Unique Plan Description: Neuro Endovascular Procedure Pre-op
Plan Selection Display: Neuro Endovascular Procedure Pre-op
PlanType: Medical                                 
Version: 1          
Begin Effective Date: 2022-05-02 09:13:39
End Effective Date: 2100-12-31 00:00:00
Last Updated Date: 2022-05-02 09:13:39
Available at all facilities: Yes

Neuro Endovascular Procedure Pre-op
Admit/Discharge/Transfer
	Admit to Inpatient Status
		T;N, Anticipated LOS 1 midnight or less
	Admit to Observation Status
		T;N
Diet
	NPO
		Except for Medications | Except for Sips of Water
		After Midnight
			Comment: including tube feedings
Laboratory
	INR - MH/WH/JE
		Stat, spec type = Blood
	Prothrombin Time (PT) - FH
		T;N, Stat, spec type = Diagnostic Blood
		T;N, Stat, spec type = Therapeutic Blood
	PTT - MH/WH/JE
		Stat, spec type = Blood
	Partial Thromboplastin Time (PTT) - FH
		T;N, Stat, spec type = Diagnostic Blood
	CBC with Diff
		Stat, spec type = Blood
	Basic Metabolic Panel
		Stat, spec type = Blood
	BUN
		Stat, spec type = Blood
	Creatinine
		Stat, spec type = Blood
	Comprehensive Metabolic Panel
		Stat, spec type = Blood
	Pregnancy Test Urine
		T;N, Stat, Stat, spec type = Urine
	Glucose POC - RN
		T;N, