Unique Plan Description: GYNONC Cisplatin/Gemzar (MH)
Plan Selection Display: GYNONC Cisplatin/Gemzar (MH)
PlanType: Medical                                 
Version: 1          
Begin Effective Date: 2019-11-14 10:08:00
End Effective Date: 2100-12-31 00:00:00
Last Updated Date: 2025-01-14 13:08:35
Available at all facilities: No

GYNONC Cisplatin/Gemzar (MH)
IV Solutions
Chemotherapy PreHydration
	Dextrose 5% with 0.9% NaCl w/KCl 20 mEq
		1,000 mL, IV, Routine, T;N, 1 Dose(s)/Time(s), 500 ml/hr
			Comment: Administer 500 mL at 500 mL/hr 1 hrs prior to chemotherapy and 1 hours after chemo
	Sodium Chloride 0.9% IVPB
		100 mL, Solution-Injection, IVPB, Once
			Comment: Infuse at a rate of 20ml/hr
Premeds
	Ativan
		0.5 mg, Tab, By Mouth, Once, PRN for anxiety, duration: 1 Dose(s)/Time(s)
		1 mg, Tab, By Mouth, Once, PRN for anxiety, duration: 1 Dose(s)/Time(s)
	potassium chloride Oral
		20 mEq, Tablet-Extended-Release, By Mouth, Once, T;N
	Aloxi/Decadron/NS 50mL
		12 mg, EVERY BAG
		50 mL, EVERY BAG
		0.25 mg, IVPB, Once, Routine, infuse over 15 min(s), 200 ml/hr, T;N+150
			Comment: 30 min prior to chemotherapy
	ondansetron/dexamethasone/NS 50mL
		16 mg, IVPB, Once, Routine, infuse over 15 min(s), 200 ml/hr, T;N+150
			Comment: 30 min prior to chemotherapy
		12 mg, EVERY BAG
		50 mL, EVERY BAG
	magnesium sulfate IVPB
		2 gm, INT, IVPB, Once, T;N
Chemotherapy Agent
	CISplatin/NS 500mL
		500 mL, EVERY BAG
		50 mL, EVERY BAG
		50 mg/m2, IVPB, Once, T;N+120, Infuse Over 60 min(s)
		500 mL, EVERY BAG
		50 mL, EVERY BAG
		40 mg/m2, IVPB, Once, T;N+120, Infuse Over 60 min(s)
	gemcitabine/NS 250 mL
		850 mg/m2, IVPB, Once, T;N+60, Infuse Over 30 min(s)
		250 mL, EVERY BAG
		25 mL, EVERY BAG
		25 mL, EVERY BAG
		250 mL, EVERY BAG
		1,000 mg/m2, IVPB, Once, T;N+60, Infuse Over 30 min(s)
Medications

Patient Care
	Notify MD
		T;N, Contact Provider for further orders if allergic reaction protocol initiated
	Initiate MD Plan for:
		T;N, Allergy Reaction protocol if patient experiences reaction to treatment

CHEMO Reaction Protocol
Vital Signs
	Vital Signs
		Assess vital signs every 2 to 5 minutes until the patient is stable. Place patient into a recumbent position with elevation of the lower extremities if hypotensive
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		Reassess vital signs every 15 minutes x 2, then q30min x 2, or more frequently as needed, I&O, etc until stable
Activity
	Position Patient
		T;N
			Comment: If hypotensive, keep patient supine with legs elevated or bed in Trendelenburg.
IV Solutions
	Sodium Chloride 0.9% IVPB
		500 mL, IV Large Volume, IVPB, DAILY, PRN for see comment, 999 ml/hr
			Comment: for reaction to chemotherapy
		1,000 mL, IV Large Volume, IVPB, DAILY, PRN for see comment, 999 ml/hr
			Comment: for reaction to chemotherapy
Medications
	Benadryl
		50 mg, Injection, IV Push, DAILY, PRN see comment
			Comment: for moderate to severe reaction to chemotherapy
		25 mg, Injection, IV Push, DAILY, PRN see comment
			Comment: for moderate to severe reaction to chemotherapy
	Decadron (MH/WH)
		20 mg, Injection, IV Push, DAILY, PRN see comment
			Comment: for moderate to severe reaction to chemotherapy, 1st choice steroid
	SOLU-Medrol
		125 mg, Injection, IV Push, DAILY, PRN see comment
			Comment: for moderate to severe reaction to chemotherapy, 2nd choice steroid
	Solu-CORTEF
		100 mg, Injection, IV Push, DAILY, PRN see comment
			Comment: for moderate to severe reaction to chemotherapy, 3rd choice steroid
	EPINEPHrine
		0.5 mg, Injection, SUBCUTANEOUS, DAILY, PRN see comment
			Comment: for hypersensitivity reaction not resolved by diphenhydramine and/or anaphylactic				reactions to chemotherapy, may repeat every 10 minutes for up to 3 doses
		0.5 mg, Injection, IM-Intramuscular, DAILY, PRN see comment
			Comment: for hypersensitivity reaction not resolved by diphenhydramine and/or anaphylactic				reactions to chemotherapy, may repeat every 10 minutes for up to 3 doses
	meperidine
		25 mg, Syringe, IV Push, Once, PRN for see comment
			Comment: For chills and rigors
	morphine  IV
		2 mg, Syringe, IV PUSH, Once, PRN for see comment
			Comment: For chills and rigors
Patient Care
	Notify MD
		T;N, Contact the oncologist if any of the reaction protocol medications are administered to the patient.

*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