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/clinical/cckm-tools/content/order-sets/inpatient/orthopedicsrehab/name-121247-en.cckm

201712349

page

100

UWHC,UWMF,

Tools,

Clinical Hub,UW Health Clinical Tool Search,UW Health Clinical Tool Search,Order Sets,Inpatient,Orthopedics/Rehab

IP - Spine - Adult - Postoperative [6350]

IP - Spine - Adult - Postoperative [6350] - Clinical Hub, UW Health Clinical Tool Search, UW Health Clinical Tool Search, Order Sets, Inpatient, Orthopedics/Rehab


IP - Spine - Adult - Postoperative [6350]
for Adult Patients OnlyIntended
Spinal Procedure Specific Orders
Spinal Procedure Orders [231251]
Lumbar Decompressive Laminectomy /
Microdiscectomy [228113]
Logroll Only [NURACT0008] CONTINUOUS, Starting today, Routine
AD LIB:
AMBULATE:
CHAIR:
DANGLE:
BEDREST: strict logroll
RESTRICTIONS:
UPPER LEFT EXTREMITY WEIGHT BEARING:
UPPER RIGHT EXTREMITY WEIGHT BEARING:
LOWER LEFT EXTREMITY WEIGHT BEARING:
LOWER RIGHT EXTREMITY WEIGHT BEARING:
Post-Op/Phase II
Elevate Head Of Bed - 0 Degrees
[NURACT0002]
Equal to (degrees): 0
Greater than (degrees):
Less than (degrees):
Other options: At all times
Routine, CONTINUOUS, Starting today, Post-
Op/Phase II
Ambulate Twice Daily Beginning Day of Surgery
[NURACT0008]
CONTINUOUS, Starting today, Routine
AD LIB:
AMBULATE: 2x daily
CHAIR:
DANGLE:
BEDREST:
RESTRICTIONS:
UPPER LEFT EXTREMITY WEIGHT BEARING:
UPPER RIGHT EXTREMITY WEIGHT BEARING:
LOWER LEFT EXTREMITY WEIGHT BEARING:
LOWER RIGHT EXTREMITY WEIGHT BEARING:
Post-Op/Phase II
Ambulate Three Times Daily Beginning on
Postoperative Day 1 [NURACT0008]
CONTINUOUS, Starting tomorrow, Routine
AD LIB:
AMBULATE: 3x daily
CHAIR:
DANGLE:
BEDREST:
RESTRICTIONS:
UPPER LEFT EXTREMITY WEIGHT BEARING:
UPPER RIGHT EXTREMITY WEIGHT BEARING:
LOWER LEFT EXTREMITY WEIGHT BEARING:
LOWER RIGHT EXTREMITY WEIGHT BEARING:
Post-Op/Phase II
Cervical Spine Fusion / Artificial Cervical Disc
[231254]
Cervical Collar - Soft - For Comfort
[NURTRT0014]
CONTINUOUS, Starting today For Until specified,
Routine
Type: Cervical Collar - soft
Wearing schedule: Other (Comment) (For Comfort)
No pillow under the head, Post-Op/Phase II
Page 1 of 16
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Cervical Collar - Soft - Continuous
[NURTRT0014]
CONTINUOUS, Starting today For Until specified,
Routine
Type: Cervical Collar - soft
Wearing schedule: Continuous
No pillow under the head, Post-Op/Phase II
Cervical Collar - Soft - When Out of Bed
[NURTRT0014]
CONTINUOUS, Starting today For Until specified,
Routine
Type: Cervical Collar - soft
Wearing schedule: When out of bed
No pillow under the head, Post-Op/Phase II
PMT Collar - Continuous [NURTRT0014] CONTINUOUS, Starting today For Until specified,
Routine
Type: PMT Collar
Wearing schedule: Continuous
No pillow under the head., Post-Op/Phase II
PMT Collar - When Out of Bed [NURTRT0014] CONTINUOUS, Starting today For Until specified,
Routine
Type: PMT Collar
Wearing schedule: When out of bed
No pillow under the head, Post-Op/Phase II
Order Tracheostomy Tray From Central Services
[SUP0001]
Order Tracheostomy Tray from Central Services;
order ID# 1224158., Post-Op/Phase II
Keep Tracheostomy Tray on Unit
[NURCOM0022]
ONCE, Provide Tracheostomy Tray at Bedside,
Post-Op/Phase II
Ambulate Twice Daily Beginning Day of Surgery
[NURACT0008]
CONTINUOUS, Starting today, Routine
AD LIB:
AMBULATE: 2x daily
CHAIR:
DANGLE:
BEDREST:
RESTRICTIONS:
UPPER LEFT EXTREMITY WEIGHT BEARING:
UPPER RIGHT EXTREMITY WEIGHT BEARING:
LOWER LEFT EXTREMITY WEIGHT BEARING:
LOWER RIGHT EXTREMITY WEIGHT BEARING:
Post-Op/Phase II
Ambulate Three Times Daily Beginning on
Postoperative Day [NURACT0008]
CONTINUOUS, Starting tomorrow, Routine
AD LIB:
AMBULATE: 3x daily
CHAIR:
DANGLE:
BEDREST:
RESTRICTIONS:
UPPER LEFT EXTREMITY WEIGHT BEARING:
UPPER RIGHT EXTREMITY WEIGHT BEARING:
LOWER LEFT EXTREMITY WEIGHT BEARING:
LOWER RIGHT EXTREMITY WEIGHT BEARING:
