Unique Plan Description: GI Special Procedures
Plan Selection Display: GI Special Procedures
PlanType: Medical                                 
Version: 1          
Begin Effective Date: 2012-03-20 16:24:35
End Effective Date: 2100-12-31 00:00:00
Last Updated Date: 2021-12-27 10:49:04
Available at all facilities: Yes

GI Special Procedures
Admit/Discharge/Transfer
	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
		to: Home
			Comment: when meet discharge criteria
	Discharge Instructions Other
		to be driven home by responsible adult.  May resume activities in the morning.
Laboratory
Today's Lab
	Albumin Body Fluid
		Stat, spec type = Ascites Fluid
		Stat, spec type = Peritoneal Fluid
	Amylase Body Fluid
		Stat, spec type = Ascites Fluid
		Stat, spec type = Peritoneal Fluid
		Stat, spec type = Pleural Fluid
	Cell Count/Diff Body Fluid
		Stat, spec type = Ascites Fluid
		Stat, spec type = Pleural Fluid
	Culture Routine
		Stat, spec type = Body Fluid
			Comment: Paracentesis Fluid
	LD Body Fluid
		Stat, spec type = Pleural Fluid
	Non Gyn Cytology Request
		Stat, Cytology, Stat
	Total Protein Body Fluid
		Stat, spec type = Ascites Fluid
		Stat, spec type = Pleural Fluid
IV Solutions

	Lactated Ringers Injection
		1,000 mL, IV, 20 ml/hr
	Dextrose 5% with 0.9% NaCl
		500 mL, IV, 20 ml/hr
	Sodium Chloride 0.9%
		500 mL, IV, 20 ml/hr
Medications
	sodium chloride 0.9% flush injectable soln
		10 mL, Syringe, IV PUSH, Q5MIN, PRN, IV line flush
	albumin human 25% intravenous solution
		12.5 gm, 50 mL, Injection-Premix, IVPB, Q30MIN, PRN, see comment, 4 Dose(s)/Time(s)
			Comment: Titrate to affect per MD.
	Xylocaine 2% topical gel
		1 appl, Gel, TOPICAL, Once
	zzlactose (JE)
		1 gm/kg, Solution, By Mouth, Once
			Comment: Maximum dose = 25 gm.  Mix in 8 oz water
		2 gm/kg, Solution, By Mouth, Once
			Comment: Maximum dose = 25 gm.  Mix in 8 oz water
		25 gm, Solution, By Mouth, Once
			Comment: Once Mix in 8oz water
	lactose (MH/WH)
		1 gm/kg, Powder, By Mouth, Once
			Comment: Maximum dose = 25 gm.  Mix in 8 oz water
		2 gm/kg, Powder, By Mouth, Once
			Comment: Maximum dose = 25 gm.  Mix in 8 oz water
		25 gm, Powder, By Mouth, Once
			Comment: Once Mix in 8oz water
	lactulose
		10 gm, Syrup, BY MOUTH, Once
			Comment: 10gm=15mL
	Reglan
		10 mg, Tab, BY MOUTH, Once
Patient Care
	Obtain Consent/Permit for:
		Esophagogastroduodenoscopy with possible biopsies and/or dilation
		Esophagogastroduodenoscopy with Fluoroscopy, possible biopsies and/or dilation
		Esophagogastroduodenoscopy with PH capsule placement with possible biopsies and/or dilation
		Colonoscopy with possible biopsies and/or polypectomy
		Flexible Sigmoidoscopy with possible biopsies and/or polypectomy
		Pouchoscopy with possible biopsies and/or polypectomy
		Ilioscopy with possible biopsies and/or polypectomy
		Endoscopic Retrograde Cholangiopancreatogram with possible biopsies, brushings, dilation sphincterotomy, stent placement and/or stent removal
		Esophagogastroduodenoscopy & Flexible Sigmoidoscopy with possible biopsies, dilation, and/or polypectomy
		Esophagoscopy with Ablation with possible biopsies and/or dilation
		Esophagogastroduodenoscopy with Ablation with possible biopsies and/or polypectomy
		Colonoscopy with Ablation with possible biopsies and/or polypectomy
