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IP - IR - Post Gastrojejunostomy - Adult - Postprocedure [1120]

IP - IR - Post Gastrojejunostomy - Adult - Postprocedure [1120] - Clinical Hub, UW Health Clinical Tool Search, UW Health Clinical Tool Search, Order Sets, Inpatient, Radiology


IP - IR - Post Gastrojejunostomy - Adult - Postprocedure [1120]
Patient Care Orders
Vital Signs [213198]
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 15 minutes times 4, then every 30 minutes
times 2, then every hour times 2, then return to
baseline order.
Activity [14263]
Position Somnolent Patients on Left Side to
Prevent Aspiration [NURACT0011]
CONTINUOUS, Starting today
Nutrition [14264]
NPO Postprocedure - Hold Diet [DIE0007] CONTINUOUS NPO For 4 Hours, Routine
NPO For Which Procedure? IR Postprocedure
Modifiers: NPO EXCEPT MEDICATIONS
DO NOT use Gastrostomy Tube x 4 hours post
procedure.
4 Hours After Placement, Initiate Feeding
Through Jejunostomy Port Per Clinical Nutrition
[NURDIE0013]
SEE COMMENTS, Starting today, Starting 4 hours
after placement, initiate feeding through jejunostomy
port per clinical nutrition.
Respiratory [14265]
Oxygen Therapy [RT0032] CONTINUOUS, Starting today, Routine
FiO2 (%) Titrate to Keep Sats >/= to ___%:
Liter Flow:
Titrate oxygen to maintain O2 sat at (%):
O2 Delivery Device: Nasal Cannula
Attempt to Wean Off Oxygen? Yes
Drain/Tube Care [14266]
Maintain Gastrostomy Jejunostomy Tube
[NURTAD0008]
CONTINUOUS, Starting today, Routine
Gastrostomy Port Drainage:
Jejunostomy Port Drainage:
Flush Gastrostomy and Jejunostomy Port With: Water
(As needed)
Flush Volume (mL):
Flush Frequency:
Site Assessment Frequency: EVERY 8 HOURS
Care Frequency: SEE COMMENTS (daily and as
needed)
Wash With: Other (Comment) (Mild soap and water)
Primary Dressing: Gauze (2 x 2)
Secondary Dressing: Transparent Dressing
(TEGADERM)
After 48 hours may leave site open to air.
Properly Label Jejunostomy Port and
Gastrostomy Port for Easy Identification
[NURTAD0046]
ONCE, Starting today For 1 Occurrences
Do not pull on or remove T-fastener buttons if
present [NURTAD0046]
CONTINUOUS, Starting today
Page 1 of 2
Printed by O'BRIEN, RYLEY P [RPO249] at 6/23/2017 4:02:01 PM
Copyright © 2017 University of Wisconsin Hospitals and Clinics Authority
Contact: Lee Vermeulen, CCKM@uwhealth.org Last Revised: 06/2017CCKM@uwhealth.org

Medication Administration [NURCOM0022] SEE COMMENTS, All medications administered
through the Gastrostomy Jejunostomy Tube must be
crushed and completely disolved in water.
Contingency Parameters [14267]
Notify Interventional Radiology Resident On Call
[NURCOM0001]
Provider to Notify: Other (Comment)
If systolic blood pressure > (mmHg):
If systolic blood pressure < (mmHg): 100 during first
24 hours after procedure
If diastolic blood pressure > (mmHg):
If diastolic blood pressure < (mmHg):
If temperature > (C): 38.5 during first 24 hours after
procedure
If temperature < (C):
If heart rate > (bpm): 120 during first 24 hours after
procedure
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: Gastrojejunostomy tube obstruction,New
abdominal pain,Excessive drainage or erythema at
the procedure site,Unable to differentiate
Gastrostomy port from Jejunostomy port
Intravenous Therapy
IV Fluids (Single Response) [14688]
dextrose 5%-NaCl 0.45% infusion [51613] Intravenous, CONTINUOUS
sodium chloride 0.9 % infusion [64367] Intravenous, CONTINUOUS
Page 2 of 2
Printed by O'BRIEN, RYLEY P [RPO249] at 6/23/2017 4:02:01 PM
Copyright © 2017 University of Wisconsin Hospitals and Clinics Authority
Contact: Lee Vermeulen, CCKM@uwhealth.org Last Revised:
 
06/2017CCKM@uwhealth.org