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/clinical/cckm-tools/content/order-sets/inpatient/neurosciences/name-98147-en.cckm

201607188

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UWHC,UWMF,

Clinical Hub,UW Health Clinical Tool Search,UW Health Clinical Tool Search,Order Sets,Inpatient,Neurosciences

IP - Neurosurgery - Adult - Preprocedure [4988]

IP - Neurosurgery - Adult - Preprocedure [4988] - Clinical Hub, UW Health Clinical Tool Search, UW Health Clinical Tool Search, Order Sets, Inpatient, Neurosciences


IP - Neurosurgery - Adult - Preprocedure [4988]
Intended for Adult Patients Only
For Carotid Stent or Carotid Endarterectomy Preprocedure orders use one of the following order sets:
FDS - Carotid Endarterectomy - Adult - Preprocedure [5292]
FDS - Carotid Stent Placement (Neuro Suite/OR) - Adult - Preprocedure [5295]
FDS - Carotid Stent Placement (Cath Lab) - Adult - Preprocedure [5322]
Patient Care Orders
Vital Signs [134738]
Vital Signs [NURMON0013] EVERY 4 HOURS, Routine
Temperature Measurement Method:
Temperature Measurement Restrictions:
BP Source:
BP Location:
BP Position:
BP Restrictions:
Nutrition [133150]
NPO for Procedure - Hold Diet [DIE0007] EFFECTIVE MIDNIGHT, Starting tomorrow at 12:15 AM For
24 Hours, Routine
NPO For Which Procedure? Surgery
Modifiers: NPO EXCEPT MEDICATIONS
Surgical Site Care [133151]
chlorhexidine gluconate (HIBICLENS) 4 % topical soln
[64730]
Topical, ONCE Starting today at 10:00 PM For 1 Doses
chlorhexidine gluconate (HIBICLENS) 4 % topical soln
[64730]
Topical, ONCE Starting tomorrow at 6:00 AM For 1 Doses
Intake and Output [134827]
Measure Intake And Output [NURMON0005] EVERY 8 HOURS, Routine
Respiratory [134828]
Incentive Spirometry [NURTRT0018] EVERY 2 HOURS, Routine
Intravenous Therapy
IV Fluids [134739]
sodium chloride 0.9 % infusion [64367] at 100 mL/hr, Intravenous, CONTINUOUS Starting tomorrow
at 12:01 AM
Start at midnight the day of surgery
sodium chloride 0.9% with KCl 20 mEq/L infusion
[46261]
at 100 mL/hr, Intravenous, CONTINUOUS Starting tomorrow
at 12:01 AM
Medications - Pre-Procedure
Bowel Management [134829]
magnesium citrate soln [39309] 148 mL, Oral, ONCE For 1 Doses
Start at 12 noon the day prior to surgery
bisacodyl (DULCOLAX) EC tab [49076] 10 mg, Oral, 1 X DAILY (NOON)
Start at 12 noon the day prior to surgery
Preprocedure Medications [134830]
dexamethasone (DECADRON) tab [36586] 4 mg, Oral, EVERY 6 HOURS
levetiracetam (KEPPRA) tab [63274] 500 mg, Oral, 2 X DAILY
Surgical Prophylaxis - Cerebrospinal Fluid Shunt
First Line (Single Response) [136184]
cefuroxime (ZINACEF) intraVENOUS - Patient who is 40
-120 kg [800030]
1.5 g, Intravenous, ON CALL For 1 Doses, IntraOp
cefuroxime (ZINACEF) intraVENOUS - Patient who is
121 kg and greater [800030]
3 g, Intravenous, ON CALL For 1 Doses, IntraOp
MRSA/Document MRSA History (Single Response) [136205]
Patients who are 40-120 kg [206481]
Page 1 of 4
Printed by O'BRIEN, RYLEY P [RPO249] at 7/5/2016 2:57:31 PM
Copyright © 201� University of Wisconsin Hospitals and Clinics Authority
Contact: Lee Vermeulen, CCKM@uwhealth.org Last Revised: 07/2016CCKM@uwhealth.org