		Flexible Sigmoidoscopy with Ablation with possible biopsies and/or polypectomy
		Esophagogastroduodenoscopy with Double Balloon Enteroscopy with possible biopsies and/or dilation
		Colonoscopy with Double Balloon Enteroscopy with possible biopsies, dilation, and/or polypectomy
		Percutaneous Endoscopic Gastrostomy Tube Placement
		Percutaneous Endoscopic Gastrostomy Tube Replacement
		Liver Biopsy
		Paracentesis
		Small Bowel Capsule
		Small Bowel Agile Capsule
		Esophagogastroduodenoscopy with Small Bowel Capsule Placement with possible biopsies and/or dilation
		Esophagogastroduodenoscopy with Endoscopic Ultrasound with possible biopsies, dilation and/or fine needle aspiration
		Colonoscopy with Endoscopic Ultrasound with possible biopsies, dilation and/or fine needle aspiration
		Flexible Sigmoidoscopy with Endoscopic Ultrasound with possible biopsies, dilation and/or fine needle aspiration
		Esophagogastroduodenoscopy with Endoscopic Ultrasound & Endoscopic Retrograde Cholangiopancreatogram with possible biopsies, dilation fine needle aspiration, sphinterotomy, stent placement and/or stent
		Esophagogastroduodenoscopy with possible biopsies, dilation, and/or Endoscopic Mucosal Resection
		Colonoscopy with possible biopsies, dilation and/or Endoscopic Mucosal Resection
		Transanal Ultrasound
		Transrectal Ultrasound
		Transanal/Transrectal Ultrasound rectal Electromyogram, Anorectal Manometry, Pudendal Nerve Study
		Rectal Electromyogram, Anorectal Manometry, with Pudendal Nerve Study
		Esophagogastroduodenoscopy with possible biopsies and/or dilation
		Esophagogastroduodenoscopy with Fluoroscopy, possible biopsies and/or dilation
		Esophagogastroduodenoscopy with PH capsule placement with possible biopsies and/or dilation
		Colonoscopy with possible biopsies and/or polypectomy
		Flexible Sigmoidoscopy with possible biopsies and/or polypectomy
		Pouchoscopy with possible biopsies and/or polypectomy
		Ilioscopy with possible biopsies and/or polypectomy
		Endoscopic Retrograde Cholangiopancreatogram with possible biopsies, brushings, dilation sphincterotomy, stent placement and/or stent removal
		Esophagogastroduodenoscopy & Flexible Sigmoidoscopy with possible biopsies, dilation, and/or polypectomy
		Esophagoscopy with Ablation with possible biopsies and/or dilation
		Esophagogastroduodenoscopy with Ablation with possible biopsies and/or polypectomy
		Colonoscopy with Ablation with possible biopsies and/or polypectomy
		Flexible Sigmoidoscopy with Ablation with possible biopsies and/or polypectomy
		Esophagogastroduodenoscopy with Double Balloon Enteroscopy with possible biopsies and/or dilation
		Colonoscopy with Double Balloon Enteroscopy with possible biopsies, dilation, and/or polypectomy
		Percutaneous Endoscopic Gastrostomy Tube Placement
		Percutaneous Endoscopic Gastrostomy Tube Replacement
		Liver Biopsy
		Paracentesis
		Small Bowel Capsule
		Small Bowel Agile Capsule
		Esophagogastroduodenoscopy with Small Bowel Capsule Placement with possible biopsies and/or dilation
		Esophagogastroduodenoscopy with Endoscopic Ultrasound with possible biopsies, dilation and/or fine needle aspiration
		Colonoscopy with Endoscopic Ultrasound with possible biopsies, dilation and/or fine needle aspiration
		Flexible Sigmoidoscopy with Endoscopic Ultrasound with possible biopsies, dilation and/or fine needle aspiration
