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Clinical Hub,UW Health Clinical Tool Search,UW Health Clinical Tool Search,Order Sets,Inpatient,Cardiology/CT Surgery

IP - Cardiac Catheterization/Electrophysiology Lab - Pediatric - Postprocedure [1266]

IP - Cardiac Catheterization/Electrophysiology Lab - Pediatric - Postprocedure [1266] - Clinical Hub, UW Health Clinical Tool Search, UW Health Clinical Tool Search, Order Sets, Inpatient, Cardiology/CT Surgery


IP - Cardiac Catheterization/Electrophysiology Lab - Pediatric - Postprocedure [1266]
Admission Status
Level of Care (Single Response) [187485]
*An admit patient order has already been written, but the level of care at which the patient should be placed still needs to
be identified.
Place Patient on General Care [ADT0018] General Care, has already been signed. This order will
ensure that the patient is placed at the appropriate level of
care.
Place Patient on Intermediate Care (IMC) [ADT0018] Intermediate Care, has already been signed. This order will
ensure that the patient is placed at the appropriate level of
care.
Place Patient on Intensive Care (ICU) [ADT0018] Intensive Care, has already been signed. This order will
ensure that the patient is placed at the appropriate level of
care.
Admit to Inpatient (Single Response) [188296]
Admit To Inpatient [ADT0001] Attending:
Admitting Resident:
Requested Floor:
Service:
I certify that an inpatient stay is medically necessary
because of either an anticipated LOS >2 midnights,
complexity and/or severity of illness, an inpatient-only
surgery, or a previously-authorized inpatient stay.
Rationale listed below. Yes
C - CLEAR DIAGNOSIS:
E - EVALUATIONS PLANNED:
R - RESULTS EXPECTED:
T - TREATMENTS ORDERED:
Post-Op/Phase II
Admit to Observation (Single Response) [188297]
Admit To Observation [ADT0002] Attending:
Admitting Resident:
Requested Floor:
Service:
Post-Op/Phase II
Admit to Outpatient Short Stay (Single Response)
[188298]
Admit To Outpatient Short Stay [ADT0003] Attending:
Admitting Resident:
Requested Floor:
Service:
Post-Op/Phase II
Admission Status (Single Response) [99220]
Admit To Inpatient Status [ADT0001] Attending:
Admitting Resident:
Requested Floor:
Service:
I certify that an inpatient stay is medically necessary because
of either an anticipated LOS >2 midnights, complexity and/or
severity of illness, an inpatient-only surgery, or a previously-
authorized inpatient stay. Rationale listed below. Yes
C - CLEAR DIAGNOSIS:
E - EVALUATIONS PLANNED:
R - RESULTS EXPECTED:
T - TREATMENTS ORDERED:
Post-Op/Phase II
Admit To Observation Status [ADT0002] Attending:
Admitting Resident:
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Requested Floor:
Service:
Post-Op/Phase II
Admit To Outpatient Short Stay [ADT0003] Attending:
Admitting Resident:
Requested Floor:
Service:
Post-Op/Phase II
Admission Status (Single Response) [195320]
Admit To Inpatient [ADT0001] Attending:
Admitting Resident:
Requested Floor:
Service:
I certify that an inpatient stay is medically necessary because
of either an anticipated LOS >2 midnights, complexity and/or
severity of illness, an inpatient-only surgery, or a previously-
authorized inpatient stay. Rationale listed below. Yes
C - CLEAR DIAGNOSIS:
E - EVALUATIONS PLANNED:
R - RESULTS EXPECTED:
T - TREATMENTS ORDERED:
Post-Op/Phase II
Admit To Observation [ADT0002] Attending:
Admitting Resident:
Requested Floor:
Service:
Post-Op/Phase II
Admit To Outpatient Short Stay [ADT0003] Attending:
Admitting Resident:
Requested Floor:
Service:
Post-Op/Phase II
Patient Care Orders
Vital Signs [17308]
Vital Signs [NURMON0013] SEE COMMENTS, Starting today 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 2, then every 4 hours., Post-Op/Phase
II
Patient Monitoring [17309]
Cardio-Respiratory Monitor - Pediatric - With Rhythm
[139419]
Cardio-Respiratory Monitor - Pediatric - With Rhythm
[NURMON0014]