Post-Op/Phase II
Elevate Head Of Bed [NURACT0002] Equal to (degrees): 45
Greater than (degrees):
Less than (degrees):
Other options:
Routine, CONTINUOUS, Post-Op/Phase II
Anterior / Posterior Lumbar or Thoracic Spine
Fusion [231253]
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Bedrest - Day of Surgery [NURACT0008] CONTINUOUS, Starting today For 1 Days, Routine
AD LIB:
AMBULATE:
CHAIR:
DANGLE:
BEDREST: other (comment)
RESTRICTIONS:
UPPER LEFT EXTREMITY WEIGHT BEARING:
UPPER RIGHT EXTREMITY WEIGHT BEARING:
LOWER LEFT EXTREMITY WEIGHT BEARING:
LOWER RIGHT EXTREMITY WEIGHT BEARING:
Post-Op/Phase II
Logroll Only [NURACT0008] CONTINUOUS, Routine
AD LIB:
AMBULATE:
CHAIR:
DANGLE:
BEDREST: strict logroll
RESTRICTIONS:
UPPER LEFT EXTREMITY WEIGHT BEARING:
UPPER RIGHT EXTREMITY WEIGHT BEARING:
LOWER LEFT EXTREMITY WEIGHT BEARING:
LOWER RIGHT EXTREMITY WEIGHT BEARING:
Post-Op/Phase II
Elevate Head Of Bed - 0 Degrees
[NURACT0002]
Equal to (degrees): 0
Greater than (degrees):
Less than (degrees):
Other options: At all times
Routine, CONTINUOUS, Starting today, Post-
Op/Phase II
Ambulate Twice Daily Beginning Day of Surgery
[NURACT0008]
CONTINUOUS, Starting today, Routine
AD LIB:
AMBULATE: 2x daily
CHAIR:
DANGLE:
BEDREST:
RESTRICTIONS:
UPPER LEFT EXTREMITY WEIGHT BEARING:
UPPER RIGHT EXTREMITY WEIGHT BEARING:
LOWER LEFT EXTREMITY WEIGHT BEARING:
LOWER RIGHT EXTREMITY WEIGHT BEARING:
Post-Op/Phase II
Ambulate Three Times Daily Beginning on
Postoperative Day 1 [NURACT0008]
CONTINUOUS, Starting tomorrow, Routine
AD LIB:
AMBULATE: 3x daily
CHAIR:
DANGLE:
BEDREST:
RESTRICTIONS:
UPPER LEFT EXTREMITY WEIGHT BEARING:
UPPER RIGHT EXTREMITY WEIGHT BEARING:
LOWER LEFT EXTREMITY WEIGHT BEARING:
LOWER RIGHT EXTREMITY WEIGHT BEARING:
Post-Op/Phase II
Page 3 of 16
Printed by BENNETT, SARA J [SJB008] at 12/15/2017 7:19:14 AM
Copyright © 2017 University of Wisconsin Hospitals and Clinics Authority
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12/2017CCKM@uwhealth.org

Lumbosacral Orthosis - At All Times
[NURTRT0014]
CONTINUOUS, Starting today For Until specified,
Routine
Type: Lumbosacral Orthosis-Hard
Wearing schedule: Continuous
Post-Op/Phase II
Lumbosacral Orthosis - When Out of Bed
[NURTRT0014]
CONTINUOUS, Starting today For Until specified,
Routine
Type: Lumbosacral Orthosis-Hard
Wearing schedule: When out of bed
Post-Op/Phase II
Orthoalign - At All Times [NURTRT0014] CONTINUOUS, Starting today For Until specified,
Routine
Type: Orthoalign
Wearing schedule: Continuous
Post-Op/Phase II
Orthoalign - When Out of Bed [NURTRT0014] CONTINUOUS, Starting today For Until specified,
Routine
Type: Orthoalign
Wearing schedule: When out of bed
Post-Op/Phase II
Thoracic Lumbosacral Orthosis - At All Times
[NURTRT0014]
CONTINUOUS, Starting today, Routine
Type: Thoracic Lumbosacral Orthosis-Hard TLSO
Wearing schedule: Continuous
Post-Op/Phase II
Thoracic Lumbosacral Orthosis - When Out of
Bed [NURTRT0014]
CONTINUOUS, Starting today, Routine
Type: Thoracic Lumbosacral Orthosis-Hard TLSO
Wearing schedule: When out of bed
Post-Op/Phase II
Maintain Chest Tube [NURTAD0001] CONTINUOUS, Starting today, Routine
Location:
Position: N/A - Single Location
Drainage Options: -20 cm wall suction
Site Assessment Frequency:
Care Frequency:
Wash With:
Primary Dressing:
Secondary Dressing:
Post-Op/Phase II
X-RAY CERVICAL SPINE 2-3 VIEWS [R72040] ONCE-RAD NEXT AVAILABLE, Starting tomorrow
For 1 Occurrences, Routine
Current signs and symptoms? Back Pain
What specific question(s) would you like answered
by this exam? Postoperative alignment
Relevant recent/past history? Postoperative spinal
fusion
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
Post-Op/Phase II
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12/2017CCKM@uwhealth.org

X-RAY THORACIC SPINE 2 VIEWS [R72070] ONCE-RAD NEXT AVAILABLE, Starting tomorrow
For 1 Occurrences, Routine
Current signs and symptoms? Back Pain
