Unique Plan Description: Cards Transcatheter Mitral Valve Repair Pre op (MH)
Plan Selection Display: Cards Transcatheter Mitral Valve Repair Pre op (MH)
PlanType: Medical                                 
Version: 1          
Begin Effective Date: 2020-02-19 08:42:19
End Effective Date: 2100-12-31 00:00:00
Last Updated Date: 2024-10-15 16:29:35
Available at all facilities: Yes

Cards Transcatheter Mitral Valve Repair Pre op (MH
Admit/Discharge/Transfer
	Admit to Inpatient Status
		T;N
Vital Signs
	Vital Signs
		T;N, Routine
Activity
	Activity-As Tolerated
		
Diet
	NPO
		After Midnight, Except for Medications
Laboratory
	CBC with Diff
		T;N, Stat, spec type = Blood
	INR - MH/WH/JE
		T;N, Stat, spec type = Blood
	Basic Metabolic Panel
		T;N, Stat, spec type = Blood
	Magnesium Level
		T;N, Stat, spec type = Blood
	Urinalysis (Culture if Pos)
		T;N, Stat, Stat, spec type = Urine
	Albumin
		T;N, Stat, spec type = Blood
	ProBNP
		T;N, Stat, spec type = Blood
	Type and Screen (No Product on hold)
		T;N, Stat, spec type = Blood
	Crossmatch Red Blood Cells
		T;N, Stat, spec type = Blood, 2, No Requirements, Keep Ahead
Diagnostic Tests
	Chest 2 View
		T;N, Routine, Chest Pain
	ECG
		
IV Solutions
	Sodium Chloride 0.45%
		1,000 mL, IV, 100 ml/hr
		1,000 mL, IV, 10 ml/hr
		1,000 mL, IV, 20 ml/hr
	Dextrose 5% in Water
		1,000 mL, IV, 100 ml/hr
		1,000 mL, IV, 20 ml/hr
Medications
	metoprolol TARTRATE
		12.5 mg, Tab, By Mouth, PREOP, for see comment
			Comment: if no beta blocker ordered
	aspirin
		81 mg, Tablet-Chew, By Mouth, PREOP, T;N
	Ancef (MH/WH)
		2,000 mg, Syringe, IV Push, PREOP, Surgical prophylaxis
			Comment: To be started 1 hour prior to procedure; coordinate with Cath Lab
	vancomycin IVPB
		15 mg/kg, Injection-Premix, IVPB, PREOP, Surgical prophylaxis
			Comment: To be started 2 hours prior to procedure; coordinate with Cath Lab
Patient Care
	Obtain Consent/Permit for:
		Transcatheter Mitral Valve Repair
	Foley Catheter
		Insert, am of procedure
	Notify MD
		Temperature > 101.5, pulse < 50 or >120, resp rate <8 or >28, systolic bp < 90 or >180, diastolic bp >90, oxygen saturation < 88%.
		INR > 1.5
	Resuscitation Status
		Full Code
	Do not give medication
		T;N, Hold Metformin day of cardiac procedure
		T;N, Hold angiotensin converting enzyme inhibitors, angiotensin receptor blockers day of procedure.
Therapies
	Consult Physical Therapy, Evaluate and Treat
		T;N, Reason to See: Evaluate and Treat
			Comment: Transcatheter Mitral Valve Repair: 6 minute walk measures in feet. To be done within 30 days of procedure.

*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