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IP - Leech Therapy - Adult - Supplemental [810]

IP - Leech Therapy - Adult - Supplemental [810] - Clinical Hub, UW Health Clinical Tool Search, UW Health Clinical Tool Search, Order Sets, Inpatient, Plastics


IP - Leech Therapy - Adult - Supplemental [810]
for Adult Patients OnlyIntended
Patient Care Orders
Activity [8757]
Bed Rest During Leech Administration
[NURACT0008]
CONTINUOUS, Starting today, 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:
Non-Categorized Patient Care Orders [8758]
Wound Care (Leech Administration Site)
[NURWND0015]
CONTINUOUS, Starting today, Routine
Wound Type: Other (Comment) (Leech administration
site)
Wound Site:
Wound Location:
Assess Frequency: EVERY 8 HOURS
Care Frequency: 2X DAILY (After leech detaches)
Wash With: Soap and Water
Irrigate/Rinse With:
Apply (Must also enter separate medication order to
obtain drug):
Primary Dressing: Gauze
Secondary Dressing:
Contingency Parameters [8759]
Notify Provider [NURCOM0001] CONTINUOUS
Provider to Notify: Provider
If systolic blood pressure > (mmHg):
If systolic blood pressure < (mmHg):
If diastolic blood pressure > (mmHg):
If diastolic blood pressure < (mmHg):
If temperature > (C):
If temperature < (C):
If heart rate > (bpm):
If heart rate < (bpm):
If respiratory rate >:
If respiratory rate <:
If blood glucose > (mg/dL):
If blood glucose < (mg/dL):
If pain score >:
Pulse Oximetry < (%):
If urine output < (mL):
Other: Hematocrit less than 9
milligrams/deciliter,Capillary refill is less than 2 or
greater than 3 seconds,Failure of leech to attach to
targeted treatment area,Treatment area has dark
color, congested appearance,Treatment area has
significantly improved appearance
Medications
Page 1 of 2
Printed by STRAKA, KEVIN F [KFS1] at 3/21/2017 1:26:51 PM
Copyright © 2017 University of Wisconsin Hospitals and Clinics Authority
Contact: Lee Vermeulen, CCKM@uwhealth.org Last Revised: 03/2017CCKM@uwhealth.org

Leech Therapy [10936]
leech, medicinal - NOTE: Scheduled [785047] Topical
Apply to ***
leech, medicinal - NOTE: As Needed (PRN)
[785047]
Topical, PRN, capillary refill less than 2 seconds;
treatment area has dark color, congested
appearance, elevated tissue turgor or swelling
Apply to ***
Anti-infectives (Single Response) [10937]
sulfamethoxazole-trimethoprim (BACTRIM DS)
800-160 MG per tab [46804]
1 tab, Oral, 2 X DAILY (AT MEALTIME)
Discontinue when leech therapy terminated
cefuroxime (ZINACEF) intraVENOUS [800030] 1.5 g, Intravenous, EVERY 12 HOURS
Discontinue when leech therapy terminated unless
additional indication beyond leech therapy
cefpodoxime (VANTIN) tab [44562] 400 mg, Oral, EVERY 12 HOURS
Discontinue when leech therapy terminated unless
additional indication beyond leech therapy
ciprofloxacin (CIPRO) tab - NOTE: Order for
patients allergic to sulfonamides [61499]
500 mg, Oral, 2 X DAILY
Discontinue when leech therapy terminated
NOTE: Order for patients allergic to sulfonamides
Laboratory
Laboratory [8760]
HEMATOCRIT [HCT] CONDITIONAL - RN COLLECT For 4 Days, Routine
If add on test, what should lab do if unable to add test
to previous specimen?
If Conditional, What Condition? Draw every *** hours
during leech administration.
Blood Bank
Blood Bank [8761]
TYPE AND SCREEN [HCTS] CONDITIONAL - RN COLLECT, Starting today,
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.
If Conditional, What Condition? With next blood draw
after initiating leech therapy.
Page 2 of 2
Printed by STRAKA, KEVIN F [KFS1] at 3/21/2017 1:26:51 PM
Copyright © 2017 University of Wisconsin Hospitals and Clinics Authority
Contact: Lee Vermeulen, CCKM@uwhealth.org Last Revised: 03/2017CCKM@uwhealth.org