cefuroxime (ZINACEF) intraVENOUS [800030] 1.5 g, Intravenous, ON CALL For 1 Doses, IntraOp
vancomycin (VANCOCIN) intraVENOUS [800084] 20 mg/kg, Intravenous, ON CALL For 1 Doses, Pre-Op
Day Of Procedure
Patients who are 121 kg and greater [206484]
cefuroxime (ZINACEF) intraVENOUS [800030] 3 g, Intravenous, ON CALL For 1 Doses, Pre-Op Day Of
Procedure
vancomycin (VANCOCIN) intraVENOUS [800084] 20 mg/kg, Intravenous, ON CALL For 1 Doses, Pre-Op
Day Of Procedure
Immediate/Severe Reactions to Penicillin or Known Cephalosporin Allergies (Single Response) [148765]
Patients who are 40-160 kg [191780]
levofloxacin (LEVAQUIN) intraVENOUS [800052] 500 mg, Intravenous, ON CALL For 1 Doses, Pre-Op Day
Of Procedure
vancomycin (VANCOCIN) intraVENOUS [800084] 20 mg/kg, Intravenous, ON CALL For 1 Doses, Pre-Op
Day Of Procedure
Patients who are 160 kg and greater [191784]
levofloxacin (LEVAQUIN) intraVENOUS [800052] 750 mg, Intravenous, ON CALL For 1 Doses, Pre-Op Day
Of Procedure
vancomycin (VANCOCIN) intraVENOUS [800084] 20 mg/kg, Intravenous, ON CALL For 1 Doses, Pre-Op
Day Of Procedure
Surgical Prophylaxis - Craniotomy
First Line (Single Response) [136234]
cefazolin (ANCEF) intraVENOUS - NOTE: Patients who
are 40-120 kg [800000]
2 g, Intravenous, ON CALL For 1 Doses, IntraOp
cefazolin (ANCEF) intraVENOUS - NOTE: Patients who
are 121 kg and greater [800000]
3 g, Intravenous, ON CALL For 1 Doses, IntraOp
cefuroxime (ZINACEF) intraVENOUS - NOTE: Patients
who are 40-120 kg Order if expanded gram negative
coverage is needed [800030]
1.5 g, Intravenous, ON CALL For 1 Doses, IntraOp
cefuroxime (ZINACEF) intraVENOUS - NOTE: Patients
who are 121 kg or greater. Order if expanded gram
negative coverage is needed [800030]
3 g, Intravenous, ON CALL For 1 Doses, IntraOp
MRSA/Document MRSA History (Single Response) [136205]
Patients who are 40-120 kg [206481]
cefuroxime (ZINACEF) intraVENOUS [800030] 1.5 g, Intravenous, ON CALL For 1 Doses, IntraOp
vancomycin (VANCOCIN) intraVENOUS [800084] 20 mg/kg, Intravenous, ON CALL For 1 Doses, Pre-Op
Day Of Procedure
Patients who are 121 kg and greater [206484]
cefuroxime (ZINACEF) intraVENOUS [800030] 3 g, Intravenous, ON CALL For 1 Doses, Pre-Op Day Of
Procedure
vancomycin (VANCOCIN) intraVENOUS [800084] 20 mg/kg, Intravenous, ON CALL For 1 Doses, Pre-Op
Day Of Procedure
Immediate/Severe Reaction to Penicillin or Known Cephalosporin Allergies [146295]
vancomycin (VANCOCIN) intraVENOUS [800084] 20 mg/kg, Intravenous, ON CALL For 1 Doses, Pre-Op Day
Of Procedure
Surgical Prophylaxis - Other
First Line (Single Response) [136235]
cefazolin (ANCEF) intraVENOUS - NOTE: Patients who
are 40-120 kg [800000]
2 g, Intravenous, ON CALL For 1 Doses, IntraOp
cefazolin (ANCEF) intraVENOUS - NOTE: Patients who
are 121 kg and greater [800000]
3 g, Intravenous, ON CALL For 1 Doses, IntraOp
cefuroxime (ZINACEF) intraVENOUS - NOTE: Patients
who are 40-120 kg [800030]
1.5 g, Intravenous, ON CALL For 1 Doses
NOTE: Order if gram negative coverage is needed.
IntraOp
Page 2 of 4
Printed by O'BRIEN, RYLEY P [RPO249] at 7/5/2016 2:57:31 PM
Copyright © 201� University of Wisconsin Hospitals and Clinics Authority
Contact: Lee Vermeulen, CCKM@uwhealth.org Last Revised:
 