CONTINUOUS, Routine, Most pediatric patients do NOT
require rhythm analysis. Please complete the Notify
Provider order below, including specification for apnea >
*** seconds. If indicated, order pulse oximetry separately.
Device Present:
Device Mode:
Device Low Rate Limit (BPM):
Notify Provider: Symptomatic Change in Rhythm,Serious
Arrhythmia
Post-Op/Phase II
Notify [NURCOM0001] Provider to Notify: Provider
Notify based on:
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Notify provider for apnea > 20 seconds, Post-Op/Phase II
Activity [17310]
Bedrest with Extremity Straight [NURACT0008] CONTINUOUS, Starting today, 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 with extremity straight: {right, left, bilateral:3200103},
Post-Op/Phase II
Ad Lib [NURACT0008] CONTINUOUS, Starting today For Until specified, Routine
AD LIB: ad lib
AMBULATE:
CHAIR:
DANGLE:
BEDREST:
RESTRICTIONS:
UPPER LEFT EXTREMITY WEIGHT BEARING:
UPPER RIGHT EXTREMITY WEIGHT BEARING:
LOWER LEFT EXTREMITY WEIGHT BEARING:
LOWER RIGHT EXTREMITY WEIGHT BEARING:
Post-Op/Phase II
Elevate Head Of Bed - Less than 30 degrees
[NURACT0002]
Equal to (degrees):
Greater than (degrees):
Less than (degrees): 30
Other options: At all times
Routine, CONTINUOUS, Starting today For Until specified,
Post-Op/Phase II
Infant May Be Held [NURACT0011] SEE COMMENTS, Starting today For Until specified, Infant
may be held., Post-Op/Phase II
Nutrition [20373]
NPO Except Medications [NUT0001] EFFECTIVE NOW, Starting today, Routine
General Diet:
Diabetic Diet:
NPO (If patient receiving tube feeding see question 25): NPO
EXCEPT MEDICATIONS
Liquids & Modified Consistency (If Dysphagia Protocol see
questions 21-24):
Fiber:
Renal & Dialysis Multi-Nutrient Restriction:
Lactose Restricted:
Protein:
Fat:
Sodium:
Potassium:
Phosphorus:
Other Minerals:
Calories:
Fluid Restriction: Total mLs/24 hours (IV & PO):
Research:
Metabolic:
Other Modifiers:
Infant Nutrition (Select product and calories per ounce):
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Infant Formula (Calories per Ounce):
Dysphagia Protocol:
Dysphagia Protocol-Modified Consistency (Also select
Dysphagia Protocol Liquid Consistency and Dysphagia
Protocol-Supervision):
Dysphagia Protocol-Liquid Consistency:
Dysphagia Protocol-Supervision:
Tube Feeding (Use Tube Feeding Order Set to indicate order
detail):
Room Service Class:
Post-Op/Phase II
General Diet [NUT0001] EFFECTIVE NOW, Starting today, Routine
General Diet: GENERAL;
Diabetic Diet:
NPO (If patient receiving tube feeding see question 25):
Liquids & Modified Consistency (If Dysphagia Protocol see
questions 21-24):
Fiber:
Renal & Dialysis Multi-Nutrient Restriction:
Lactose Restricted:
Protein:
Fat:
Sodium:
Potassium:
Phosphorus:
Other Minerals:
Calories:
Fluid Restriction: Total mLs/24 hours (IV & PO):
Research:
Metabolic:
Other Modifiers:
Infant Nutrition (Select product and calories per ounce):
Infant Formula (Calories per Ounce):
Dysphagia Protocol:
Dysphagia Protocol-Modified Consistency (Also select
Dysphagia Protocol Liquid Consistency and Dysphagia
Protocol-Supervision):
Dysphagia Protocol-Liquid Consistency:
Dysphagia Protocol-Supervision:
Tube Feeding (Use Tube Feeding Order Set to indicate order
detail):
