9% 0.1
MG/ML injection [755110]
Intravenous, EVERY 10 MINUTES PRN For 2 Hours,
hypotension - see Admin Instructions
Administer for systolic blood pressure less than *** Hg.
If two - three hypotension therapies are ordered,
these should be considered to be concurrent
administration orders. If blood pressure increase is
insufficient within *** minutes of administration, notify
provider. Maximum 3 total doses of phenylEPHRINE.
Post-Op/Phase II
Anti-hypertensives (Single Response) [91034]
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enalaprilat (VASOTEC) 1.25 mg/mL injection
[45046]
1.25 mg, Intravenous, ONCE PRN For 2 Hours,
hypertension - see Admin Instructions
Administer for systolic blood pressure greater than ***
mmHg or diastolic blood pressure greater than ***
mmHg
If blood pressure decrease is insufficient within ***
minutes, notify provider
for 5 Minutes, Post-Op/Phase II
hydrALAZINE (APRESOLINE) injection 5 mg
[800109]
5 mg, Intravenous, ONCE PRN For 2 Hours,
hypertension - see Admin Instructions
Administer for systolic blood pressure greater than ***
mmHg or diastolic blood pressure greater than ***
If blood pressure decrease is insufficient within ***
minutes, notify provider
Post-Op/Phase II
hydrALAZINE (APRESOLINE) injection 10 mg
[800109]
10 mg, Intravenous, ONCE PRN For 2 Doses,
hypertension - see Admin Instructions
Administer for systolic blood pressure greater than ***
mmHg or diastolic blood pressure greater than ***
If blood pressure decrease is insufficient within ***
minutes, notify provider
Post-Op/Phase II
labetalol (NORMODYNE;TRANDATE) injection
[750053]
5-10 mg, Intravenous, EVERY 10 MINUTES PRN For
2 Hours, hypertension - see Admin Instructions
Administer for systolic blood pressure greater than ***
mmHg or diastolic blood pressure greater than ***
mmHg (maximum 40 mg)
If blood pressure decrease is insufficient within ***
minutes, notify provider
for 2 Minutes, Post-Op/Phase II
metoprolol (LOPRESSOR) injection [800274] Intravenous, ONCE PRN For 2 Hours, hypertension -
see Admin Instructions
Administer for systolic blood pressure greater than ***
mmHg or diastolic blood pressure greater than ***
mmHg
If blood pressure decrease is insufficient within ***
minutes, notify provider
Post-Op/Phase II
nitroglycerin (NITROSTAT) sublingual tab [40283] 0.4 mg, Sublingual, EVERY 10 MINUTES PRN For 2
Hours, chest pain, hypertension - see Admin
Instructions
Administer for systolic blood pressure greater than ***
mmHg or diastolic blood pressure greater than ***
mmHg. Maximum *** doses
If blood pressure decrease is insufficient within ***
minutes, notify provider
Post-Op/Phase II
Infusions [109720]
amiodarone (CORDARONE) non- PVC infusion
[700135]
Intravenous, CONTINUOUS, Post-Op/Phase II
diltiazem (CARDIZEM) infusion [700192] Intravenous, CONTINUOUS, Post-Op/Phase II
epINEPHrine infusion [700197] Intravenous, CONTINUOUS, Post-Op/Phase II
isoproterenol (ISUPEL) infusion [700221] Intravenous, CONTINUOUS, Post-Op/Phase II
naloxone (NARCAN) infusion [700242] Intravenous, CONTINUOUS, Post-Op/Phase II
nicardipine (CARDENE) 50 mg in sodium chloride
0.9 % 250 mL infusion [700960]
Intravenous, CONTINUOUS, Post-Op/Phase II
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norepinephrine (LEVOPHED) infusion [700247] Intravenous, CONTINUOUS, Post-Op/Phase II
phenylEPHRINE(NEO-SYNEPHRINE) infusion
[700258]
Intravenous, CONTINUOUS, Post-Op/Phase II
sodium bicarbonate 150 mEq in sodium chloride
0.45% 1,000 mL infusion [700376]
Intravenous, CONTINUOUS
(SHOCK) vasopressin (PITRESSIN) 20 units in
dextrose 5 % 100 mL infusion [700977]
Intravenous, CONTINUOUS For 4 Hours, Post-
Op/Phase II
Infusions - Stock Bags [109721]
DOBUTamine (DOBUTREX) 1000mg in dextrose
5% 250 mL infusion [51747]
Intravenous, CONTINUOUS, Post-Op/Phase II
DOPamine (INTROPIN) 800 mg in dextrose 5%
250 mL infusion [50506]
Intravenous, CONTINUOUS, Post-Op/Phase II
esmolol (BREVIBLOC) 2.5 g in sodium chloride
0.9% 250 mL infusion [66486]
Intravenous, CONTINUOUS, Post-Op/Phase II
lidocaine 2000 mg in dextrose 5% 500 mL
infusion [50530]
Intravenous, CONTINUOUS, Post-Op/Phase II
milrinone (PRIMACOR) 20 mg in dextrose 5%
100 mL infusion [175995]
Intravenous, CONTINUOUS, Post-Op/Phase II
nitroglycerin 50 mg in dextrose 5% 250 mL
infusion [51611]
Intravenous, CONTINUOUS, Post-Op/Phase II
Nalbuphine [109722]
nalbuphine (NUBAIN) injection [39994] 2.5 mg, Intravenous, ONCE PRN For 2 Hours, opioid-
induced pruritus, for 3 Minutes, Post-Op/Phase II
Postoperative Laboratory
Immediately Postoperatively [109857]
CALCIUM [CA] STAT, Starting today For 1 Occurrences, Routine
If add on test, what should lab do if unable to add test
to previous specimen?
If Conditional, What Condition?
Draw immediately postoperatively., Post-Op/Phase II
MAGNESIUM [MAG] STAT, Starting today For 1 Occurrences, Routine
If add on test, what should lab do if unable to add test
to previous specimen?
If Conditional, What Condition?
Draw immediately postoperatively., Post-Op/Phase II
POTASSIUM [K] STAT, Starting today For 1 Occurrences, Routine
If add on test, what should lab do if unable to add test
to previous specimen?
If Conditional, What Condition?
Draw immediately postoperatively., Post-Op/Phase II
SODIUM [NA] STAT, Starting today For 1 Occurrences, Routine
If add on test, what should lab do if unable to add test
to previous specimen?
If Conditional, What Condition?
Draw immediately postoperatively., Post-Op/Phase II
TROPONIN [GM2447] STAT, Starting today For 1 Occurrences, Routine
If add on test, what should lab do if unable to add test
to previous specimen?
If Conditional, What Condition?
Draw immediately postoperatively. If ordering troponin
notify surgeon., Post-Op/Phase II
BUN [BUN] STAT, Starting today For 1 Occurrences, Routine
If add on test, what should lab do if unable to add test
to previous specimen?
If Conditional, What Condition?
Draw immediately postoperatively., Post-Op/Phase II
Page 10 of 12
Printed by BENNETT, SARA J [SJB008] at 12/15/2017 7:11:39 AM
Copyright © 2017 University of Wisconsin Hospitals and Clinics Authority
Contact: Lee Vermeulen, CCKM@uwhealth.org Last Revised:
 
