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UWHC,UWMF,

Clinical Hub,UW Health Clinical Tool Search,UW Health Clinical Tool Search,Order Sets,Inpatient,Vascular Surgery

IP - Vascular Surgery - Carotid Endarterectomy - Adult - Postoperative [2748]

IP - Vascular Surgery - Carotid Endarterectomy - Adult - Postoperative [2748] - Clinical Hub, UW Health Clinical Tool Search, UW Health Clinical Tool Search, Order Sets, Inpatient, Vascular Surgery


IP - Vascular Surgery - Carotid Endarterectomy - Adult - Postoperative [2748]
Intended for Adult Patients Only
Admission Status
Admission Status [84057]
Admit To Inpatient [ADT0001] Attending:
Admitting Resident:
Requested Floor:
Service:
I certify that a LOS of > 2 midnights is medically necessary;
rationale listed below: Yes
C - CLEAR DIAGNOSIS:
E - EVALUATIONS PLANNED:
R - RESULTS EXPECTED:
T - TREATMENTS ORDERED:
Post-Op/Phase II
Admit To Observation [ADT0002] Attending:
Admitting Resident:
Requested Floor:
Service:
Post-Op/Phase II
Admit To Outpatient Short Stay [ADT0003] Attending:
Admitting Resident:
Requested Floor:
Service:
Post-Op/Phase II
Venous Thromboembolism (VTE) Prophylaxis
VTE Prophylaxis (Single Response) [131985]
Caprini VTE Risk Assessment URL: https://uconnect.wisc.edu/servlet/Satellite?
cid=1126666624583&pagename=B_EXTRANET_UWH_HOME%
2FFlexMemberFile%2FLoad_File&c=FlexMemberFile
Low VTE Risk [130084]
VTE Prophylaxis - Reason Not Ordered [COR0008] ONCE, Starting today, Routine
Reason Not Ordered: Low Risk
Moderate VTE Risk with Low Bleed Risk (Single
Response) [129778]
enoxaparin (LOVENOX) injection [800040] 40 mg, Subcutaneous, EVERY 24 HOURS
heparin PF 5000 UNIT/0.5ML injection [156571] 5,000 units, Subcutaneous, EVERY 12 HOURS
heparin PF 5000 UNIT/0.5ML injection [156571] 5,000 units, Subcutaneous, EVERY 8 HOURS
Sequential Compression Device (SCD) / Foot Pump
[EQP0023]
CONTINUOUS, Starting today, Routine
Left/Right/Bilateral? Bilateral
Type: Knee High
High VTE Risk with Low Bleed Risk [130127]
enoxaparin (LOVENOX) injection [800040] 40 mg, Subcutaneous, EVERY 24 HOURS
heparin PF 5000 UNIT/0.5ML injection [156571] 5,000 units, Subcutaneous, EVERY 12 HOURS
heparin PF 5000 UNIT/0.5ML injection [156571] 5,000 units, Subcutaneous, EVERY 8 HOURS
Sequential Compression Device (SCD) / Foot Pump
[EQP0023]
CONTINUOUS, Starting today, Routine
Left/Right/Bilateral? Bilateral
Type: Knee High
High Bleed Risk (Single Response) [129757]
Sequential Compression Device (SCD) / Foot Pump
[EQP0023]
CONTINUOUS, Starting today, Routine
Left/Right/Bilateral? Bilateral
Type: Knee High
Post-Op/Phase II
Apply and Maintain Anti-Embolism Stocking
[NURTRT0039]
CONTINUOUS, Starting today, Routine
Does this need to be inserted/placed?
Left/Right/Bilateral? Bilateral
Type: Knee high
Post-Op/Phase II
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No VTE Prophylaxis [130084]
VTE Prophylaxis - Reason Not Ordered [COR0008] ONCE, Starting today, Routine
Reason Not Ordered:
Patient Care Orders
Vitals [86051]
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 hour times 4, then every 2 hours times 4, then every 8
hours., Post-Op/Phase II
Patient Monitoring [86052]
Assess Neurologic Status [NURMON0006] SEE COMMENTS, Starting today For Until specified, Routine,
Every hour times 4, then every 2 hours times 4, then every 8
hours., Post-Op/Phase II
Activity [86053]
Chair Ad Lib [NURACT0008] CONTINUOUS, Starting today For Until specified, Routine
AD LIB:
AMBULATE:
CHAIR: ad lib
DANGLE:
BEDREST:
RESTRICTIONS:
UPPER LEFT EXTREMITY WEIGHT BEARING:
UPPER RIGHT EXTREMITY WEIGHT BEARING:
LOWER LEFT EXTREMITY WEIGHT BEARING:
LOWER RIGHT EXTREMITY WEIGHT BEARING:
Post-Op/Phase II
Elevate Head Of Bed [NURACT0002] Equal to (degrees):
Greater than (degrees): 30
Less than (degrees):
Other options:
Routine, CONTINUOUS, Starting today For Until specified,
Post-Op/Phase II
Nutrition [86054]
Clear Liquid Diet [NUT0001] EFFECTIVE NOW, Starting today, Routine
General Diet:
Diabetic Diet:
NPO (If patient receiving tube feeding see question 25):
Liquids & Modified Consistency (If Dysphagia Protocol see
questions 21-24): CLEAR LIQUID;
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:
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Copyright © 2014 University of Wisconsin Hospital and Clinics Authority


