Unique Plan Description: Cards Heart Cath Pre-Op
Plan Selection Display: Cards Heart Cath Pre-Op
PlanType: Medical                                 
Version: 1          
Begin Effective Date: 2012-11-02 11:50:06
End Effective Date: 2100-12-31 00:00:00
Last Updated Date: 2025-05-28 07:21:04
Available at all facilities: Yes

Cards Heart Cath Pre-Op
Diet
	NPO
		After Midnight, NPO Except for: Medications
			Comment: May have sips of water up to 2 hours prior to procedure. No coumadin, glucophage or ACEs/ARBs
		After Midnight, NPO Except for: Medications
			Comment: No coumadin, glucophage or ACEs/ARBs
Laboratory
	INR - MH/WH/JE
		Stat, spec type = Blood
	Prothrombin Time (PT) - FH
		T;N, Stat, spec type = Diagnostic Blood
		T;N, Stat, spec type = Therapeutic Blood
	Lipid Panel
		Stat, spec type = Blood
	CBC with Diff
		Stat, spec type = Blood
	Basic Metabolic Panel
		Stat, spec type = Blood
	PTT - MH/WH/JE
		Stat, spec type = Blood
		T;N, Stat, spec type = Blood
	Pregnancy Test Urine
		Routine, Routine, spec type = Urine
			Comment: if still menstruating and has not had not had hysterectomy or tubal ligation
	WB Triage Panel Nurse Collect - RN
		T;N, Once
Diagnostic Tests
	Chest 2 View
		Routine, Chest Pain
	ECG
		Routine, Indication: CAD (Coronary Artery Disease)
IV Solutions
	Sodium Chloride 0.9%
		1,000 mL, IV, 40 ml/hr
			Comment: Continue until d/c. Start in pre op in right arm if  possible, unless other fluid ordered.
		1,000 mL, IV, 75 ml/hr
			Comment: Continue until d/c. Start in pre op in right arm if  possible, unless other fluid ordered.
Medications
	aspirin
		324 mg, Tablet-Chew, BY MOUTH, PREOP, T;N
			Comment: Administer with Valium (diazepam) if no aspirin taken at home.
	Valium
		5 mg, Tab, BY MOUTH, PREOP, T;N
		10 mg, Tab, BY MOUTH, PREOP, T;N
	Xanax
		0.25 mg, Tab, By Mouth, PREOP, T;N
		0.5 mg, Tab, By Mouth, PREOP, T;N
	Benadryl
		25 mg, Tab, BY MOUTH, PREOP, T;N
	Pepcid
		20 mg, Tab, BY MOUTH, PREOP, T;N
Patient Care
	Obtain Consent/Permit for:
		Left heart catheterization with coronary arteriography possible percutaneous transluminal coronary angioplasty possible stent placement with moderate sedation
		Percutaneous Coronary Intervention (if PTCA or stent scheduled) with moderate sedation
			Comment: Heart catheterization, possible PTCA/Stent
		Right heart catheterization with moderate sedation
		Right heart catheterization with adenosine challenge with moderate sedation
		Right and left heart catheterization with coronary arteriography, possible percutaneous transluminal coronary angioplasty possible stent placement with moderate sedation
		Right heart catheterization with pulmonary artery pressure sensor implant with moderate sedation
		Coronary arteriogram with moderate sedation
		Left heart catheterization with coronary arteriography possible percutaneous transluminal coronary angioplasty possible stent placement
		Percutaneous Coronary Intervention (if PTCA or stent scheduled)
			Comment: Heart catheterization, possible PTCA/Stent
		Right heart catheterization
		Right heart catheterization with adenosine challenge
		Right and left heart catheterization with coronary arteriography, possible percutaneous transluminal coronary angioplasty possible stent placement
		Right heart catheterization with pulmonary artery pressure sensor implant
		Coronary arteriogram
	Notify MD of Lab results
		INR >1.7 and abnormal labs.
	Notify MD
		If history of contrast reaction with no prophylaxis order; of previously undocumented allergy to cephalosporins.
Therapies
	Continuous Pulse Oximetry Monitoring Check
		T;N, BID
			Comment: Keep O2 sat monitor on thumb of affected hand.

*Report Legend:
DEF - This order sentence is the default for the selected order
GOAL - This component is a goal
IND - This component is an indicator
INT - This component is an intervention
IVS - This component is an IV Set
NOTE - This component is a note
Rx - This component is a prescription
SUB - This component is a sub phase