Unique Plan Description: Cards TAVR Workup (MH)
Plan Selection Display: Cards TAVR Workup (MH)
PlanType: Medical                                 
Version: 1          
Begin Effective Date: 2019-04-26 15:04:00
End Effective Date: 2100-12-31 00:00:00
Last Updated Date: 2021-12-20 09:48:35
Available at all facilities: Yes

Cards TAVR Workup (MH)
Laboratory
	CBC with Diff
		T;N, Stat, spec type = Blood
	Basic Metabolic Panel
		T;N, Stat, spec type = Blood
	BNP-Pro
		T;N, Stat, spec type = Blood
	Albumin
		T;N, Stat, spec type = Blood
	Type and Screen (No Product on hold)
		T;N, Stat, spec type = Blood
Diagnostic Tests
	Carotid Artery Duplex Bil
		T;N
	Echo w Doppler resting
		T;N
			Comment: TAVR TTE facility.
	CTA Aorta Complete for TAVR
		T;N
	Complete pulmonary function
		T;N
	Native Artery Duplex Bil Lower Exercise
		T;N, Routine, Indication: Weak Pulse
			Comment: TAVR workup
Therapies
	Consult Occupational Therapy, Evaluate and Treat
		Reason to See: Evaluate and Treat
			Comment: TAVR: To include ADL and Grip Assessment
	Consult Physical Therapy, Evaluate and Treat
		Reason to See: Evaluate and Treat
			Comment: TAVR: To include 5 M walk with 3 different times documented. To be done within 30 days of procedure.
Consults/Follow-up
	Consult Cardio-Thoracic Surgery

RAD CTA Coronary Procedure
Vital Signs
	BP, Pulse and Respirations
		T;N, Prior to medication administration
		T;N, Q15MIN, post medication administration
		T;N, Q15MIN, 2, Dose(s)/Time(s), post imaging exam
Laboratory
	Glucose POC - RN
		T;N, Once
Medications
	Lopressor
		5 mg, Solution-Injection, IV Push, Q5MIN, PRN for see comment, duration: 4 Dose(s)/Time(s)
			Comment: In Imaging per protocol.  If HR >60 give first 5mg IV dose.  If HR >/=56 5 minutes after first dose, give 2nd 5mg dose. If HR > /=61  5 minutes after 2nd dose, give 3rd 5mg dose and notify IR MD. Administer doses over 1 minute. Max dose 15mg.
	Cardizem
		10 mg, Injection, IV Push, Q5MIN, PRN, see comment, 2 Dose(s)/Time(s)
			Comment: In Imaging per protocol.   If HR > 56 give first dose.  If HR >= 56  five minutes after first dose give 2nd dose.  Administer doses over 2 minutes.
		5 mg, Injection, IV Push, Once, PRN, as needed
			Comment: In Imaging per protocol.  If HR >=61  five minutes after 2nd dose, give 5mg dose and notify IR MD. Administer doses over 2 minutes. Max diltiazem dose is 25mg.
	Nitrostat
		0.4 mg, Tab, SUBLINGUAL, Once
			Comment: In Imaging. For SBP 90-110
		0.8 mg, Tab, SUBLINGUAL, Once
			Comment: In Imaging. For SBP > 110
	midazolam
		1 mg, Injection, IV Push, Q5MIN, PRN, anxiety, 5 Dose(s)/Time(s)
			Comment: In Imaging per MD up to 5 mg.
Patient Care
	Notify MD
		T;N, if HR <45 or SBP <90.
Therapies
Respiratory Therapy
	Oxygen Therapy
		T;N
	Pulse Oximetry Spot Check RT
		T;N, BID
	Continuous Pulse Oximetry Monitoring Check
		T;N, BID

*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