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:
Post-Op/Phase II
Respiratory [86055]
Pulse Oximetry [NURMON0009] CONTINUOUS, Starting today For Until specified, Routine,
Post-Op/Phase II
Oxygen Therapy [RT0032] CONTINUOUS, Starting today For Until specified, Routine
FiO2 (%):
Liter Flow:
Titrate oxygen to maintain O2 sat at (%): 92
O2 Delivery Device: Nasal Cannula
Attempt to Wean Off Oxygen? Yes
Post-Op/Phase II
Cough And Deep Breathe [NURTRT0019] EVERY 2 HOURS, Starting today For Until specified, Routine,
While awake., Post-Op/Phase II
Incentive Spirometry [NURTRT0018] EVERY 2 HOURS, Starting today For Until specified, Routine,
While awake., Post-Op/Phase II
Wound Care [86056]
Wound Care [NURWND0015] CONTINUOUS, Starting tomorrow, Routine
Wound Type: Closed - Incision
Wound Site: Head/Neck
Wound Location:
Assess Frequency:
Care Frequency: 1X DAILY
Wash With: Soap and Water
Irrigate/Rinse With:
Apply (Must also enter separate medication order to obtain
drug):
Primary Dressing:
Secondary Dressing:
Rinse and pat dry., Post-Op/Phase II
Physician to Change First Dressing [NURWND0018] ONCE, Starting tomorrow For 1 Occurrences, Post-Op/Phase
II
Intake and Output [86057]
Measure Intake And Output [NURMON0005] SEE COMMENTS, Starting today For Until specified, Routine,
Every hour times 4, then every 2 hours times 4, then every 8
hours., Post-Op/Phase II
Non-Categorized Patient Care Orders [86058]
Maintain Arterial Line [NURVAD0001] CONTINUOUS, Starting today For Until specified, Routine
Flush Solution:
Post-Op/Phase II
Cardiac Rhythm Monitoring - Adult [NURMON0010] ONCE, Starting today, Routine
Notify Provider: Symptomatic Change in Rhythm
Functional Cardiac Defibrillator Present:
Post-Op/Phase II
Insert and Maintain Urinary Catheter [NURELM0013] CONTINUOUS, Starting today For Until specified, Routine
Type: Indwelling Single Lumen
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Copyright © 2014 University of Wisconsin Hospital and Clinics Authority