12/2017CCKM@uwhealth.org

CREATININE [CRET] STAT, Starting today For 1 Occurrences, Routine
If add on test, what should lab do if unable to add test
to previous specimen?
If Conditional, What Condition?
Draw immediately postoperatively., Post-Op/Phase II
HEMOGLOBIN [HGB] STAT, Starting today For 1 Occurrences, Routine
If add on test, what should lab do if unable to add test
to previous specimen?
If Conditional, What Condition?
Draw immediately postoperatively., Post-Op/Phase II
PLATELET COUNT [PLT] STAT, Starting today For 1 Occurrences, Routine
If add on test, what should lab do if unable to add test
to previous specimen?
If Conditional, What Condition?
Draw immediately postoperatively., Post-Op/Phase II
PROTHROMBIN TIME/INR [PT] STAT, Starting today For 1 Occurrences, Routine
If add on test, what should lab do if unable to add test
to previous specimen?
If Conditional, What Condition?
Draw immediately postoperatively., Post-Op/Phase II
PTT [PTT] STAT, Starting today For 1 Occurrences, Routine
If add on test, what should lab do if unable to add test
to previous specimen?
If Conditional, What Condition?
Draw immediately postoperatively., Post-Op/Phase II
BLOOD GASES AND O2 SATURATION
[HCBGASOS]
STAT, Starting today For 1 Occurrences, STAT
Indicate FIO2:
If add on test, what should lab do if unable to add test
to previous specimen?
If Conditional, What Condition?
Draw immediately postoperatively., Post-Op/Phase II
CALCIUM, IONIZED [XICAL] STAT, Starting today For 1 Occurrences, Routine
If add on test, what should lab do if unable to add test
to previous specimen?
If Conditional, What Condition?
Draw immediately postoperatively., Post-Op/Phase II
Postoperative Diagnostic Tests and Imaging
Studies [91047]
ECG - 12 Lead Without Rhythm [EKG0008] ONCE, Starting today For 1 Occurrences, Routine
Reason for exam:
Disclaimer for University Hospital Only: A Stat status
for an ECG is in reference to the timing of the ECG.
The goal is to perform a STAT ECG within 10 minutes
of the order being placed. It is the responsibility of the
ordering provider to review the STAT ECGs. All ECGs
(stat or routine) will be formally reviewed within one
business day.
Post-Op/Phase II
Page 11 of 12
Printed by BENNETT, SARA J [SJB008] at 12/15/2017 7:11:39 AM
Copyright © 2017 University of Wisconsin Hospitals and Clinics Authority
Contact: Lee Vermeulen, CCKM@uwhealth.org Last Revised:
 
12/2017CCKM@uwhealth.org

X-RAY CHEST AP VIEW [R71010] ONCE-RAD NEXT AVAILABLE, Starting today For 1
Occurrences, Routine
Current signs and symptoms?
What specific question(s) would you like answered by
this exam?
Relevant recent/past history?
Is patient pregnant?
If being performed remotely, where? IP PACU
Last patient weight? (will auto pull in value and date in
comment):
Transport Method: Floor Determined/Entered
Post-Op/Phase II
X-RAY CHEST PA & LAT VIEWS [R71020] ONCE-RAD NEXT AVAILABLE, Starting today For 1
Occurrences, Routine
Radiology Specialty Area: GENERAL IMAGING
Current signs and symptoms?
What specific question(s) would you like answered by
this exam?
Relevant recent/past history?
Is patient pregnant?
If being performed remotely, where?
Last patient weight? (will auto pull in value and date in
comment):
Transport Method: Floor Determined/Entered
Post-Op/Phase II
Page 12 of 12
Printed by BENNETT, SARA J [SJB008] at 12/15/2017 7:11:39 AM
Copyright © 2017 University of Wisconsin Hospitals and Clinics Authority
Contact: Lee Vermeulen, CCKM@uwhealth.org Last Revised:
 
12/2017CCKM@uwhealth.org