		Esophagogastroduodenoscopy with Endoscopic Ultrasound & Endoscopic Retrograde Cholangiopancreatogram with possible biopsies, dilation fine needle aspiration, sphinterotomy, stent placement and/or stent
		Esophagogastroduodenoscopy with possible biopsies, dilation, and/or Endoscopic Mucosal Resection
		Colonoscopy with possible biopsies, dilation and/or Endoscopic Mucosal Resection
		Transanal Ultrasound
		Transrectal Ultrasound
		Transanal/Transrectal Ultrasound rectal Electromyogram, Anorectal Manometry, Pudendal Nerve Study
		Rectal Electromyogram, Anorectal Manometry, with Pudendal Nerve Study
		Esophagogastroduodenoscopy with possible biopsies and/or dilation
		Esophagogastroduodenoscopy with Fluoroscopy, possible biopsies and/or dilation
		Esophagogastroduodenoscopy with PH capsule placement with possible biopsies and/or dilation
		Colonoscopy with possible biopsies and/or polypectomy
		Flexible Sigmoidoscopy with possible biopsies and/or polypectomy
		Pouchoscopy with possible biopsies and/or polypectomy
		Ilioscopy with possible biopsies and/or polypectomy
		Endoscopic Retrograde Cholangiopancreatogram with possible biopsies, brushings, dilation sphincterotomy, stent placement and/or stent removal
		Esophagogastroduodenoscopy & Flexible Sigmoidoscopy with possible biopsies, dilation, and/or polypectomy
		Esophagoscopy with Ablation with possible biopsies and/or dilation
		Esophagogastroduodenoscopy with Ablation with possible biopsies and/or polypectomy
		Colonoscopy with Ablation with possible biopsies and/or polypectomy
		Flexible Sigmoidoscopy with Ablation with possible biopsies and/or polypectomy
		Esophagogastroduodenoscopy with Double Balloon Enteroscopy with possible biopsies and/or dilation
		Colonoscopy with Double Balloon Enteroscopy with possible biopsies, dilation, and/or polypectomy
		Percutaneous Endoscopic Gastrostomy Tube Placement
		Percutaneous Endoscopic Gastrostomy Tube Replacement
		Liver Biopsy
		Paracentesis
		Small Bowel Capsule
		Small Bowel Agile Capsule
		Esophagogastroduodenoscopy with Small Bowel Capsule Placement with possible biopsies and/or dilation
		Esophagogastroduodenoscopy with Endoscopic Ultrasound with possible biopsies, dilation and/or fine needle aspiration
		Colonoscopy with Endoscopic Ultrasound with possible biopsies, dilation and/or fine needle aspiration
		Flexible Sigmoidoscopy with Endoscopic Ultrasound with possible biopsies, dilation and/or fine needle aspiration
		Esophagogastroduodenoscopy with Endoscopic Ultrasound & Endoscopic Retrograde Cholangiopancreatogram with possible biopsies, dilation fine needle aspiration, sphinterotomy, stent placement and/or stent
		Esophagogastroduodenoscopy with possible biopsies, dilation, and/or Endoscopic Mucosal Resection
		Colonoscopy with possible biopsies, dilation and/or Endoscopic Mucosal Resection
		Transanal Ultrasound
		Transrectal Ultrasound
		Transanal/Transrectal Ultrasound rectal Electromyogram, Anorectal Manometry, Pudendal Nerve Study
		Rectal Electromyogram, Anorectal Manometry, with Pudendal Nerve Study
	Enema-Administer
		T;N, Fleets, PREOP, 1, Dose(s)/Time(s)
	Discontinue Peripheral Lock
		T;N, Once
			Comment: prior to dismissal when patient awake.
	Patient Education
		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