Indication for Placement:
Initiate Urinary Catheter Removal Protocol? (NP/PA Must
Select "No"): Yes
Details: To Dependent Drainage
Irrigate With:
Irrigation Frequency:
Does this need to be inserted/placed?
Discontinue morning of postoperative day 1.
Urinary Catheter Removal Protocol does NOT apply to
Urology, Gynecology, spinal cord injured patients or patients
with catheters placed by Urology on prior admission. Not
appropriate for Pediatric patients., Post-Op/Phase II
Urinary Catheterization-Intermittent [NURELM0018] EVERY 6 HOURS PRN, Starting tomorrow, Routine, If unable
to void., Post-Op/Phase II
Maintain Drain [NURTAD0003] CONTINUOUS, Starting today For Until specified, Routine
Type: Closed Suction (Jackson-Pratt)
Site:
Location:
Suction Options: Bulb
Irrigate:
Irrigate With:
Irrigant Volume (mL):
Strip: EVERY 2 HOURS
Strip For:
Dressing Change Frequency:
Dressing Type:
Post-Op/Phase II
Contingency Parameters [86059]
Notify Provider [NURCOM0001] Provider to Notify: Provider
If systolic blood pressure > (mmHg): 160
If systolic blood pressure < (mmHg): 100
If diastolic blood pressure > (mmHg): 100
If diastolic blood pressure < (mmHg): 50
If temperature > (C): 38.5
If temperature < (C):
If heart rate > (bpm): 100
If heart rate < (bpm): 50
If respiratory rate >: 20
If respiratory rate <:
If blood glucose > (mg/dL):
If blood glucose < (mg/dL):
If pain score >:
Pulse Oximetry < (%):
If urine output < (mL): 30 mL/h
Other: Stridor
Post-Op/Phase II
Intravenous Therapy
Premedications for Needle Insertion [106327]
Use lidocaine topical dressing kit for stable patient, no lidocaine allergies, have at least 30 minutes time prior to needing
to use IV
Sodium chloride (bacteriostatic) 0.9% intradermal: Useful for patients requiring urgent IV access; onset is within 1 minute.
Choice of medication should be based on patient’s previous experience/preference, history of lidocaine allergy and ease
of access.
lidocaine (LMX) 4% topical dressing kit [66882] Topical, EVERY 1 HOUR PRN, peripheral line insertion - see
Admin Instructions
Do NOT apply to area greater than 200 square centimeters
(maximum 2.5 g/site; maximum 4 sites per hour, 6 times per
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Copyright © 2014 University of Wisconsin Hospital and Clinics Authority