What specific question(s) would you like answered
by this exam? Postoperative alignment
Relevant recent/past history? Postoperaive spinal
fusion
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
Post-Op/Phase II
X-RAY LUMBAR SPINE 2-3 VIEWS [R72100] ONCE-RAD NEXT AVAILABLE, Starting tomorrow
For 1 Occurrences, Routine
Current signs and symptoms? Back Pain
What specific question(s) would you like answered
by this exam? Postoperative alignment
Relevant recent/past history? Postoperative spinal
fusion
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
Post-Op/Phase II
Admission Status
Level of Care (Single Response) [187485]
*An admit patient order has already been written, but the level of care at which the patient
should be placed still needs to be identified.
Place Patient on General Care [ADT0018] General Care, has already been signed. This order
will ensure that the patient is placed at the appropriate
level of care.
Place Patient on Intermediate Care (IMC)
[ADT0018]
Intermediate Care, has already been signed. This
order will ensure that the patient is placed at the
appropriate level of care.
Place Patient on Intensive Care (ICU) [ADT0018] Intensive Care, has already been signed. This order
will ensure that the patient is placed at the appropriate
level of care.
Admit to Inpatient (Single Response) [188296]
Admit To Inpatient [ADT0001] Attending:
Admitting Resident:
Requested Floor:
Service:
I certify that an inpatient stay is medically necessary
because of either an anticipated LOS >2 midnights,
complexity and/or severity of illness, an inpatient-
only surgery, or a previously-authorized inpatient
stay. Rationale listed below. Yes
C - CLEAR DIAGNOSIS:
E - EVALUATIONS PLANNED:
R - RESULTS EXPECTED:
T - TREATMENTS ORDERED:
Post-Op/Phase II
Admit to Observation (Single Response)
[188297]
Page 5 of 16
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Admit To Observation [ADT0002] Attending:
Admitting Resident:
Requested Floor:
Service:
Post-Op/Phase II
Admit to Outpatient Short Stay (Single
Response) [188298]
Admit To Outpatient Short Stay [ADT0003] Attending:
Admitting Resident:
Requested Floor:
Service:
Post-Op/Phase II
Admission Status [95524]
Admit To Inpatient [ADT0001] Attending:
Admitting Resident:
Requested Floor:
Service:
I certify that an inpatient stay is medically necessary
because of either an anticipated LOS >2 midnights,
complexity and/or severity of illness, an inpatient-only
surgery, or a previously-authorized inpatient stay.
Rationale listed below. Yes
C - CLEAR DIAGNOSIS:
E - EVALUATIONS PLANNED:
R - RESULTS EXPECTED:
T - TREATMENTS ORDERED:
Post-Op/Phase II
Admission Status [84059]
Admit To Inpatient [ADT0001] Attending:
Admitting Resident:
Requested Floor:
Service:
I certify that an inpatient stay is medically necessary
because of either an anticipated LOS >2 midnights,
complexity and/or severity of illness, an inpatient-only
surgery, or a previously-authorized inpatient stay.
Rationale listed below. Yes
C - CLEAR DIAGNOSIS:
E - EVALUATIONS PLANNED:
R - RESULTS EXPECTED:
T - TREATMENTS ORDERED:
Post-Op/Phase II
Admit To Observation [ADT0002] Attending:
Admitting Resident:
Requested Floor:
Service:
Post-Op/Phase II
Admit To Outpatient Short Stay [ADT0003] Attending:
Admitting Resident:
Requested Floor:
Service:
Post-Op/Phase II
Venous Thromboembolism (VTE) Prophylaxis
VTE Prophylaxis (Single Response) [130140]
Page 6 of 16
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12/2017CCKM@uwhealth.org

Caprini VTE Risk Assessment URL: https://uconnect.wisc.edu/clinical/cckm-
tools/content/cpg/hematology-and-
coagulation/related/name-97521-en.cckm
Moderate VTE Risk with High Bleed Risk
[231259]
Sequential Compression Device (SCD)
(TREATMENT) [NURTRT0028]
CONTINUOUS, Routine
Left/Right/Bilateral? Bilateral
Post-Op/Phase II
Sequential Compression Device (SCD) / Foot
Pump (SUPPLY) [EQP0023]
CONTINUOUS, Routine
Left/Right/Bilateral?
