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ED - CLINICAL DECISION UNIT - VOMITING AND DEHYDRATION - ADULT [6119]

ED - CLINICAL DECISION UNIT - VOMITING AND DEHYDRATION - ADULT [6119] - Clinical Hub, UW Health Clinical Tool Search, UW Health Clinical Tool Search, Order Sets, Inpatient, Emergency Medicine


ED - Clinical Decision Unit - Vomiting and Dehydration - Adult [6119]
Inclusion Criteria for this Order Set:
1. Mild to moderate dehydration
- Evidenced by vomiting/diarrhea, elevated BUN/Cr ratio, high urine specific gravity, or
hemoconcentration
Exclusion Criteria for this Order Set:
1. Unstable vital signs (SBP < 100, HR > 110)
2. Severe electrolyte abnormality (Sodium < 130 mE1 or > 155 mEq, or potassium < 2.5 mEq or
> 6 mEq
3. Associated cause of dehydration and vomiting will require longer-term treatment. Examples
include:
bowel obstruction, pancreatitis, sepsis, etc.
Prior to Observation Admission:
1. Administer antiemetic medication X2 in the ED
2. Obtain CBC, BMP, and UA
3. Appropriately rule out associated cause of dehydration
requiring longer-term care and hospitalization
Admission Status
Admission Status [211535]
Admit to CDU (ED Observation) [ADT0019] Patient Class: Observation
Accommodation Code, if IMC request, please enter
Comments in field to the right: OSS/OBS
Will the patient require special placement due to
ISOLATION Precautions?
Is the patient currently a Department of Corrections
(DOC) Inmate?
Is a nursing assessment for CONSTANT
OBSERVATION recommended?
Is the patient currently a resident of CWC or Mendota
Mental Health (MMHI)?
Will the patient go directly to the OR from the ED?
Could this patient have ACS/MI?
Does the patient require CARDIAC MONITORING for
transport?
Admitting Provider?
Attending Provider?
CDU Protocol: Vomiting/Dehydration
Family History:
Expected Treatment/Procedures:
Intravenous Therapy
IV Fluids [211113]
sodium chloride 0.9 % infusion [64367] Intravenous, CONTINUOUS
dextrose 5%-NaCl 0.9% infusion [51641] Intravenous, CONTINUOUS
dextrose 5%-NaCl 0.45% with KCl 20 mEq/L
infusion [44910]
Intravenous, CONTINUOUS
Medications
Antiemetics (Single Response) [211466]
ondansetron (ZOFRAN ODT) disintegrating tab
[64224]
4 mg, Oral, EVERY 24 HOURS PRN,
nausea/vomiting
Administer first line as needed when able to tolerate
oral medications.
Page 1 of 3
Printed by STRAKA, KEVIN F [KFS1] at 11/13/2016 7:42:34 PM
Copyright © 201� University of Wisconsin Hospitals and Clinics Authority
Contact: Lee Vermeulen, CCKM@uwhealth.org Last Revised: 11/2016CCKM@uwhealth.org

ondansetron (ZOFRAN) injection [800202] 4 mg, Intravenous, EVERY 6 HOURS PRN,
nausea/vomiting
Administer first line as needed when unable to
tolerate oral medications.
prochlorperazine (COMPAZINE) tab [41372] 10 mg, Oral, EVERY 6 HOURS PRN, nausea
Administer second line if there is no response to first
line antiemetic within 30 minutes.
prochlorperazine (COMPAZINE) injection [41369] 10 mg, Intravenous, EVERY 6 HOURS PRN, nausea
Administer second line if there is no response to first
line antiemetic within 30 minutes.
promethazine (PHENERGAN) tab [41416] 12.5-25 mg, Oral, EVERY 6 HOURS PRN,
nausea/vomiting
promethazine (PHENERGAN) injection [800112] 12.5-25 mg, Intravenous, EVERY 6 HOURS PRN,
nausea/vomiting
Patient Care Orders
Vital Signs [211114]
Vital Signs [NURMON0013] SEE COMMENTS, Starting today, Routine
Temperature Measurement Method:
Temperature Measurement Restrictions:
BP Source:
BP Location:
BP Position:
BP Restrictions:
Every *** Hours, STAT
Activity [212530]
Activity [NURACT0008] CONTINUOUS, Routine
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:
Nutrition [211116]
Diet - Custom [NUT9999] EFFECTIVE NOW, Starting today, Routine
Patient Type: Adult
Room Service Class:
Diet Type: Diet Modifications
Diet Modifications:
Bedside Meal Instructions:
Diet - General [NUT9999] EFFECTIVE NOW, Starting today, Routine
Patient Type: Adult
Diet Type: General (no Modifications)
Bedside Meal Instructions:
Room Service Class:
Diet - 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:
Page 2 of 3
Printed by STRAKA, KEVIN F [KFS1] at 11/13/2016 7:42:34 PM
Copyright © 201� University of Wisconsin Hospitals and Clinics Authority
Contact: Lee Vermeulen, CCKM@uwhealth.org Last Revised: 11/2016CCKM@uwhealth.org

Diet - Adult Renal [NUT9999] EFFECTIVE NOW, Starting today, Routine
Patient Type: Adult
Diet Type: Diet Modifications
Diet Modifications: Renal
Sodium:
Potassium:
Phosphorus:
Fluid Restriction Total mLs/24H (IV/PO):
Protein:
Bedside Meal Instructions:
Room Service Class:
Contingency Parameters [211118]
Notify Provider [NURCOM0001] Provider to Notify: Provider
If systolic blood pressure > (mmHg): 180
If systolic blood pressure < (mmHg): 100
If diastolic blood pressure > (mmHg): 95
If diastolic blood pressure < (mmHg): 60
If temperature > (C): 38
If temperature < (C): 36
If heart rate > (bpm): 120
If heart rate < (bpm): 50
If respiratory rate >:
If respiratory rate <:
If blood glucose > (mg/dL): 300
If blood glucose < (mg/dL): 80
If pain score >:
Pulse Oximetry < (%): 92
If urine output < (mL):
Other:
Disposition Criteria
Home [211536]
Disposition Criteria - Home [NURCOM0022] CONTINUOUS, 1. Stable and acceptable vital signs
2. Patient is tolerating oral fluids
Hospital [210827]
Disposition Criteria - Hospital [NURCOM0022] CONTINUOUS, 1. Inability to tolerate oral fluids
persists
2. Concerning, unstable vital signs
Page 3 of 3
Printed by STRAKA, KEVIN F [KFS1] at 11/13/2016 7:42:34 PM
Copyright © 201� University of Wisconsin Hospitals and Clinics Authority
Contact: Lee Vermeulen, CCKM@uwhealth.org Last Revised: 11/2016CCKM@uwhealth.org