day). Do NOT leave on longer than 2 hours. Use for stable
patient, no allergies to lidocaine, with at least 30 minutes time
prior to IV use
Post-Op/Phase II
lidocaine (XYLOCAINE) 1% injection [39034] 0.1-0.4 mL, Intradermal, PRN, peripheral line insertion - see
Admin Instructions
Use an insulin or TB syringe with a 25-30 gauge needle to
inject solution and create a wheal. Wait 30 seconds to 1
minute then insert IV catheter into center of wheal. Use if IV
is needed within 30 minutes. Choice of medication should be
based on patient’s previous experience/preference, history of
lidocaine allergy and ease of access
Post-Op/Phase II
sodium chloride (bacteriostatic) 0.9 % injection [50585] 0.05-0.1 mL, Intradermal, PRN, peripheral line insertion - see
Admin Instructions
Use an insulin or TB syringe with a 25-30 gauge needle to
inject solution and create a wheal. Wait 30 seconds to 1
minute then insert IV catheter into center of wheal. Use if IV
is needed within 30 minutes. Choice of medication should be
based on patient’s previous experience/preference, history of
lidocaine allergy and ease of access
Post-Op/Phase II
IV Fluids [86061]
dextrose 5%-NaCl 0.45% infusion [51613] Intravenous, CONTINUOUS, Post-Op/Phase II
sodium chloride 0.45 % infusion [42187] Intravenous, CONTINUOUS, Post-Op/Phase II
sodium chloride 0.9 % infusion [64367] Intravenous, CONTINUOUS, Post-Op/Phase II
General Medications
Analgesics [86063]
acetaMINOPHEN (TYLENOL) tab [34149] 650 mg, Oral, EVERY 4 HOURS PRN, pain, temperature
greater than 38.5 degrees Celsius or pain, Post-Op/Phase II
hydrocodone-acetaminophen (NORCO) 5-325 MG per
tab [750021]
1-2 tab, Oral, EVERY 4 HOURS PRN, pain, Post-Op/Phase II
Anti-emetics [86064]
ondansetron (ZOFRAN) injection [142579] 4 mg, Intravenous, EVERY 24 HOURS PRN,
nausea/vomiting, Post-Op/Phase II
Antihypertensives - NOTE: Choose both nicardipine and esmolol drips for blood pressure greater than 160 mmHg
[86065]
esmolol (BREVIBLOC) 2.5 g in sodium chloride 0.9%
250 mL infusion [66486]
50-300 mcg/kg/min, Intravenous
Give 0.5 mg/kg bolus prior to starting esmolol drip and before
each dose increase.
Titrate per ADULT protocol. Initiate at 25 mcg/kg/min or
current rate and titrate to maintain SBP between *** to ***
mmHg
Post-Op/Phase II
nicardipine (CARDENE) 40 mg in 0.9% NaCl 200 mL
infusion [133304]
0.5-7 mcg/kg/min, Intravenous
{Titration Y/N:2000175}
Post-Op/Phase II
Beta-Blockers [86066]
atenolol (TENORMIN) tab [720016] Oral
Hold for heart rate less than 50 beats/min or systolic blood
pressure less than 100 mmHg
Post-Op/Phase II
carvedilol (COREG) tab [54511] Oral, 2 X DAILY
Hold for heart rate less than 50 beats/min or systolic blood
pressure less than *** mmHg
Post-Op/Phase II
labetalol (NORMODYNE;TRANDATE) injection [750053] 10-20 mg, Intravenous, EVERY 1 HOUR PRN, systolic blood
pressure greater than 160 mmHg or diastolic blood pressure
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Copyright © 2014 University of Wisconsin Hospital and Clinics Authority


greater than 100 mmHg
Hold for heart rate less than 50 beats/min
for 2 Minutes, Post-Op/Phase II
metoprolol (LOPRESSOR) tab [720094] Oral
Hold for heart rate less than 50 beats/min or systolic blood
pressure less than 100 mmHg
Post-Op/Phase II
Bowel Management [86067]
senna-docusate (SENOKOT-S) 8.6-50 mg per tab
[60530]
2 tab, Oral, 2 X DAILY, Post-Op/Phase II
magnesium hydroxide (MILK OF MAGNESIA) susp
[65443]
30 mL, Oral, 1 X DAILY PRN, constipation, Post-Op/Phase II
bisacodyl (DULCOLAX) rectal suppository [35231] 10 mg, Rectal, 1 X DAILY PRN, constipation, Post-Op/Phase
II
Hypnotics [111640]
traZODONE (DESYREL) tab [720150] 25 mg, Oral, 1 X DAILY (HS) PRN, sleep
Offer only after failure of non-pharmacologic interventions
(see IPOC supplemental Sleep/Rest Disturbance Adult)
Post-Op/Phase II
Platelet Inhibitors [86068]
aspirin rectal suppository [34799] 300 mg, Rectal, ONCE For 1 Doses
Give in PACU
PACU
aspirin chew tab [720014] 81 mg, Oral, 1 X DAILY, Post-Op/Phase II
aspirin EC tab [49098] 325 mg, Oral, 1 X DAILY, Post-Op/Phase II
clopidogrel (PLAVIX) tab [58345] 75 mg, Oral, 1 X DAILY, Post-Op/Phase II
Statins (Single Response) [86069]
pravastatin (PRAVACHOL) tab [46294] 40 mg, Oral, 1 X DAILY (HS), Post-Op/Phase II
simvastatin (ZOCOR) tab [46562] 20 mg, Oral, 1 X DAILY (HS), Post-Op/Phase II
simvastatin (ZOCOR) tab [46562] 40 mg, Oral, 1 X DAILY (HS), Post-Op/Phase II
Vasoactive Agents [86070]
phenylEPHRINE (NEO-SYNEPHRINE) 20 mg in
dextrose 5 % 250 mL infusion [700258]
0.1-1 mcg/kg/min, Intravenous
Titrate per ADULT protocol. Initiate at 0.25 mcg/kg/min or
current rate and titrate to maintain SBP between *** to ***
mmHg
Post-Op/Phase II
Non-categorized [140089]
metoclopramide (REGLAN) injection [800059] Intravenous, Post-Op/Phase II
Laboratory
On Arrival to Post-Anesthesia Recovery [86072]
ELECTROLYTES [LYTE] STAT - RN COLLECT, Starting today For 1 Occurrences,
Routine
If add on test, what should lab do if unable to add test to
previous specimen?
If Conditional, What Condition?
Post-Op/Phase II
Postoperative Day 1 in AM [86073]
HEMATOCRIT [HCT] NEXT AM, Starting today For 1 Occurrences, Routine
If add on test, what should lab do if unable to add test to
previous specimen?
If Conditional, What Condition?
Post-Op/Phase II
PROTHROMBIN TIME/INR [PT] NEXT AM, Starting today For 1 Occurrences, Routine
If add on test, what should lab do if unable to add test to
previous specimen?
If Conditional, What Condition?
Post-Op/Phase II
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Copyright © 2014 University of Wisconsin Hospital and Clinics Authority


