Unique Plan Description: GI Liver Biopsy
Plan Selection Display: GI Liver Biopsy
PlanType: Medical                                 
Version: 1          
Begin Effective Date: 2012-01-11 17:58:41
End Effective Date: 2100-12-31 00:00:00
Last Updated Date: 2021-12-20 10:34:53
Available at all facilities: Yes

GI Liver Biopsy
Admit/Discharge/Transfer
	Discharge
		to: Home
			Comment: when meet discharge criteria
	Discharge Conditional
		Conditions to be met: When ok with anesthesia
		Conditions to be met: To nursing unit or previous level of care with spontaneous and unassisted aldrete of 7 or greater or returns to pre procedure aldrete status
	Discharge Instructions Other
		to be driven home by responsible adult.  May resume activities in the morning.
Vital Signs
	Vital Signs
		T;N, Routine post op
Activity
	Bedrest
		1, hr
		2, hr
		3, hr
		4, hr
	Activity-Position
		On right side | Supine, 1, hr
			Comment: then up ad lib or supine.
		On right side | Supine, 2, hr
			Comment: then up ad lib or supine.
		On right side | Supine, 3, hr
			Comment: then up ad lib or supine.
		On right side | Supine, 4, hr
			Comment: then up ad lib or supine.
	Activity-As Tolerated
		T;N+240, after bedrest
Diet
	NPO
		After Midnight
		For 2 hours post op
		For 4 hours post op
	Clear Liquid Diet
		Advance as Tolerated
			Comment: begin clear liquids after NPO
Laboratory
Today's Lab
	CBC with Diff
		Stat, spec type = Blood
	INR - MH/WH/JE
		Stat, spec type = Blood
	PTT - MH/WH/JE
		Stat, spec type = Blood
Diagnostic Tests
Radiology
	US Abd Limited
		Routine
			Comment: for marking.
IV Solutions

	Lactated Ringers Injection
		1,000 mL, IV, 20 ml/hr
	Dextrose 5% with 0.9% NaCl
		500 mL, IV, 20 ml/hr
			Comment: Start if no current IV orders.
	Sodium Chloride 0.9%
		500 mL, IV, 20 ml/hr
Medications
	Versed 5 mg/5 mL vial
		5 mg, Injection, IV Push, Q5MIN, PRN, sedation, 5 Dose(s)/Time(s)
			Comment: in GI lab. Titrate 1-5mg to affect per MD
	fentaNYL
		25 mcg, Injection, IV Push, Q5MIN, PRN, sedation, T;N, 8 Dose(s)/Time(s)
			Comment: in GI lab. Titrate 25-50 mcg to affect per MD
	meperidine
		50 mg, Syringe, IV PUSH, Q5MIN, PRN, sedation, 2 Dose(s)/Time(s)
			Comment: In GI Lab. Titrate 25mg-50mg to affect per MD. Maximum dose = 100mg.
	sodium chloride 0.9% flush injectable soln
		10 mL, Syringe, IV PUSH, Q5MIN, PRN, IV line flush
Patient Care
	VTE Advisor
		General surgery
	Obtain Consent/Permit for:
		Percutaneous Liver Biopsy
	Discontinue Peripheral Lock
		Once
			Comment: prior to dismissal.
	Notify MD
		prior to discharge
	Oxygen Therapy, Nurse to Administer
		Via Nasal Cannula, O2 @ 2L/min, Titrate->Keep Sats>/= to 92
	Patient Education
		No aspirin or NSAIDS for _____ weeks
		No heavy lifting of 20 pounds or greater for 3 days

Peripheral Lock - Access
Medications
	sodium chloride 0.9% flush injectable soln
		10 mL Syringe IV PUSH BID
		10 mL, Syringe, IV PUSH, Q5MIN, PRN, IV line flush
	lidocaine 1% injectable solution (MH/WH/FH)
		0.1 mL, IntraDermal, Q1H, PRN, see comment
			Comment: For IV start
	sodium chloride bacteriostatic 0.9% injectable soln
		0.1 mL, Injection, IntraDermal, Q1H, PRN, see comment
			Comment: For IV start, use if patient has lidocaine allergy.
	Sodium Chloride 0.9% IVPB Flush
		25 mL, IVPB, Q1H, PRN, IV line flush, 5 min(s)
			Comment: Use if medication not compatible with primary line or there is no primary line;  infuse 25mL.
Patient Care
	Peripheral Lock-Insert
		T;N

*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