Type: Knee High
Post-Op/Phase II
Apply and Maintain Anti-Embolism Stocking
[NURTRT0039]
CONTINUOUS, Routine
Does this need to be inserted/placed?
Left/Right/Bilateral? Bilateral
Type: Knee high
Post-Op/Phase II
No VTE Prophylaxis [231260]
VTE Prophylaxis - Reason Not Ordered
[COR0008]
ONCE, Routine
Reason Not Ordered:
Post-Op/Phase II
VTE Prophylaxis (Single Response) [233390]
Caprini VTE Risk Assessment URL: https://uconnect.wisc.edu/clinical/cckm-
tools/content/cpg/hematology-and-
coagulation/related/name-97521-en.cckm
Moderate VTE Risk [231262]
Sequential Compression Device (SCD)
(TREATMENT) [NURTRT0028]
CONTINUOUS, Routine
Left/Right/Bilateral? Bilateral
Post-Op/Phase II
Sequential Compression Device (SCD) / Foot
Pump (SUPPLY) [EQP0023]
CONTINUOUS, Routine
Left/Right/Bilateral?
Type: Knee High
Post-Op/Phase II
Apply and Maintain Anti-Embolism Stocking
[NURTRT0039]
CONTINUOUS, Routine
Does this need to be inserted/placed?
Left/Right/Bilateral? Bilateral
Type: Knee high
Post-Op/Phase II
No VTE Prophylaxis [231264]
VTE Prophylaxis - Reason Not Ordered
[COR0008]
ONCE, Routine
Reason Not Ordered:
Post-Op/Phase II
Patient Care Orders
Vital Signs [87425]
Vital Signs [NURMON0013] SEE COMMENTS, Starting today For Until specified,
Routine
Temperature Measurement Method:
Temperature Measurement Restrictions:
BP Source:
BP Location:
BP Position:
BP Restrictions:
Every 2 hours times 4, then every 4 hours., Post-
Op/Phase II
Page 7 of 16
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Neurovascular Checks [NURMON0045] SEE COMMENTS, Starting today For Until specified,
Routine
Location:
Every 2 hours times 4, then every 4 hours., Post-
Op/Phase II
Nutrition [87428]
Strict NPO [NUT9999] EFFECTIVE NOW, Starting today, Routine
Patient Type: Adult
Diet Type: NPO
NPO: Strict NPO,NPO except Medications
Bedside Meal Instructions:
Room Service Class:
Post-Op/Phase II
Clear Liquid Diet [NUT9999] EFFECTIVE NOW, Starting today, Routine
Patient Type: Adult
Diet Type: Diet Modifications
Diet Modifications: Liquid
Liquid: Clear Liquid
No Red or Purple Dye:
Liquid Thickness: Thin
Bedside Meal Instructions:
Room Service Class:
Post-Op/Phase II
Genearl Diet [NUT9999] EFFECTIVE NOW, Starting today, Routine
Patient Type: Adult
Diet Type: General (no Modifications)
Bedside Meal Instructions:
Room Service Class:
Post-Op/Phase II
Respiratory [87429]
Pulse Oximetry [NURMON0009] CONTINUOUS, Starting today For 24 Hours, Routine,
Post-Op/Phase II
Oxygen Therapy [RT0032] CONTINUOUS, Starting today For Until specified,
Routine
FiO2 (%) Titrate to Keep Sats >/= to ___%:
Liter Flow:
Titrate oxygen to maintain O2 sat at (%): 92
O2 Delivery Device: Nasal Cannula
Attempt to Wean Off Oxygen?