PLATELET COUNT [PLT] NEXT AM, Starting today For 1 Occurrences, Routine
If add on test, what should lab do if unable to add test to
previous specimen?
If Conditional, What Condition?
Post-Op/Phase II
ELECTROLYTES [LYTE] NEXT AM, Starting today For 1 Occurrences, Routine
If add on test, what should lab do if unable to add test to
previous specimen?
If Conditional, What Condition?
Post-Op/Phase II
CALCIUM [CA] NEXT AM, Starting today For 1 Occurrences, Routine
If add on test, what should lab do if unable to add test to
previous specimen?
If Conditional, What Condition?
Post-Op/Phase II
MAGNESIUM [MAG] NEXT AM, Starting today For 1 Occurrences, Routine
If add on test, what should lab do if unable to add test to
previous specimen?
If Conditional, What Condition?
Post-Op/Phase II
PHOSPHATE [PHOS] NEXT AM, Starting today For 1 Occurrences, Routine
If add on test, what should lab do if unable to add test to
previous specimen?
If Conditional, What Condition?
Post-Op/Phase II
Diagnostic Tests and Imaging
Studies [86075]
ECG - 12 Lead [EKG0008] ONCE, Starting today For 1 Occurrences, Routine
Reason for exam:
Post-Op/Phase II
Consults
Consults [86077]
Consult Nephrology (Inpatient) [CON0083] ONCE, Starting today
Intent:
Concern or Specific Question or Task to be Addressed
(Symptom, Sign, or Diagnosis):
Post-Op/Phase II
Consult Diabetes Management (Inpatient) [CON0022] ONCE, Starting today
New diagnosis of diabetes (any type):
Intent:
Concern or Specific Question or Task to be Addressed
(Symptom, Sign, or Diagnosis):
Post-Op/Phase II
Consult Stroke - Non-Acute (Inpatient) [CON0133] ONCE, Starting today
Intent:
Concern or Specific Question or Task to be Addressed
(Symptom, Sign, or Diagnosis):
Post-Op/Phase II
BestPractice
No Hospital Problems have yet been identified [107363]
Specify Hospital Problem(s) [COR0018] Post-Op/Phase II
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Copyright © 2014 University of Wisconsin Hospital and Clinics Authority