07/2016CCKM@uwhealth.org

cefuroxime (ZINACEF) intraVENOUS - NOTE: Patients
who are 121 kg or greater [800030]
3 g, Intravenous, ON CALL For 1 Doses
NOTE: Order if gram negative coverage is needed
IntraOp
MRSA/Documented MRSA History (Single Response) [148773]
Patients who are 40-120 kg [206557]
cefuroxime (ZINACEF) intraVENOUS [800030] 1.5 g, Intravenous, ON CALL For 1 Doses, IntraOp
vancomycin (VANCOCIN) intraVENOUS [800084] 20 mg/kg, Intravenous, ON CALL For 1 Doses, Pre-Op
Day Of Procedure
Patients who are 121 kg or greater [206560]
cefuroxime (ZINACEF) intraVENOUS [800030] 3 g, Intravenous, ON CALL For 1 Doses, IntraOp
vancomycin (VANCOCIN) intraVENOUS [800084] 20 mg/kg, Intravenous, ON CALL For 1 Doses, Pre-Op
Day Of Procedure
Immediate/Severe Reactions to Penicillin or Known Cephalosporin Allergies (Single Response) [148765]
Patients who are 40-160 kg [191780]
levofloxacin (LEVAQUIN) intraVENOUS [800052] 500 mg, Intravenous, ON CALL For 1 Doses, Pre-Op Day
Of Procedure
vancomycin (VANCOCIN) intraVENOUS [800084] 20 mg/kg, Intravenous, ON CALL For 1 Doses, Pre-Op
Day Of Procedure
Patients who are 160 kg and greater [191784]
levofloxacin (LEVAQUIN) intraVENOUS [800052] 750 mg, Intravenous, ON CALL For 1 Doses, Pre-Op Day
Of Procedure
vancomycin (VANCOCIN) intraVENOUS [800084] 20 mg/kg, Intravenous, ON CALL For 1 Doses, Pre-Op
Day Of Procedure
Laboratory
Labs [134740]
BUN [BUN] NEXT DRAW For 1 Occurrences, Routine
If add on test, what should lab do if unable to add test to
previous specimen?
If Conditional, What Condition?
CALCIUM [CA] NEXT DRAW For 1 Occurrences, Routine
If add on test, what should lab do if unable to add test to
previous specimen?
If Conditional, What Condition?
CBC WITH DIFFERENTIAL [CBC] NEXT DRAW For 1 Occurrences, Routine
If add on test, what should lab do if unable to add test to
previous specimen?
If Conditional, What Condition?
CREATININE [CRET] NEXT DRAW For 1 Occurrences, Routine
If add on test, what should lab do if unable to add test to
previous specimen?
If Conditional, What Condition?
ELECTROLYTES [LYTE] NEXT DRAW For 1 Occurrences, Routine
If add on test, what should lab do if unable to add test to
previous specimen?
If Conditional, What Condition?
GLUCOSE [GLU] NEXT DRAW For 1 Occurrences, Routine
If add on test, what should lab do if unable to add test to
previous specimen?
If Conditional, What Condition?
HCG, QUALITATIVE, URINE [UPREG] ONCE, Starting today 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 3 of 4
Printed by O'BRIEN, RYLEY P [RPO249] at 7/5/2016 2:57:31 PM
Copyright © 201� University of Wisconsin Hospitals and Clinics Authority
Contact: Lee Vermeulen, CCKM@uwhealth.org Last Revised:
 
07/2016CCKM@uwhealth.org

PROTHROMBIN TIME/INR [PT] NEXT DRAW For 1 Occurrences, Routine
If add on test, what should lab do if unable to add test to
previous specimen?
If Conditional, What Condition?
TYPE AND SCREEN [HCTS] NEXT DRAW For 1 Occurrences, Routine, As good clinical
practice and for patient safety, the Transfusion Service will
automatically crossmatch 2 packed RBCs on all patients with
antibodies to ensure blood would be available in the event it
is needed. If you would like to opt out of this automatic order
for this patient please contact the UWHC Blood Bank at (608)
263-8367 or The American Center Lab at (608) 234-6600 as
appropriate.
URINALYSIS WITH MICROSCOPY [UA] ONCE, Starting today For 1 Occurrences, Routine
If add on test, what should lab do if unable to add test to
previous specimen?
If Conditional, What Condition?
Blood Bank
For Blood Products Refer to the "IP - Blood Transfusion - Adult - Supplemental [996]" Order Set
Diagnostic Tests and Imaging
Studies [134766]
ECG - 12 Lead Without Rhythm [EKG0008] ONCE For 1 Occurrences, Routine
Reason for exam:
X-RAY CHEST PA & LAT VIEWS DUAL ENERGY
[R71020A]
ONCE-RAD NEXT AVAILABLE 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?
Last patient weight? (will auto pull in value and date in
comment):
Transport Method: Floor Determined/Entered
Consults
Consults [134772]
Consult Cardiology (Inpatient) [CON0012] ONCE
Intent:
Concern or Specific Question or Task to be Addressed
(Symptom, Sign, or Diagnosis):
Can this consult be done via video?
Call back number:
Consult Hospitalist (Inpatient) [CON0134] ONCE
Intent:
Concern or Specific Question or Task to be Addressed
(Symptom, Sign, or Diagnosis):
Can this consult be done via video?
Call back number:
Consult Nutrition (Inpatient) [CON0043] ONCE, Routine
Reason for Consult: Nutrition Assessment w/
Recommendations
Delegate to Initiate and Manage Tube Feeding:
Delegate to Initiate Feeding Tube Placement Order Set:
Delegate to Manage Diet Order/Supplement Order:
Delegate to Dysphagia Diet Order Progression:
Page 4 of 4
Printed by O'BRIEN, RYLEY P [RPO249] at 7/5/2016 2:57:31 PM
Copyright © 201� University of Wisconsin Hospitals and Clinics Authority
Contact: Lee Vermeulen, CCKM@uwhealth.org Last Revised:
 
07/2016CCKM@uwhealth.org