Post-Op/Phase II
Pulse Oximetry [NURMON0009] SEE COMMENTS, Starting today For Until specified,
Routine, Every 2 hours times 4, then every 4 hours.,
Post-Op/Phase II
Incentive Spirometry [NURTRT0018] EVERY 1 HOUR, Starting today For Until specified,
Routine, Post-Op/Phase II
Cough And Deep Breathe [NURTRT0019] EVERY 1 HOUR, Starting today For Until specified,
Routine, Post-Op/Phase II
Respiratory Therapy per Protocol [RT0035] Routine
Protocol Type:
Post-Op/Phase II
Intake and Output [87430]
Measure Intake And Output [NURMON0005] EVERY 4 HOURS, Starting today For Until specified,
Routine, Post-Op/Phase II
Wound Care (Single Response) [239575]
Page 8 of 16
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Wound Care - Closed Incision with
Sutures/Staples [NURWND0055]
CONTINUOUS, Routine
Wound Site:
Wound Location:
Assess Frequency: EVERY 8 HOURS
Incision Closed With: Other (Comment)
(Sutures/Staples)
Maintain OR Dressing: Minimum of 48 hours
Remove OR Dressing after 48 hours: No
Removal of OR Dressing performed by: Provider
Cleansing with Removal of OR Dressing:
Primary Dressing (after 48 hours):
Incision Care (after 48 hours):
If dressing becomes saturated in 48 hours, sterile
dressing change? No - Notify provider
Post-Op/Phase II
Wound Care - Closed Incision with
Dermabond/Other [NURWND0055]
CONTINUOUS, Routine
Wound Site:
Wound Location:
Assess Frequency: EVERY 8 HOURS
Incision Closed With:
Post-Op/Phase II
Non-Categorized Patient Care Orders [231252]
Initiate Bladder Management Protocol
[NURELM0014]
CONTINUOUS, Routine, Post-Op/Phase II
Insert and Maintain Urinary Catheter
[NURELM0013]
CONTINUOUS, Starting today For Until specified,
Routine, To discontinue this order, enter a new order
for "Discontinue Urinary Catheter".
To modify this order, enter a new order for "Maintain
Urinary Catheter" and make the necessary changes in
the new order.
Type:
Indication for Placement:
Details: To Dependent Drainage
Does this need to be inserted/placed?
Post-Op/Phase II
Assess Adult Sedation Score [NURACT0011] SEE COMMENTS, Starting today For Until specified,
Assess Adult Sedation Score every 2 hours times 4,
then every 4 hours., Post-Op/Phase II
Drain Orders [227568]
Maintain Drain [NURTAD0003] CONTINUOUS, Routine
Type:
Site:
Location:
Drainage Options:
Irrigate Frequency:
Irrigate With:
Irrigant Volume (mL):
Strip:
Strip For:
Dressing Change Frequency:
Dressing Type:
Post-Op/Phase II
Measure Drain Output [NURTAD0005] EVERY 4 HOURS, Routine, Post-Op/Phase II
IntravenousTherapy
Page 9 of 16
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12/2017CCKM@uwhealth.org

Premedications for Needle Insertion [106327]
Use lidocaine topical dressing kit for stable patient, no lidocaine allergies, have at least 30
minutes time prior to needing to use IV
Sodium chloride (bacteriostatic) 0.9% intradermal: Useful for patients requiring urgent IV
access; onset is immediate.
Insert and Maintain Peripheral IV [NURVAD0013] CONTINUOUS, Routine
Peripheral IV Size: RN Discretion
Does this need to be inserted/placed?
Post-Op/Phase II
lidocaine (LMX) 4% topical dressing kit [66882] Topical, EVERY 1 HOUR PRN, peripheral line
insertion - see Admin Instructions
Do NOT apply to area greater than 200 square
centimeters (maximum 2.5 g/site; maximum 4 sites
per hour, 6 times per day). Do NOT leave on longer
than 2 hours. Use for stable patient, no allergies to
lidocaine, with at least 30 minutes time prior to IV use
Post-Op/Phase II
sodium chloride (bacteriostatic) 0.9 % injection
[50585]
0.05-0.1 mL, Intradermal, PRN, peripheral line
insertion - see Admin Instructions
Use an insulin or TB syringe with a 25-30 gauge
needle to inject solution and create a wheal. Wait 30
seconds to 1 minute then insert IV catheter into center
of wheal. Use if IV is needed within 30 minutes.
Post-Op/Phase II
IV Fluids (Single Response) [87213]
dextrose 5%- NaCl 0.9% with KCl 20 mEq/L
infusion [44904]
at 100 mL/hr, Intravenous, CONTINUOUS
Discontinue when taking adequate oral intake
Post-Op/Phase II
dextrose 5 %-NaCl 0.9% infusion [51641] at 100 mL/hr, Intravenous, CONTINUOUS
Discontinue when taking adequate oral intake
Post-Op/Phase II
dextrose 5%-lactated ringers infusion [44897] at 100 mL/hr, Intravenous, CONTINUOUS
Discontinue when taking adequate oral intake
Post-Op/Phase II
sodium chloride 0.9% infusion [64367] at 100 mL/hr, Intravenous, CONTINUOUS
Discontinue when taking adequate oral intake
Post-Op/Phase II
Flushes [228398]
Insert and Maintain Peripheral IV [NURVAD0013] CONTINUOUS, Routine
Peripheral IV Size: RN Discretion
Does this need to be inserted/placed?
