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/clinical/cckm-tools/content/order-sets/inpatient/radiology/name-97950-en.cckm

201605142

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100

UWHC,UWMF,

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

IP - Body - Percutaneous Biopsy - Adult - Postprocedure [1610]

IP - Body - Percutaneous Biopsy - Adult - Postprocedure [1610] - Clinical Hub, UW Health Clinical Tool Search, UW Health Clinical Tool Search, Order Sets, Inpatient, Radiology


IP - Body - Percutaneous Biopsy - Adult - Postprocedure [1610]
Intended for Adult Patients Only
Patient Care Orders
Vital Signs [22288]
Vital Signs [NURMON0013] SEE COMMENTS, Starting today, Routine
Temperature Measurement Method:
Temperature Measurement Restrictions:
BP Source:
BP Location:
BP Position:
BP Restrictions:
Every 15 minutes times 4, then every 30 minutes times 2
Activity [22292]
Bedrest [NURACT0008] CONTINUOUS, Starting today For 1 Hours, Routine
AD LIB:
AMBULATE:
CHAIR:
DANGLE:
BEDREST: with bathroom privileges
RESTRICTIONS:
UPPER LEFT EXTREMITY WEIGHT BEARING:
UPPER RIGHT EXTREMITY WEIGHT BEARING:
LOWER LEFT EXTREMITY WEIGHT BEARING:
LOWER RIGHT EXTREMITY WEIGHT BEARING:
Post procedure
Bedrest affected side down [NURACT0008] CONTINUOUS, Starting today For 1 Hours, Routine
AD LIB:
AMBULATE:
CHAIR:
DANGLE:
BEDREST: with bathroom privileges
RESTRICTIONS:
UPPER LEFT EXTREMITY WEIGHT BEARING:
UPPER RIGHT EXTREMITY WEIGHT BEARING:
LOWER LEFT EXTREMITY WEIGHT BEARING:
LOWER RIGHT EXTREMITY WEIGHT BEARING:
Post procedure
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:
Beginning 1 hour post procedure with bathroom privileges.
Nutrition [22295]
Page 1 of 4
Printed by O'BRIEN, RYLEY P [RPO249] at 12/16/2015 4:40:13 PM

Copyright © 2015 University of Wisconsin Hospital and Clinics Authority, University of Wisconsin Medical Foundation, Inc, UW-Madison
Contact: Lee Vermeulen, CCKM@uwhealth.org Last Revised:



















 
12/2015Lee Vermeulen, CCKM@uwhealth.org

NPO [NUT0001] EFFECTIVE NOW, Starting today For 1 Hours, Routine
General Diet:
Diabetic Diet:
NPO (If patient receiving tube feeding see question 25):
STRICT NPO
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):
Tube Feeding Management:
Room Service Class:
For 1 hour post procedure
Page 2 of 4
Printed by O'BRIEN, RYLEY P [RPO249] at 12/16/2015 4:40:13 PM

Copyright © 2015 University of Wisconsin Hospital and Clinics Authority, University of Wisconsin Medical Foundation, Inc, UW-Madison
Contact: Lee Vermeulen, CCKM@uwhealth.org Last Revised:



















 
12/2015Lee Vermeulen, CCKM@uwhealth.org

General Diet [NUT0001] EFFECTIVE NOW, Starting today For Until specified, 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):
Tube Feeding Management:
Room Service Class:
Wound Care [22299]
Wound Care [NURWND0015] CONTINUOUS, Starting today For 4 Occurrences, Routine
Wound Type: Puncture
Wound Site:
Wound Location:
Assess Frequency: EVERY 15 MINUTES
Care Frequency: EVERY 15 MINUTES
Wash With:
Irrigate/Rinse With:
Apply (Must also enter separate medication order to obtain
drug):
Primary Dressing:
Secondary Dressing:
Every 15 minutes times 4, then every 30 minutes times 2
Contingency Parameters [22300]
Page 3 of 4
Printed by O'BRIEN, RYLEY P [RPO249] at 12/16/2015 4:40:13 PM

Copyright © 2015 University of Wisconsin Hospital and Clinics Authority, University of Wisconsin Medical Foundation, Inc, UW-Madison
Contact: Lee Vermeulen, CCKM@uwhealth.org Last Revised:



















 
12/2015Lee Vermeulen, CCKM@uwhealth.org

Notify - Radiologist On Call [NURCOM0001] Provider to Notify: Provider
If systolic blood pressure > (mmHg):
If systolic blood pressure < (mmHg): 100
If diastolic blood pressure > (mmHg):
If diastolic blood pressure < (mmHg):
If temperature > (C):
If temperature < (C):
If heart rate > (bpm): 100
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: Pain not controlled with ordered analgesics or ordered
intervention,Dyspnea
Medications - Post-procedure
Medications - Post Procedure [147528]
acetaMINOPHEN (TYLENOL) tab [34149] 650 mg, Oral, EVERY 4 HOURS PRN, pain, pain
Give as second line agent.
ketOROLAC (TORADOL) injection - NOTE: Do NOT
order ketorolac if patient 65 years or older, 50 kg or less,
or serum creatinine 1.2 mg/dL or more [800050]
15 mg, Intravenous, EVERY 6 HOURS For 4 Doses
ibuprofen (MOTRIN) tab [38353] 600 mg, Oral, EVERY 4 HOURS PRN, pain
Give as first line agent.
Diagnostic Tests and Imaging
Diagnostic Tests and Imaging [22303]
X-RAY CHEST AP VIEW - Upright [R71010] ONCE-RAD NEXT AVAILABLE, Starting today, Routine
Current signs and symptoms?
What specific question(s) would you like answered by this
exam? Post procedure, assess for pneumothorax
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
1 hour post procedure
X-RAY CHEST AP VIEW - Upright [R71010] ONCE-RAD NEXT AVAILABLE, Starting today, Routine
Current signs and symptoms?
What specific question(s) would you like answered by this
exam? Post procedure, assess for pneumothorax
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
3 hours post procedure
Page 4 of 4
Printed by O'BRIEN, RYLEY P [RPO249] at 12/16/2015 4:40:13 PM

Copyright © 2015 University of Wisconsin Hospital and Clinics Authority, University of Wisconsin Medical Foundation, Inc, UW-Madison
Contact: Lee Vermeulen, CCKM@uwhealth.org Last Revised:



















 
12/2015Lee Vermeulen, CCKM@uwhealth.org