/clinical/,/clinical/cckm-tools/,/clinical/cckm-tools/content/,/clinical/cckm-tools/content/order-sets/,/clinical/cckm-tools/content/order-sets/inpatient/,/clinical/cckm-tools/content/order-sets/inpatient/radiology/,

/clinical/cckm-tools/content/order-sets/inpatient/radiology/name-97970-en.cckm

201708230

page

100

UWHC,UWMF,

Tools,

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

IP - IR - Post Gastrostomy Tube Placement - Alimentation - Adult - Postprocedure [1121]

IP - IR - Post Gastrostomy Tube Placement - Alimentation - Adult - Postprocedure [1121] - Clinical Hub, UW Health Clinical Tool Search, UW Health Clinical Tool Search, Order Sets, Inpatient, Radiology


IP - IR - Post Gastrostomy Tube Placement - Alimentation - Adult -
Postprocedure [1121]
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 [183458]
Activity - Post IR Procedure [NURACT0011] SEE COMMENTS, Bedrest for *** hours. Resume
previous activity orders after designated bedrest.
Nutrition [14314]
NPO Postprocedure - Hold Diet [DIE0007] CONTINUOUS NPO For 4 Hours, Routine
NPO For Which Procedure? IR Post Procedure
Modifiers: NPO EXCEPT MEDICATIONS
May advance to admission diet order if patient passes
water bolus challenge. DO NOT use Gastrostomy
Tube until then.
Gastrostomy Initial Use Postprocedure
[NURDIE0013]
CONTINUOUS, Starting today, Start 4 hours
postprocedure.
If bowel sounds are present, the patient is afebrile and
vital signs are at baseline discontinue wall suction and
instill 200 mL of water through G-tube and check
residual 30 minutes later. If residual is less than 100
mL begin tube feedings/oral diet per Clinical Nutrition
recommendations. If residual is greater than 100 mL
recheck residual in 1 hour.
Drain/Tube Care [14315]
Maintain Gastrostomy Tube For Alimentation
[NURTAD0035]
CONTINUOUS, Starting today, Routine
Drainage Options: Low Intermittent Wall
Flush With: Water (Flush with water or sterile water for
immunocompromised or ICU patients)
Irrigant Volume (mL): 30
Flush Frequency: SEE COMMENTS (After medication
administration or alimentation )
Site Assessment Frequency: EVERY 8 HOURS
Care Frequency: SEE COMMENTS (Daily and as
needed for wet or soiled dressing for 3 days, then 1
time a day and as needed for wet or soiled dressing)
Wash With:
Primary Dressing:
Secondary Dressing: Transparent Dressing
(TEGADERM)
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 8/17/2017 12:43:35 PM
Copyright © 2017 University of Wisconsin Hospitals and Clinics Authority
Contact: Lee Vermeulen, CCKM@uwhealth.org Last Revised: 08/2017CCKM@uwhealth.org

Nursing Communication [NURTAD0046] SEE COMMENTS, Starting today For 4 Hours,
Immediately post-procedure and continuing for 4
hours, tube should be connected to low intermittent
wall suction. Clamp Gastrostomy Tube from wall
suction for 30 minutes post oral medication
administration.
Patient Teaching [NURTAD0046] ONCE For 1 Occurrences, Before discharge, patient
to perform a return demonstration of free water flush
with 30 mL via syringe and the administration of one
tube feed via gravity bag.
Time to be coordinated between RN and
patient/family.
Non-Categorized Patient Care Orders [227414]
Give Patient HFFY: Placement and Care of Your
Gastrostomy Tube (Interventional Radiology)
[NURCOM0025]
ONCE, Routine, Give patient HFFY #5899: Placement
and Care of Your Gastrostomy Tube (Interventional
Radiology)
Contingency Parameters [14317]
Notify Interventional Radiologist On Call
[NURCOM0001]
Provider to Notify: Other (Comment)
If systolic blood pressure > (mmHg): 100 during first
24 hours post-procedure
If systolic blood pressure < (mmHg):
If diastolic blood pressure > (mmHg):
If diastolic blood pressure < (mmHg):
If temperature > (C): 38.5 during first 24 hours post-
procedure
If temperature < (C):
If heart rate > (bpm): 120 during first 23 hours post-
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: Gastrostomy tube obstruction,New Abdominal
Pain,Excessive drainage or erythema at the procedure
site,Wet or soiled dressing
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 8/17/2017 12:43:35 PM
Copyright © 2017 University of Wisconsin Hospitals and Clinics Authority
Contact: Lee Vermeulen, CCKM@uwhealth.org Last Revised:
 
08/2017CCKM@uwhealth.org