Post-Op/Phase II
sodium chloride flush 0.9% 10 mL injection
[785055]
Flush, PRN, flush/line care
Per VAD Guidelines
Post-Op/Phase II
Surgical Prophylaxis
First Line (Single Response) [228101]
cefazolin (ANCEF) intraVENOUS - Patients who
are 40-120 kg [800000]
2 g, Intravenous, EVERY 8 HOURS For 1 Doses,
Post-Op/Phase II
cefazolin (ANCEF) intraVENOUS - Patients who
are 121 kg or greater [800000]
3 g, Intravenous, EVERY 8 HOURS For 1 Doses,
Post-Op/Phase II
cefuroxime (ZINACEF) intraVENOUS - Patients
who are 40-120 kg [800030]
1.5 g, Intravenous, EVERY 8 HOURS For 1 Doses,
Post-Op/Phase II
Page 10 of 16
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Copyright © 2017 University of Wisconsin Hospitals and Clinics Authority
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12/2017CCKM@uwhealth.org

cefuroxime (ZINACEF) intraVENOUS - Patients
who are 121 kg and greater [800030]
3 g, Intravenous, EVERY 8 HOURS For 1 Doses,
Post-Op/Phase II
Documented MRSA or history of MRSA or MRSE risk (Single Response) [233400]
Patients who are 40-120 kg - Cefazolin and
Vancomycin [231268]
cefazolin (ANCEF) intraVENOUS [800000] 2 g, Intravenous, EVERY 8 HOURS For 1 Doses
vancomycin (VANCOCIN) intraVENOUS
[800084]
15 mg/kg, Intravenous, EVERY 12 HOURS For 1
Doses
Patients who are 121 kg or greater - Cefazolin
and Vancomycin [231270]
cefazolin (ANCEF) intraVENOUS [800000] 3 g, Intravenous, EVERY 12 HOURS For 1 Doses
vancomycin (VANCOCIN) intraVENOUS
[800084]
15 mg/kg, Intravenous, EVERY 12 HOURS For 1
Doses
Patients who are 40-120 kg - Cefuroxime and
Vancomycin [231265]
cefuroxime (ZINACEF) intraVENOUS [800030] 1.5 g, Intravenous, EVERY 8 HOURS For 1 Doses,
Post-Op/Phase II
vancomycin (VANCOCIN) intraVENOUS
[800084]
15 mg/kg, Intravenous, EVERY 12 HOURS For 1
Doses, Post-Op/Phase II
Patients who are 121 kg or greater - Cefuroxume
and Vancomycin [231267]
cefuroxime (ZINACEF) intraVENOUS [800030] 3 g, Intravenous, EVERY 8 HOURS For 1 Doses,
Post-Op/Phase II
vancomycin (VANCOCIN) intraVENOUS
[800084]
15 mg/kg, Intravenous, EVERY 12 HOURS For 1
Doses, Post-Op/Phase II
Patients with IgE-mediated or severe reaction to beta-lactam [219787]
vancomycin (VANCOCIN) intraVENOUS (Max
dose 2000 mg) [800084]
15 mg/kg, Intravenous, EVERY 12 HOURS For 1
Doses, Post-Op/Phase II
Patients with IgE-mediated or severe reaction to beta-lactam AND MRSA or history of MRSA or MRSE
risk [232211]
vancomycin (VANCOCIN) intraVENOUS (Max
dose 2000 mg) [800084]
15 mg/kg, Intravenous, EVERY 12 HOURS For 1
Doses, Post-Op/Phase II
Medications
Analgesics - Acetaminophen - Scheduled [228098]
acetaMINOPHEN (TYLENOL) tab [34149] 1,000 mg, Oral, 3 X DAILY, Post-Op/Phase II
Analgesics - Acetaminophen - PRN [231235]
acetaMINOPHEN (TYLENOL) tab [750000] 325-650 mg, Oral, EVERY 4 HOURS PRN, pain
See Pain Management Algorithm for the Selection of
As-Needed Analgesics
No more than 4 grams acetaminophen per 24 hours
for adults or 15mg/kg per dose for peds <40kg.
Post-Op/Phase II
Analgesics - Opioid - Oral - PRN (Single Response) [231242]
hydrocodone-acetaminophen (NORCO) 5-325
MG per tab [750021]
1-2 tab, Oral, EVERY 4 HOURS PRN, pain
See Pain Management Algorithm for the Selection of
As-Needed Analgesics
No more than 4 grams acetaminophen per 24 hours
for adults or 15mg/kg per dose for peds <40kg.
