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IP – Temporary Transvenous Pacemaker – Adult – Postprocedure [2576]

IP – Temporary Transvenous Pacemaker – Adult – Postprocedure [2576] - Clinical Hub, UW Health Clinical Tool Search, UW Health Clinical Tool Search, Order Sets, Inpatient, Cardiology/CT Surgery


IP - Temporary Transvenous Pacemaker - Adult - Postprocedure [2576]
for Adult Patients OnlyIntended
Patient Care Orders
Activity [82556]
Bedrest [NURACT0008] CONTINUOUS, Starting today, 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:
Chair with Assistance [NURACT0008] CONTINUOUS, Starting today For Until specified,
Routine
AD LIB:
AMBULATE:
CHAIR: other (comment)
DANGLE:
BEDREST:
RESTRICTIONS:
UPPER LEFT EXTREMITY WEIGHT BEARING:
UPPER RIGHT EXTREMITY WEIGHT BEARING:
LOWER LEFT EXTREMITY WEIGHT BEARING:
LOWER RIGHT EXTREMITY WEIGHT BEARING:
Chair with assistance
Pacemaker Care [82557]
Record the Number of Centimeters Pacemaker
Wire is in at Entrance to the Skin [NURTRT0048]
EVERY 4 HOURS, Starting today
Temporary Transvenous Pacemaker Settings [82559]
Temporary Transvenous Pacemaker Settings
[NURTRT0079]
CONTINUOUS, Starting today, Routine
Mode: VVI
Ventricular Voltage (Milliamperes):
Ventricular Sensitivity (Millivolts):
Ventricular Rate (Beats/Min):
Battery Change:
Temporary Transvenous Pacemaker Status (Single Response) [83703]
Pacemaker On [NURTRT0080] CONTINUOUS, Starting today, Routine
Pacemaker Off and Connected [NURTRT0081] CONTINUOUS, Starting today, Routine
Contingency Parameters [82560]
Page 1 of 2
Printed by LIND, JANNA S [JSL237] at 7/28/2016 9:05:01 AM
Copyright © 201� University of Wisconsin Hospitals and Clinics Authority
Contact: Lee Vermeulen, CCKM@uwhealth.org Last Revised: 07/2016CCKM@uwhealth.org

Notify Provider [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):
If temperature < (C):
If heart rate > (bpm):
If heart rate < (bpm): Falls below set pacer rate
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: Failure to sense ,Failure to capture,Failure to
fire
Diagnostic Tests and Imaging
Diagnostic Tests and Imaging [82561]
X-RAY CHEST AP VIEW [R71010] ONCE-RAD NEXT AVAILABLE, Starting today For 1
Occurrences, Routine
Current signs and symptoms? Bradycardia
What specific question(s) would you like answered by
this exam? Post-insertion of Temporary Transvenous
Pacemaker
Relevant recent/past history? Post-insertion of
Temporary Transvenous Pacemaker
Is patient pregnant?
If being performed remotely, where? Bedside
Transport Method: Floor Determined/Entered
ECG - 12 Lead [EKG0008] ONCE, Starting today For 1 Occurrences, Routine
Reason for exam: OTHER (COMMENT)
Page 2 of 2
Printed by LIND, JANNA S [JSL237] at 7/28/2016 9:05:01 AM
Copyright © 201� University of Wisconsin Hospitals and Clinics Authority
Contact: Lee Vermeulen, CCKM@uwhealth.org Last Revised: 07/2016CCKM@uwhealth.org