Unique Plan Description: GYNONC Gemcitabine (MH)
Plan Selection Display: GYNONC Gemcitabine (MH)
PlanType: Medical                                 
Version: 2          
Begin Effective Date: 2018-05-15 07:01:00
End Effective Date: 2100-12-31 00:00:00
Last Updated Date: 2024-04-18 11:58:23
Available at all facilities: No

GYNONC Gemcitabine (MH)
IV Solutions
Chemotherapy PreHydration
	Sodium Chloride 0.9% IVPB
		100 mL, Solution-Injection, IVPB, Once
			Comment: Infuse at 20 mL/hr
Premeds
	ondansetron/dexamethasone/NS 50mL
		16 mg, IVPB, Once, Routine, infuse over 15 min(s), 200 ml/hr, T;N+90
			Comment: 30 min prior to chemotherapy
		50 mL, EVERY BAG
		20 mg, EVERY BAG
Chemotherapy Agent
	gemcitabine/NS 250 mL
		850 mg/m2, IVPB, Once, T;N+60, Infuse Over 30 min(s)
		25 mL, EVERY BAG
		250 mL, EVERY BAG
		1,000 mg/m2, IVPB, Once, T;N+60, Infuse Over 30 min(s)
		25 mL, EVERY BAG
		250 mL, EVERY BAG
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
		<!DOCTYPE HTML PUBLIC "-//W3C//DTD HTML 4.0 Transitional//EN"><HTML><HEAD><META content="text/html; charset=windows-1252" http-equiv=Content-Type><STYLE> BODY background-color: rgb(128,255,255);margin:0; P margin:0 </STYLE><META name=GENERAT(NOTE)*
		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, Solution-Injection, IVPB, DAILY, PRN see comment, 999 ml/hr
			Comment: for reaction to chemotherapy
		1,000 mL, Solution-Injection, IVPB, DAILY, PRN 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
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