Post-Op/Phase II
oxycodone tab RANGE [750032] Oral, EVERY 3 HOURS PRN, pain
See Pain Management Algorithm for the Selection of
As-Needed Analgesics
Post-Op/Phase II
Analgesics - Opioids - Intravenous - PRN [231243]
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HYDROmorphone PF (DILAUDID) injection
[750050]
0.2-0.5 mg, Intravenous, EVERY 2 HOURS PRN, pain
See Pain Management Algorithm for the Selection of
As-Needed Analgesics
for 3 Minutes, Post-Op/Phase II
Analgesics - Other (Single Response) [231236]
gabapentin (NEURONTIN) cap [54258] 600 mg, Oral, 3 X DAILY, Post-Op/Phase II
gabapentin (NEURONTIN) cap [54258] 300 mg, Oral, 3 X DAILY, Post-Op/Phase II
Anti-emetics [86592]
Adult - Standard - Anti-emetics [242247]
ondansetron (ZOFRAN ODT) disintegrating tab
[64224]
4 mg, Oral, EVERY 6 HOURS PRN,
nausea/vomiting
Use first line
Post-Op/Phase II
ondansetron (ZOFRAN) injection [800202] 4 mg, Intravenous, EVERY 6 HOURS PRN,
nausea/vomiting
Use first line if unable to take medications by mouth
or enteral tube OR if immediate effect is needed.
Post-Op/Phase II
prochlorperazine (COMPAZINE) tab [41372] 10 mg, Oral, EVERY 6 HOURS PRN,
nausea/vomiting
Use second line if there is inadequate response to
first line anti-emetic within 30 minutes. If there is no
response to second line therapy within 30 minutes,
notify provider
Post-Op/Phase II
prochlorperazine (COMPAZINE) injection [41369] 10 mg, Intravenous, EVERY 6 HOURS PRN,
nausea/vomiting
Use second line. Use if there is inadequate
response to first line anti-emetic within 30 minutes
and if unable to take medications by mouth or
enteral tube OR if immediate effect is needed. If
there is no response to second line therapy within 30
minutes, notify provider
Post-Op/Phase II
Bowel Management [86594]
Adult - Bowel Management - Scheduled
[242250]
senna-docusate (SENOKOT S) 8.6-50 MG per
tab [60530]
2 tab, Oral, 2 X DAILY, Post-Op/Phase II
Adult - Bowel Management - As Needed
[242251]
polyethylene glycol (MIRALAX) oral packet
[61829]
17 g, Oral, 1 X DAILY PRN, constipation
First Line Therapy
Post-Op/Phase II
magnesium hydroxide (MILK OF MAGNESIA)
susp [65443]
30 mL, Oral, 1 X DAILY PRN, constipation
Administer as second line agent if no response to
first line agent after two hours.
Post-Op/Phase II
bisacodyl (DULCOLAX) rectal suppository
[35231]
10 mg, Rectal, 1 X DAILY PRN, constipation
If unable to take medications by mouth or enteral
tube OR if need immediate laxation OR if failure of
second line agent after 6 hours
Post-Op/Phase II
Gastric [86596]
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calcium carbonate (TUMS) chew tab [44477] 500-1,000 mg, Oral, EVERY 4 HOURS PRN,
dyspepsia
Administer as first line agent.
Post-Op/Phase II
mag-al-simeth (MYLANTA ES) 400-400-40
MG/5ML susp [44073]
15 mL, Oral, EVERY 4 HOURS PRN, dyspepsia
Administer as second line agent if no response to first
line agent after two hours.
Post-Op/Phase II
pantoprazole (PROTONIX) delayed release tab
[62661]
40 mg, Oral, 1 X DAILY, Post-Op/Phase II
Pruritus [153195]
loratadine (CLARITIN) tab [45611] 10 mg, Oral, 1 X DAILY PRN, allergies, itching
Administer as first line agent.
Post-Op/Phase II
diphenhydramine (BENADRYL) cap - NOTE: Do
NOT order for patients older than 65 years
[36791]
25 mg, Oral, EVERY 6 HOURS PRN, itching
Administer as a second line agent if no response to
first-line agent after two hours.
NOTE: Do NOT order for patients older than 65 years
Post-Op/Phase II
diphenhydramine (BENADRYL) injection - NOTE:
Do NOT order for patients older than 65 years
[800106]
25 mg, Intravenous, EVERY 6 HOURS PRN, itching
Administer as a second line agent if no response to
first-line agent after two hours any unable to take
orally.
NOTE: Do NOT order for patients older than 65 years
Post-Op/Phase II
Hypnotics (Single Response) [229303]
traZODONE (DESYREL) tab [720150] 50 mg, Oral, 1 X DAILY (HS) PRN, sleep
Offer only after failure of non-pharmacologic
interventions (see RN Care Problem Sleep/Rest
Disturbance Adult)
Post-Op/Phase II
melatonin tab [119466] 3 mg, Oral, 1 X DAILY (HS) PRN, sleep
Offer only after failure of non-pharmacologic
interventions (see RN Care Problem Sleep/Rest
Disturbance Adult)
Post-Op/Phase II
Trazodone - Melatonin [227765] "And" Linked Panel
traZODONE (DESYREL) tab [720150] 50 mg, Oral, 1 X DAILY (HS) PRN, sleep
Use first line.
