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/clinical/cckm-tools/content/order-sets/inpatient/radiology/name-98006-en.cckm

201708237

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IP - Musculoskeletal - Vertebroplasty - Adult - Preprocedure [1771]

IP - Musculoskeletal - Vertebroplasty - Adult - Preprocedure [1771] - Clinical Hub, UW Health Clinical Tool Search, UW Health Clinical Tool Search, Order Sets, Inpatient, Radiology


IP - Musculoskeletal - Vertebroplasty - Adult - Preprocedure [1771]
for Adult Patients OnlyIntended
Patient Care Orders
Activity [26139]
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:
Nutrition [111358]
NPO Except Medications [NUT9999] EFFECTIVE NOW, Starting today, Routine
Patient Type: Adult
Diet Type: NPO
NPO: NPO except Medications
Bedside Meal Instructions:
Room Service Class:
Patient Education [26150]
Provide Patient Education - HFFY #5821
[NURCOM0025]
ONCE, Starting today For 1 Occurrences, Routine,
Patient to read HFFY #5821 Moderate Sedation prior
to transport to Radiology.
Provide Patient Education - HFFY #5685
[NURCOM0025]
ONCE, Starting today For 1 Occurrences, Routine,
Patient to read HFFY #5685 Percutaneous
Vertebroplasty prior to transport to Radiology.
Non-Categorized Patient Care Orders [26144]
Void Prior to Transport [NURELM0022] CONTINUOUS For Until specified, Routine, Void prior
to transport.
Nursing Communication - Treatment
[NURTRT0048]
SEE COMMENTS, Starting today, Patient should take
all regularly scheduled medications except blood
thinners: Warfarin, IV Heparin, Enoxaparin,
Fondaparinux, Clopidogrel, Ticlopidine, Cilostazol,
Bivalirudin, Argatroban, Abciximab, Eptifibatide or
Dipyridamole (may use heparin lock flushes).
For Diabetic Patients [26145]
Refer to "Diabetes Management - Supplemental Order Set" for insulin orders.
Glucose, POC [IPGLUCOSE] COLLECT UPON ADMISSION, Starting today For 1
Occurrences, Routine, Glucose, POC should always
be ordered in conjunction with orders for
hypoglycemia management and monitoring as
indicated in the Hypoglycemia Management (Adult)
panel.
If Conditional, What Condition?
Collect upon arrival to unit.
Contingency Parameters [26146]
Page 1 of 3
Printed by O'BRIEN, RYLEY P [RPO249] at 8/21/2017 1:29:17 PM
Copyright © 2017 University of Wisconsin Hospitals and Clinics Authority
Contact: Lee Vermeulen, CCKM@uwhealth.org Last Revised: 08/2017CCKM@uwhealth.org

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: Patient has taken aspirin in the last 3
days,Clopidogrel (PLAVIX) in the last 7
days,Dalteparin (FRAGMIN) or (LOVENOX) in the last
12 hours,Unfractionated heparin for the last 8
hours,metFORMIN (GLUCOPHAGE) the morning of
procedure,Warfarin (COUMADIN) for the last 5 days
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): 200 (Bedside)
If blood glucose < (mg/dL): 90 (Bedside)
If pain score >:
Pulse Oximetry < (%):
If urine output < (mL):
Other: International normalized ratio (INR) is greater
than 1.5,Platelet count less than 50,000/uL
Intravenous Therapy
IV FLuids [25447]
sodium chloride 0.9% infusion [64367] at 50 mL/hr, Intravenous, CONTINUOUS
Surgical Prophylaxis
First Line (Single Response) [229227]
cefazolin (ANCEF) intraVENOUS - Patients who
are 40 - 120 kg [800000]
2 g, Intravenous, ONCE For 1 Doses
cefazolin (ANCEF) intraVENOUS - Patients who
are 121 kg or greater [800000]
3 g, Intravenous, ONCE For 1 Doses
Documented MRSA or history of MRSA or MRSE risk (Single Response) [229228]
Patients who are 40 - 120 kg [229231]
cefazolin (ANCEF) intraVENOUS [800000] 2 g, Intravenous, ONCE For 1 Doses
vancomycin (VANCOCIN) intraVENOUS -
Maximum Dose = 2000 mg/dose [800084]
20 mg/kg, Intravenous, ONCE For 1 Doses
Patients who are 121 kg or greater [229234]
Page 2 of 3
Printed by O'BRIEN, RYLEY P [RPO249] at 8/21/2017 1:29:17 PM
Copyright © 2017 University of Wisconsin Hospitals and Clinics Authority
Contact: Lee Vermeulen, CCKM@uwhealth.org Last Revised:
 
08/2017CCKM@uwhealth.org

cefazolin (ANCEF) intraVENOUS [800000] 3 g, Intravenous, ONCE For 1 Doses
vancomycin (VANCOCIN) intraVENOUS -
Maximum Dose = 2000 mg/dose [800084]
20 mg/kg, Intravenous, ONCE For 1 Doses
Patients with IgE-mediated or severe reaction to Beta-lactam [229235]
vancomycin (VANCOCIN) intraVENOUS -
Maximum Dose = 2000 mg/dose [800084]
20 mg/kg, Intravenous, ONCE For 1 Doses
Patients with IgE-mediated or severe reaction to Beta-lactam AND MRSA or history of MRSA or MRSE
risk [229236]
vancomycin (VANCOCIN) intraVENOUS -
Maximum Dose = 2000 mg/dose [800084]
20 mg/kg, Intravenous, ONCE For 1 Doses
Laboratory
Draw STAT if not done in the last 30 days [26147]
PLATELET COUNT [PLT] CONDITIONAL - RN COLLECT For 1 Occurrences,
STAT
If add on test, what should lab do if unable to add test
to previous specimen?
If Conditional, What Condition? If not done in the last
30 days
PROTHROMBIN TIME/INR [PT] CONDITIONAL - RN COLLECT For 1 Occurrences,
STAT
If add on test, what should lab do if unable to add test
to previous specimen?
If Conditional, What Condition? If not done in the last
30 days
Conditional Labs [26148]
GLUCOSE [GLU] CONDITIONAL - RN COLLECT For 1 Occurrences,
STAT
If add on test, what should lab do if unable to add test
to previous specimen?
If Conditional, What Condition? If bedside glucose
monitoring less than 40 mg/dL or greater than 400
mg/dL
Page 3 of 3
Printed by O'BRIEN, RYLEY P [RPO249] at 8/21/2017 1:29:17 PM
Copyright © 2017 University of Wisconsin Hospitals and Clinics Authority
Contact: Lee Vermeulen, CCKM@uwhealth.org Last Revised:
 
08/2017CCKM@uwhealth.org