Unique Plan Description: Cards Peripheral Intervention/Angiogram pre op
Plan Selection Display: Cards Peripheral Intervention/Angiogram pre op
PlanType: Medical                                 
Version: 1          
Begin Effective Date: 2012-11-04 20:26:13
End Effective Date: 2100-12-31 00:00:00
Last Updated Date: 2025-03-06 14:51:28
Available at all facilities: No

Cards Peripheral Intervention/Angiogram pre op
Admit/Discharge/Transfer
	Admit to Observation Status
		T;N
Vital Signs
	Vital Signs
		
Diet
	Clear Liquid Diet
		
	NPO
		
Laboratory
	CBC with Diff
		Stat, spec type = Blood
			Comment: If not done within last 14 days
	Basic Metabolic Panel
		Stat, spec type = Blood
			Comment: If not done within last 7 days
	Lipid Panel
		Stat, spec type = Blood
			Comment: If not done within last 6 weeks
	INR - MH/WH/JE
		Stat, spec type = Blood
			Comment: If patient on coumadin
	Creatinine
		Stat, spec type = Blood
			Comment: If not drawn at JE
	Pregnancy Test Urine
		Stat, Stat, spec type = Urine
			Comment: If patient still menstruating and no history of hysterectomy or tubal ligation
IV Solutions
	Sodium Chloride 0.45%
		1,000 mL, IV, 125 ml/hr
			Comment: Start 6 hours prior to procedure unless IV is infusing
		Choose the following two orders if GFR<60mL/min(NOTE)*
	Sodium Chloride 0.9%
		250 mL, IV, 1 Dose(s)/Time(s), 500 ml/hr
			Comment: Renal Protocol if GFR<60
Medications
	Plavix
		300 mg, Tab, BY MOUTH, PREOP
			Comment: On arrival if Plavix is not currently ordered
	Valium
		10 mg, Tab, By Mouth, PREOP
			Comment: 1 hour prior to procedure
	aspirin
		324 mg, Tablet-Chew, BY MOUTH, PREOP
			Comment: Give with Valium; Give if ASA not currently ordered
Patient Care
	Obtain Consent/Permit for:
		Aortogram
		Aortogram with Runoff
		PTA
		Vertebroplasty
		Renal Angiogram
		Unilateral Extremity Angiogram
		IVC Filter Placemen
		Bilateral Extremity Angiogram
		Aortogram with moderate sedation
		Aortogram with Runoff with moderate sedation
		PTA with moderate sedation
		Vertebroplasty with moderate sedation
		Renal Angiogram with moderate sedation
		Unilateral Extremity Angiogram with moderate sedation
		IVC Filter Placemen with moderate sedation
		Bilateral Extremity Angiogram with moderate sedation
	Notify
		Notify Cath Lab if eGFR<60mL/min and/or INR>1.5
	Notify MD
		Contact Admitting MD: give insulin as directed  (if patient receiveing insulin as inpatient)
	Initiate MD Plan for:
		Cardiology Contrast/Shellfish Allergy Protocol if allergic to contrast or shellfish
	Discontinue Medication
		Metformin containing medications 48 hours pre and post procedure.  Hold Lovenox 8 hours, Heparin 2 hours, and Arixtra 24 hours before procedure.  Hold all anti-hypertensives for 24 hours if having a renal angioram/ angioplasty.
	Foley Catheter
		Insert
	Cardiac Telemetry Monitoring

*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