Offer only after failure of non-pharmacologic
interventions (see RN Care Problem Sleep/Rest
Disturbance Adult)
Post-Op/Phase II
melatonin tab [119466] 3 mg, Oral, 1 X DAILY (HS) PRN, sleep
Use second line if failure to respond to trazodone
within 60 minutes
Offer only after failure of non-pharmacologic
interventions (see RN Care Problem Sleep/Rest
Disturbance Adult)
Post-Op/Phase II
Hypnotics (Single Response) [229306]
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traZODONE (DESYREL) tab [720150] 25 mg, Oral, 1 X DAILY (HS) PRN, sleep
Offer only after failure of non-pharmacologic
interventions (see RN Care Problem Sleep/Rest
Disturbance Adult)
If needed, give prior to midnight if possible. May
contribute to sedation the following day.
Post-Op/Phase II
melatonin tab [119466] 1 mg, Oral, 1 X DAILY (HS) PRN, sleep
Offer only after failure of non-pharmacologic
interventions (see RN Care Problem Sleep/Rest
Disturbance Adult)
Post-Op/Phase II
Non-categorized [87440]
naloxone (NARCAN) injection [800199] 0.1 mg, Intravenous, PRN, opioid overdose, Post-
Op/Phase II
cepastat lozenge [114373] 2 lozenge, Oral, EVERY 2 HOURS PRN, sore throat,
Post-Op/Phase II
Laboratory
Postoperative Day 1 [87442]
HEMATOCRIT [HCT] NEXT AM For 1 Occurrences, Routine
If add on test, what should lab do if unable to add test
to previous specimen?
If Conditional, What Condition?
Post-Op/Phase II
ELECTROLYTES [LYTE] NEXT AM For 1 Occurrences, Routine
If add on test, what should lab do if unable to add test
to previous specimen?
If Conditional, What Condition?
Post-Op/Phase II
GLUCOSE [GLU] NEXT AM For 1 Occurrences, Routine
If add on test, what should lab do if unable to add test
to previous specimen?
If Conditional, What Condition?
Post-Op/Phase II
BUN [BUN] NEXT AM For 1 Occurrences, Routine
If add on test, what should lab do if unable to add test
to previous specimen?
If Conditional, What Condition?
Post-Op/Phase II
CREATININE [CRET] NEXT AM For 1 Occurrences, Routine
If add on test, what should lab do if unable to add test
to previous specimen?
If Conditional, What Condition?
Post-Op/Phase II
CALCIUM [CA] NEXT AM For 1 Occurrences, Routine
If add on test, what should lab do if unable to add test
to previous specimen?
If Conditional, What Condition?
Post-Op/Phase II
MAGNESIUM [MAG] NEXT AM For 1 Occurrences, Routine
If add on test, what should lab do if unable to add test
to previous specimen?
If Conditional, What Condition?
Post-Op/Phase II
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PHOSPHATE [PHOS] NEXT AM For 1 Occurrences, Routine
If add on test, what should lab do if unable to add test
to previous specimen?
If Conditional, What Condition?
Post-Op/Phase II
CBC WITHOUT DIFFERENTIAL [HEMO] NEXT AM For 1 Occurrences, Routine
If add on test, what should lab do if unable to add test
to previous specimen?
If Conditional, What Condition?
Post-Op/Phase II
Consults
Consults [231255]
Consult Physical Therapy (Inpatient) Eval and
Treat [CON0061]
ONCE For 1 Occurrences, Routine
Reason for Physical Therapy Consult:
Post-Op/Phase II
Consult Occupational Therapy (Inpatient) Eval
and Treat [CON0046]
ONCE For 1 Occurrences, Routine
Reason for Occupational Therapy Consult:
Post-Op/Phase II
Consult Social Work (Inpatient) [CON0076] ONCE For 1 Occurrences, Routine
Reason for Consult:
Is this a STAT consult?
Can this consult be done via video?
Post-Op/Phase II
Consult Case Management (Inpatient) [CON0013] ONCE For 1 Occurrences, Routine
Location?
Can this consult be done via video?
Post-Op/Phase II
Consult Rehab Medicine (Inpatient) [CON0068] ONCE
Purpose of Consult:
Call back number:
Post-Op/Phase II
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:
Post-Op/Phase II
Consult Infectious Disease (Inpatient) [CON0037] 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:
Post-Op/Phase II
Consult Orthotics / Prosthetics (Inpatient)
[CON0051]
ONCE For 1 Occurrences, Routine
Do you need Orthotics or Prosthetics? Orthotics
Reason for Consult:
Post-Op/Phase II
Consult Nutrition (Inpatient) [CON0043] ONCE For 1 Occurrences, Routine
Reason for Consult:
Delegate to Initiate and Manage Tube Feeding:
Delegate to Manage Diet Order/Supplement Order:
Delegate to Dysphagia Diet Order Progression:
Can this consult be done via video?
Post-Op/Phase II
Page 15 of 16
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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 16 of 16
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