Room Service Class:
Post-Op/Phase II
Clear Liquid Diet [NUT0001] EFFECTIVE NOW, Starting today, Routine
General Diet:
Diabetic Diet:
NPO (If patient receiving tube feeding see question 25):
Liquids & Modified Consistency (If Dysphagia Protocol see
questions 21-24): CLEAR LIQUID;
Fiber:
Renal & Dialysis Multi-Nutrient Restriction:
Lactose Restricted:
Protein:
Fat:
Sodium:
Potassium:
Phosphorus:
Other Minerals:
Calories:
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Fluid Restriction: Total mLs/24 hours (IV & PO):
Research:
Metabolic:
Other Modifiers:
Infant Nutrition (Select product and calories per ounce):
Infant Formula (Calories per Ounce):
Dysphagia Protocol:
Dysphagia Protocol-Modified Consistency (Also select
Dysphagia Protocol Liquid Consistency and Dysphagia
Protocol-Supervision):
Dysphagia Protocol-Liquid Consistency:
Dysphagia Protocol-Supervision:
Tube Feeding (Use Tube Feeding Order Set to indicate order
detail):
Room Service Class:
Post-Op/Phase II
Respiratory [17313]
Pulse Oximetry [NURMON0009] CONTINUOUS, Starting today For Until specified, Routine,
Post-Op/Phase II
Wound/Procedure Site Care [17311]
Wound Care [NURWND0015] CONTINUOUS, Starting today For Until specified, Routine
Wound Type: Puncture
Wound Site: Leg
Wound Location:
Assess Frequency: SEE COMMENTS
Care Frequency:
Wash With:
Irrigate/Rinse With:
Apply (Must also enter separate medication order to obtain
drug):
Primary Dressing:
Secondary Dressing:
Assess procedure site/access site dressings for bleeding
and/or swelling every 15 minutes times 4, then every 30
minutes times 4, then every hour times 2, then every 4 hours.,
Post-Op/Phase II
Neurovascular Checks [NURMON0045] SEE COMMENTS, Starting today For Until specified, Routine,
Every 15 minutes times 4, then every 30 minutes times 4,
then every hour times 2, then every 4 hours., Post-Op/Phase
II
Contingency Parameters [17314]
Notify Pediatric Cardiology [NURCOM0001] 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 < (%): *** or greater than ***
If urine output < (mL):
Other: Patient develops nausea or vomiting.
Post-Op/Phase II
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Intravenous Therapy
IV Fluids (Single Response) [18127]
dextrose 5%-NaCl 0.45% infusion [51613] Intravenous, CONTINUOUS, Post-Op/Phase II
dextrose 5%-NaCl 0.2% infusion [51615] Intravenous, CONTINUOUS, Post-Op/Phase II
lactated ringers infusion [38890] Intravenous, CONTINUOUS, Post-Op/Phase II
Anti-infectives
First Line (Single Response) [112541]
cefazolin (ANCEF) intraVENOUS [800000] 30 mg/kg, Intravenous, EVERY 8 HOURS For 2 Doses, Post-
Op/Phase II
cefuroxime (ZINACEF) intraVENOUS [800030] 50 mg/kg, Intravenous, EVERY 8 HOURS For 2 Doses, Post-
Op/Phase II
cefdinir (OMNICEF) 250 MG/5ML susp [104063] 14 mg/kg, Oral, EVERY 24 HOURS For 1 Doses, Post-
Op/Phase II
Patients with MRSA (Single Response) [144010]
Cefazolin - Vancomycin (Maximum Dose 2 grams)
[191197]
cefazolin (ANCEF) intraVENOUS [800000] 30 mg/kg, Intravenous, EVERY 8 HOURS For 2 Doses,
Post-Op/Phase II
vancomycin (VANCOCIN) intraVENOUS [800084] 15 mg/kg, Intravenous, EVERY 6 HOURS For 3 Doses,
Post-Op/Phase II
Cefuroxime - Vancomycin (Maximum Dose 2 grams)
[191200]
