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IP - Musculoskeletal - Vertebroplasty - Adult - Postprocedure [1770]

IP - Musculoskeletal - Vertebroplasty - Adult - Postprocedure [1770] - Clinical Hub, UW Health Clinical Tool Search, UW Health Clinical Tool Search, Order Sets, Inpatient, Radiology


IP - Musculoskeletal - Vertebroplasty - Adult - Postprocedure [1770]
for Adult Patients OnlyIntended
Patient Care Orders
Vital Signs [26154]
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, then every 1 hour.
Activity [26155]
Bedrest for 1 hour postprocedure.
[NURACT0011]
SEE COMMENTS, Bedrest for 1 hour postprocedure.
Elevate Head Of Bed [NURACT0002] Equal to (degrees):
Greater than (degrees):
Less than (degrees): 30
Other options:
Routine, CONTINUOUS, Starting today For 1 Hours
No lifting greater than 10 pounds for 24 hours
[NURACT0011]
SEE COMMENTS, No lifting greater than 10 pounds
for 24 hours
Ad Lib Starting 1 hour postprocedure
[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:
Starting 1 hour postprocedure
Nutrition [111364]
General Diet [NUT9999] EFFECTIVE NOW, Starting today, Routine
Patient Type: Adult
Diet Type: General (no Modifications)
Bedside Meal Instructions:
Room Service Class:
Wound/Procedure Site Care [26156]
Page 1 of 4
Printed by O'BRIEN, RYLEY P [RPO249] at 8/17/2017 9:50:45 AM
Copyright © 2017 University of Wisconsin Hospitals and Clinics Authority
Contact: Lee Vermeulen, CCKM@uwhealth.org Last Revised: 08/2017CCKM@uwhealth.org

Assess Dressing Site [NURWND0015] CONTINUOUS, Starting today, Routine
Wound Type: Puncture
Wound Site: Back
Wound Location: Posterior
Assess Frequency: SEE COMMENTS
Care Frequency:
Wash With:
Irrigate/Rinse With:
Apply (Must also enter separate medication order to
obtain drug):
Primary Dressing:
Secondary Dressing:
Assess dressing site every 15 minutes times 4, then
every 30 minutes times 2, then every 1 hour.
Contingency Parameters [26157]
Notify Musculosketal Radiology
 [NURCOM0001]
Provider to Notify: Other (Comment)
If systolic blood pressure > (mmHg):
If systolic blood pressure < (mmHg): 100
If diastolic blood pressure > (mmHg):
If diastolic blood pressure < (mmHg):
If temperature > (C): 38.5
If temperature < (C):
If heart rate > (bpm): 120
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: Shaking chills,Rigors,Nausea or
vomiting,Shortness of breath,Vertebroplasty site
pain or bleeding
Intravenous Therapy
IV Fluids [25441]
Maintain Peripheral IV [NURVAD0013] CONTINUOUS, Starting today, Routine
Peripheral IV Size: RN Discretion
Does this need to be inserted/placed?
Discontinue intravenous fluids when patient has
adequate oral intake
Medications - General
Analgesics - Acetaminophen - PRN [25442]
acetaMINOPHEN (TYLENOL) tab [34149] 650 mg, Oral, EVERY 4 HOURS PRN, pain,
mild/moderate pain
Diagnostic Tests and Imaging
X-Rays [111365]
Page 2 of 4
Printed by O'BRIEN, RYLEY P [RPO249] at 8/17/2017 9:50:45 AM
Copyright © 2017 University of Wisconsin Hospitals and Clinics Authority
Contact: Lee Vermeulen, CCKM@uwhealth.org Last Revised:
 
08/2017CCKM@uwhealth.org

X-RAY LUMBAR SPINE 2-3 VIEWS [R72100] ONCE-RAD NEXT AVAILABLE For 1 Occurrences,
Routine
Current signs and symptoms? s/p Vertebroplasty
What specific question(s) would you like answered
by this exam? Cement Location
Relevant recent/past history? Vertebroplasty
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
X-RAY THORACIC SPINE 2 VIEWS [R72070] ONCE-RAD NEXT AVAILABLE For 1 Occurrences,
Routine
Current signs and symptoms? s/p Vertebroplasty
What specific question(s) would you like answered
by this exam? Cement Location
Relevant recent/past history? Vertebroplasty
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
Consults
Consults [224451]
Consult to Fracture Liaison Service [CON0194] ONCE, Routine
Reason for Consult:
Can this consult be done via video?
Discharge Instructions
Discharge Instructions [27521]
Notify Provider [NURCOM0001] 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: Page / call procedure team if they have not
seen the patient before discharge.
Discharge Patient 2 Hours Postprocedure
[NURCOM0022]
ONCE, Starting today For 1 Occurrences
Follow-Up
Follow-Up [137997]
Patient and Family Education [NURCOM0022] SEE COMMENTS, Starting today, Patient and Family
Education: Check puncture site for signs and
symptoms of infection for a 2 day period.
Page 3 of 4
Printed by O'BRIEN, RYLEY P [RPO249] at 8/17/2017 9:50:45 AM
Copyright © 2017 University of Wisconsin Hospitals and Clinics Authority
Contact: Lee Vermeulen, CCKM@uwhealth.org Last Revised:
 
08/2017CCKM@uwhealth.org

Schedule Appointment [NURCOM0026] Reason for Hospital Follow Up Appointment: Verify
healing of bone
Which Provider: Patient's Specific PCP/Care Team
When do you want appointment:
Which Clinic or Specialty:
Page 4 of 4
Printed by O'BRIEN, RYLEY P [RPO249] at 8/17/2017 9:50:45 AM
Copyright © 2017 University of Wisconsin Hospitals and Clinics Authority
Contact: Lee Vermeulen, CCKM@uwhealth.org Last Revised:
 
08/2017CCKM@uwhealth.org