/clinical/,/clinical/cckm-tools/,/clinical/cckm-tools/content/,/clinical/cckm-tools/content/order-sets/,/clinical/cckm-tools/content/order-sets/inpatient/,/clinical/cckm-tools/content/order-sets/inpatient/general-surgery/,

/clinical/cckm-tools/content/order-sets/inpatient/general-surgery/name-122128-en.cckm

201711332

page

100

UWHC,UWMF,

Tools,

Clinical Hub,UW Health Clinical Tool Search,UW Health Clinical Tool Search,Order Sets,Inpatient,General Surgery

IP - Surgery - Neonatal - Preoperative [5328]

IP - Surgery - Neonatal - Preoperative [5328] - Clinical Hub, UW Health Clinical Tool Search, UW Health Clinical Tool Search, Order Sets, Inpatient, General Surgery


IP - Surgery - Neonatal - Preoperative [5328]
Patient Care Orders
Location (Single Response) [149163]
Procedure Location - ON UNIT [NURCOM0022] ONCE
Procedure Location - OFF UNIT [NURCOM0022] ONCE
Procedure ON Unit
Surgical Prophylaxis - First Line (Single Response) [149080]
cefazolin (ANCEF) intraVENOUS [800000] 30 mg/kg, Intravenous, ON CALL For 1 Doses
cefuroxime (ZINACEF) intraVENOUS [800030] 50 mg/kg, Intravenous, ON CALL For 1 Doses
cefoxitin (MEFOXIN) intraVENOUS [800022] 25 mg/kg, Intravenous, ON CALL For 1 Doses
Surgical Prophylaxis - MRSA Documented OR MRSA History OR Risk for MRSE (Single Response)
[149083]
vancomycin (VANCOCIN) intraVENOUS - Note:
Consider 10 mg/kg for patients with poor renal
function. [800084]
15 mg/kg, Intravenous, ON CALL For 1 Doses
Note: Consider 10 mg/kg for patients with poor renal
function.
clindamycin (CLEOCIN) intraVENOUS [800033] 7.5 mg/kg, Intravenous, ON CALL For 1 Doses
Non-Categorized [149882]
gentamicin (GARAMYCIN) intraVENOUS
[800049]
3.5 mg/kg, Intravenous, ON CALL For 1 Doses
Intravenous Therapy [149167]
Insert and Maintain Peripheral IV [NURVAD0013] CONTINUOUS, Routine
Peripheral IV Size: RN Discretion
Does this need to be inserted/placed? Yes
Procedure OFF Unit
Surgical Prophylaxis - First Line (Single Response) [149081]
cefazolin (ANCEF) intraVENOUS [800000] 30 mg/kg, Intravenous, ON CALL For 1 Doses,
IntraOp
cefuroxime (ZINACEF) intraVENOUS [800030] 50 mg/kg, Intravenous, ON CALL For 1 Doses,
IntraOp
cefoxitin (MEFOXIN) intraVENOUS [800022] 25 mg/kg, Intravenous, ON CALL For 1 Doses,
IntraOp
Surgical Prophylaxis - MRSA Documented OR MRSA History OR Risk for MRSE (Single Response)
[149082]
vancomycin (VANCOCIN) intraVENOUS - Note:
Consider 10 mg/kg for patients with poor renal
function. [800084]
15 mg/kg, Intravenous, ON CALL For 1 Doses
Note: Consider 10 mg/kg for patients with poor renal
function.
IntraOp
clindamycin (CLEOCIN) intraVENOUS [800033] 7.5 mg/kg, Intravenous, ON CALL For 1 Doses,
IntraOp
Non-Categorized [149886]
gentamicin (GARAMYCIN) intraVENOUS
[800049]
3.5 mg/kg, Intravenous, ON CALL For 1 Doses,
IntraOp
Intravenous Therapy [149162]
Insert and Maintain Peripheral IV [NURVAD0013] CONTINUOUS, Routine
Peripheral IV Size: RN Discretion
Does this need to be inserted/placed? Yes
IntraOp
Laboratory
Laboratory [149348]
TYPE AND SCREEN, NEONATAL [HCNTS] 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?
Page 1 of 3
Printed by STRAKA, KEVIN F [KFS1] at 8/4/2017 1:56:08 PM
Copyright © 2017 University of Wisconsin Hospitals and Clinics Authority
Contact: Lee Vermeulen, CCKM@uwhealth.org Last Revised: 08/2017CCKM@uwhealth.org

Blood Products
Blood Products [144537]
Red Blood Cells (Neonatal) [BLB0023] < 1 UNIT For 1 Occurrences, Routine
Reason for Order:
Blood Product Need (It will take approximately 30 to
60 minutes from the time nursing notifies the Blood
Bank to prepare the products):
Date Product Needed:
Consent Status:
Total Volume to be transfused (mL):
Uncrossmatched **WARNING** Requesting MD
verifies that the clinical situation is sufficiently urgent
to require release of blood before completion of
compatibility testing and agrees to hold UWHC
harmless for any and all liability for any injuries
resulting from release of blood before such testing:
Irradiated (See Blood Product Guidelines) (May be
pre-selected based on history): Yes
Indication for Irradiated Blood: S1 Patients during the
first four months of life
CMV Negative (Heart/Lung Transplant and Neonates
up to 4 Months Only) (May be pre-selected based on
history): Yes
Washed Product (Requires pathology review, call 263-
8367):
Plasma (Neonatal) [BLB0024] < 1 UNIT For 1 Occurrences, Routine
Reason for Order:
Blood Product Need (It will take approximately 30 to
60 minutes from the time nursing notifies the Blood
Bank to prepare the products):
Date Product Needed:
Consent Status:
Total Volume to be transfused (mL):
Platelets (Neonatal) [BLB0025] < 1 SINGLE DONOR UNIT For 1 Occurrences,
Routine
Reason for Order:
Blood Product Need (It will take approximately 30 to
60 minutes from the time nursing notifies the Blood
Bank to prepare the products):
Date Product Needed:
Consent Status:
Total Volume to be transfused (mL):
Irradiated (See Blood Product Guidelines) (May be
pre-selected based on history): Yes
Indication for Irradiated Blood: S1 Patients during the
first four months of life
CMV Negative (Heart/Lung Transplant and Neonates
up to 4 Months Only) (May be pre-selected based on
history): Yes
Washed Product (Requires pathology review, call 263-
8367):
HLA Matched (Requires pathology review, call 263-
8367):
Page 2 of 3
Printed by STRAKA, KEVIN F [KFS1] at 8/4/2017 1:56:08 PM
Copyright © 2017 University of Wisconsin Hospitals and Clinics Authority
Contact: Lee Vermeulen, CCKM@uwhealth.org Last Revised:
 
08/2017CCKM@uwhealth.org

Cryoprecipitate (Neonatal) [BLB0026] 1 UNIT For 1 Occurrences, Routine
Reason for Order:
Blood Product Need (It will take approximately 30 to
60 minutes from the time nursing notifies the Blood
Bank to prepare the products):
Date Product Needed:
Consent Status:
Total Volume to be transfused (mL):
Page 3 of 3
Printed by STRAKA, KEVIN F [KFS1] at 8/4/2017 1:56:08 PM
Copyright © 2017 University of Wisconsin Hospitals and Clinics Authority
Contact: Lee Vermeulen, CCKM@uwhealth.org Last Revised:
 
08/2017CCKM@uwhealth.org