Unique Plan Description: Gen Rounds
Plan Selection Display: Gen Rounds
PlanType: Medical                                 
Version: 1          
Begin Effective Date: 2012-02-15 13:59:09
End Effective Date: 2100-12-31 00:00:00
Last Updated Date: 2023-08-09 08:36:57
Available at all facilities: Yes

Gen Rounds
Admit/Discharge/Transfer
	Discharge
		
	Transfer to Critical Care (WH JE)
		
	Transfer to Med-Surg
		
Laboratory
	CBC with Diff
		T+1;0400, Routine, spec type = Blood
		Stat, spec type = Blood
	Comprehensive Metabolic Panel
		T+1;0400, Routine, spec type = Blood
		Stat, spec type = Blood
	BMP
		T+1;0400, Routine, spec type = Blood
		T;N, Stat, spec type = Blood
	INR - MH/WH/JE
		T+1;0400, Routine, spec type = Blood
		Stat, spec type = Blood
	Magnesium Level
		T+1;0400, Routine, spec type = Blood
		Stat, spec type = Blood
	Phosphorus
		T+1;0400, Routine, spec type = Blood
		Stat, spec type = Blood
	TSH
		T+1;0400, Routine, spec type = Blood
		Stat, spec type = Blood
	D-Dimer - MH/WH/JE
		T+1;0400, Routine, spec type = Blood
		Stat, spec type = Blood
	Giardia/Cryptosporidium Antigen Screen
		T+1;0400, Routine, spec type = Stool
	Occult Blood Stool - MH/WH/FH
		T;N, Routine, spec type = Stool
		T+1;0400, Routine, spec type = Stool
	Occult Blood Stool - JE
		T;N, Routine, spec type = Stool
		T+1;0400, Routine, spec type = Stool
	UA (Culture if Positive)
		T;N, Routine, Routine, Urine, spec type = Urine
Diagnostic Tests
Radiology
	Chest 1 View
		Routine
		T+1;0600
	Chest 2 View
		Routine
		T+1;0600
	CTA Chest Pulmonary Arteries
		Routine
		T+1;0600
	CTA Chest
		Routine
		T+1;0600
	CT Abd Pelvis R/O Kidney Stone
		Routine
		T+1;0600
	CT Abd Pelvis for Appy
		Routine
		T+1;0600
	CT Head w Contrast
		Routine
		T+1;0600
	CT Head w & w/o Contrast
		Routine
		T+1;0600
Cardiology
	Echo w Doppler resting
		Stat
		T+1;0600
	Carotid Artery Duplex Bil
		Stat
		T+1;0600
	ECG
		Stat
		T+1;0600
Patient Care

	Discontinue IV Fluids
		Once
	Discontinue Enteral Tube
		Once
	Discontinue Urinary Catheter
		
Consults/Follow-up
	Consult Cardiologist
		
	Consult Gastroenterologist
		
	Consult General Surgery
		
	Consult Hematologist/Oncologist
		
	Consult Infectious Disease
		
	Consult Nephrologist
		
	Consult Neurologist
		
	Consult Tele Neurology (JEFH)
		
	Consult Orthopedics
		
	Consult Urology

Adult C Diff Diagnosis and Initial Treatment
Laboratory
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	Toxigenic Clostridioides Difficile by EIA Reflex to PCR
		T;N, Routine, spec type = Stool
Medications
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		Choose 1(NOTE)*
	vancomycin oral
		125 mg, Capsule, BY MOUTH, Q6H, C difficile, 10 Day(s)
	fidaxomicin
		200 mg, Tab, By Mouth, Q12H, Other- type in, C difficle, 10 Day(s)
			Comment: (Restricted to ID & GI services)
		Initial Episode Fulminant (Hypotension or shock, ileus, megacolon)(NOTE)*
	vancomycin oral
		500 mg, Capsule, BY MOUTH, Q6H, C difficile
	metroNIDAZOLE IVPB
		500 mg, Injection-Premix, IVPB, Q8H, C difficile
		First recurrence choose 1(NOTE)*
	vancomycin oral
		125 mg, Capsule, BY MOUTH, Q6H, C difficile
	fidaxomicin
		200 mg, Tab, By Mouth, Q12H, Other- type in, C difficile, 10 Day(s)
			Comment: (restricted to ID and GI services) if vancomycin used for initial episode
		Second recurrence Consider ID or GI consult ( vancomycin tapering regimen, fidaxomycin, Fecal Microbiota Transplantation)(NOTE)*
Consults/Follow-up
	Pharmacy Consult
		assess that anti-diarrheal medications, laxatives and stool softeners are discontinued and assess for offending antibiotics and PPI's
	Consult Gastroenterologist
		Reason for Referral: C difficile
	Consult Infectious Disease
		Reason for Referral: C difficile
	Consult General Surgery
		Reason for Referral: C difficile

hs Troponin T - MH/WH/JE
Laboratory
	hs Troponin T - MH/WH/JE
		Stat, spec type = Blood
		T;N+120, Timed, spec type = Blood
		T;N+360, Timed, spec type = Blood

hs Troponin I - FH (Stat and 2hr and 6hr)
	hs Troponin I - FH
		T;N, Stat, spec type = Blood
		T;N+120, Timed, spec type = Blood
		T;N+360, Timed, spec type = Blood

*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