Unique Plan Description: Nephro Dialysis
Plan Selection Display: Nephro Dialysis
PlanType: Medical                                 
Version: 2          
Begin Effective Date: 2020-04-20 16:04:00
End Effective Date: 2100-12-31 00:00:00
Last Updated Date: 2023-08-08 12:14:33
Available at all facilities: Yes

Nephro Dialysis
Vital Signs
	Vital Signs
		Maintain SBP >/= to ______mmHg
Laboratory
	Hepatitis B Surface Antigen
		T;N, Routine, spec type = Blood
	Hepatitis B Core Antibody Total
		T;N, Routine, spec type = Blood
	Hepatitis B Surface Antibody
		T;N, Routine, spec type = Blood
	Hepatitis C Virus (HCV) Antibody with Rflx to PCR Confirmation
		T;N, Routine, spec type = Blood
	Quantiferon TB Gold
		T;N, Routine, spec type = Blood
Diagnostic Tests
	Chest 2 View
		T;N, Routine
IV Solutions
	Sodium Chloride 0.9%
		1,000 mL, IV, 2 Dose(s)/Time(s), 20 ml/hr
			Comment: to keep blood pressure > _____mmHg
	Sodium Chloride 0.9% Intravenous Solution (Bolus)
		1,000 mL, IV, 48 hr, bolus, Total Volume = 1,000
			Comment: 1 dose only to prime the dialysis machine
Medications
	sodium citrate 4% PF injection
		3 mL, Injection, Catheter, Once, T;N
			Comment: during dialysis, Instill volume sufficient to fill Arterial catheter lumen, discard remainder
		3 mL, Injection, Catheter, Once, T;N
			Comment: during dialysis, Instill volume sufficient to fill Venous catheter lumen, discard remainder
	HEParin 1000 units/mL injectable soln
		1,000 units, Injection, IV PUSH, Once, T;N
			Comment: during dialysis
		500 units, Injection, IV PUSH, Q1H, PRN, dialysis
			Comment: during dialysis
		3,900 units, Solution-Injection, Catheter, Once, T;N
			Comment: total dialysis catheter load
		3,800 units, Solution-Injection, Catheter, Once, T;N
			Comment: total dialysis catheter load
		3,700 units, Solution-Injection, Catheter, Once, T;N
			Comment: total dialysis catheter load
		3,600 units, Solution-Injection, Catheter, Once, T;N
			Comment: total dialysis catheter load
		3,500 units, Solution-Injection, Catheter, Once, T;N
			Comment: total dialysis catheter load
		3,400 units, Solution-Injection, Catheter, Once, T;N
			Comment: total dialysis catheter load
		3,300 units, Solution-Injection, Catheter, Once, T;N
			Comment: total dialysis catheter load
		3,200 units, Solution-Injection, Catheter, Once, T;N
			Comment: total dialysis catheter load
		3,100 units, Solution-Injection, Catheter, Once, T;N
			Comment: total dialysis catheter load
	Procrit
		3,000 units, Solution, IV Push, Once, T;N
			Comment: during dialysis
		4,000 units, Solution, IV Push, Once, T;N
			Comment: during dialysis
		5,000 units, Solution, IV Push, Once, T;N
			Comment: during dialysis
		6,000 units, Solution, IV Push, Once, T;N
			Comment: during dialysis
		7,000 units, Solution, IV Push, Once, T;N
			Comment: during dialysis
		8,000 units, Solution, IV Push, Once, T;N
			Comment: during dialysis
		9,000 units, Solution, IV Push, Once, T;N
			Comment: during dialysis
		10,000 units, Solution, IV Push, Once, T;N
			Comment: during dialysis
	Zemplar
		2.5 mcg, Injection, IV PUSH, Once, T;N
			Comment: during dialysis
		10 mcg, Injection, IV PUSH, Once, T;N
			Comment: during dialysis
		5 mcg, Injection, IV PUSH, Once, T;N
			Comment: during dialysis
	Hectorol
		4 mcg, Soln, IV PUSH, Once, T;N
			Comment: during dialysis
		6 mcg, Soln, IV PUSH, Once, T;N
			Comment: during dialysis
		8 mcg, Soln, IV PUSH, Once, T;N
			Comment: during dialysis
	Venofer
		50 mg, Injection, IV Push, Once, T;N
			Comment: administered slow IV injection (undiluted, directly into dialysis line)
		100 mg, Injection, IV Push, Once, T;N
			Comment: administered slow IV injection (undiluted, directly into dialysis line)
		200 mg, Injection, IV Push, Once, T;N
			Comment: administered slow IV injection (undiluted, directly into dialysis line)
		25 mg, Injection, IV Push, Once, T;N
			Comment: administered slow IV injection (undiluted, directly into dialysis line)
	sodium ferric gluconate complex
		125 mg, INT, IVPB, Once, infuse over 1 hr, T;N
		250 mg, INT, IVPB, Once, infuse over 2 hr, T;N
	albumin human 25% intravenous solution
		12.5 gm, 50 mL, Injection-Premix, IVPB, Q1H, PRN, dialysis, 12 hr
			Comment: may repeat x1 if BP <_____mmHg systolic during dialysis
		12.5 gm, 25 mL, Injection-Premix, IVPB, Q1H, PRN, dialysis, 12 hr
			Comment: may repeat x1 if BP <_____mmHg systolic during dialysis
		12.5 gm, 100 mL, Injection-Premix, IVPB, Q1H, PRN, dialysis, 12 hr
			Comment: may repeat x1 if BP <_____mmHg systolic during dialysis
	EMLA 2.5%-2.5% topical cream
		1 appl, Cream, TOPICAL, Once, T;N
Patient Care
	Hemodialysis
		T;N
	Obtain Consent/Permit for:
		Dialysis

Blood Culture Set
Laboratory
	.Blood Culture.
		T;N, Stat, spec type = Blood
		T;N, Routine, spec type = Blood
		Timed, spec type = Blood
		T+1;0400, Routine, spec type = Blood
	.Blood Culture
		T;N, Stat, spec type = Blood
		T;N, Routine, spec type = Blood
		Timed, spec type = Blood
		T+1;0400, Routine, 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