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/clinical/cckm-tools/content/order-sets/inpatient/girenal/name-98300-en.cckm

201606179

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Clinical Hub,UW Health Clinical Tool Search,UW Health Clinical Tool Search,Order Sets,Inpatient,GI/Renal

IP - pH Study - Adult - Postprocedure [1115]

IP - pH Study - Adult - Postprocedure [1115] - Clinical Hub, UW Health Clinical Tool Search, UW Health Clinical Tool Search, Order Sets, Inpatient, GI/Renal


IP - pH Study - Adult - Postprocedure [1115]
Intended for Adult Patients Only
Admission Status
Admission Status [95526]
Admit To Observation [ADT0002] Attending:
Admitting Resident:
Requested Floor:
Service:
Post-Op/Phase II
Patient Care Orders
Activity [14198]
Ad Lib [NURACT0008] CONTINUOUS, Starting today, 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:
Nutrition [14199]
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:
Patient to self-select foods that trigger symptoms.
Page 1 of 2
Printed by O'BRIEN, RYLEY P [RPO249] at 5/25/2016 2:55:31 PM
Copyright © 201� University of Wisconsin Hospitals and Clinics Authority
Contact: Lee Vermeulen, CCKM@uwhealth.org Last Revised: 06/2016CCKM@uwhealth.org

General Diet [NUT9999] EFFECTIVE NOW, Starting today, Routine
Patient Type: Adult
Diet Type: General (no Modifications)
Bedside Meal Instructions:
Room Service Class:
Patient to self-select foods that trigger symptoms.
Non-Categorized Patient Care Orders [14200]
Monitor May Not Get Wet [NURCOM0022] CONTINUOUS, Starting today
Study Ends in 22 Hours. Nurse May Remove pH Probe
at that Time [NURCOM0022]
CONTINUOUS, Starting today
Equipment and Diary will be Picked Up by pH Nurses
[NURCOM0022]
CONTINUOUS, Starting today
Monitor Should Not Be Dropped [NURCOM0022] CONTINUOUS, Starting today
Assist Patient With Recording on Monitor or Diary
Provided [NURCOM0022]
CONTINUOUS, Starting today
Notify pH Study Nurses During the Day or GI Fellow at
Night with Any Questions [NURCOM0022]
CONTINUOUS, Starting today
BestPractice
No Hospital Problems have yet been identified [107363]
Specify Hospital Problem(s) [COR0018] You will be prompted to specify a hospital problem on
signing., Post-Op/Phase II
Page 2 of 2
Printed by O'BRIEN, RYLEY P [RPO249] at 5/25/2016 2:55:31 PM
Copyright © 201� University of Wisconsin Hospitals and Clinics Authority
Contact: Lee Vermeulen, CCKM@uwhealth.org Last Revised:
 
06/2016CCKM@uwhealth.org