cefuroxime (ZINACEF) intraVENOUS [800030] 50 mg/kg, Intravenous, EVERY 8 HOURS For 2 Doses,
Post-Op/Phase II
vancomycin (VANCOCIN) intraVENOUS [800084] 15 mg/kg, Intravenous, EVERY 6 HOURS For 3 Doses,
Post-Op/Phase II
Cefdinir - Vancomycin (Maximum Dose 2 grams)
[191203]
cefdinir (OMNICEF) 250 MG/5ML susp [104063] Details
vancomycin (VANCOCIN) intraVENOUS [800084] 15 mg/kg, Intravenous, EVERY 6 HOURS For 3 Doses,
Post-Op/Phase II
Patients with Immediate/Severe Reactions to Penicillin or Known Cephalosporin Allergies and MRSA positive (Single
Response) [144086]
vancomycin (VANCOCIN) intraVENOUS [800084] 15 mg/kg, Intravenous, EVERY 6 HOURS For 3 Doses
Patients with Immediate/Severe Reactions to Penicillin or Known Cephalosporin Allergies and MRSA negative (Single
Response) [144013]
clindamycin (CLEOCIN) intraVENOUS [800033] 10 mg/kg, Intravenous, EVERY 8 HOURS For 2 Doses, Post-
Op/Phase II
Medications - Postprocedure
Analgesics (Single Response) [18128]
acetaMINOPHEN alcohol free (TYLENOL) oral
suspension - NOTE: Suggested dose 10-15 mg/kg/dose
(Maximum 650 mg/dose) [800005]
Oral, EVERY 4 HOURS PRN, pain/fever
NOTE: Suggested dose 10-15 mg/kg/dose (Maximum 650
mg/dose)
Post-Op/Phase II
acetaMINOPHEN (TYLENOL) suppository - NOTE:
Suggested dose 10-15 mg/kg/dose (Maximum 650
mg/dose) [43994]
Rectal, EVERY 4 HOURS PRN, pain
NOTE: Suggested dose 10-15 mg/kg (Maximum 650
mg/dose)
Post-Op/Phase II
acetaMINOPHEN 325 mg (TYLENOL) tab RANGE
[750000]
325-650 mg, Oral, EVERY 4 HOURS PRN, pain, Post-
Op/Phase II
Sucrose for Oral Analgesia [110667]
sucrose (SWEET-EASE) 24% buccal soln [794009] Oral, PRN, pain, mild pain or potentially painful procedures.
See Admin Instructions, Post-Op/Phase II
Sedatives [144068]
dexmedetomidine (PRECEDEX) 200 mcg/50 mL
infusion [700431]
Intravenous, Post-Op/Phase II
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Anti-Platelets (Single Response) [194858]
aspirin chew tab [720164] 81 mg, Oral, 1 X DAILY, Post-Op/Phase II
Diagnostic Tests and Imaging
Studies [17317]
X-Ray Chest AP View Bedside [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? Bedside
Last patient weight? (will auto pull in value and date in
comment):
Transport Method: Floor Determined/Entered
Post-Op/Phase II
Transthoracic Resting Echocardiogram (PEDS)
[ECH0012]
ONCE, 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?
To whom can we send the results of the study? (include
clinician and location):
Do you want Agitated Bubble Study?
Last patient height? (will auto pull in value and date in
comment):
Last patient weight? (will auto pull in value and date in
comment):
Post-Op/Phase II
ECG - 12 Lead [EKG0008] ONCE, Starting today For 1 Occurrences, Routine
Reason for exam:
Post-Op/Phase II
Holter Monitor - 24/48 Hour Monitor (Peds) [EKG0027] ONCE, Starting today For 1 Occurrences, Routine
Reason for exam:
Length of monitoring: 24 HOURS
Post-Op/Phase II
BestPractice
No Hospital Problems have yet been identified [129895]
Specify Hospital Problem(s) [COR0018] You will be prompted to specify a hospital problem on
signing., Post-Op/Phase II
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Copyright © 2015 University of Wisconsin Hospitals and Clinics Authority, University of Wisconsin Medical Foundation, Inc, UW-Madison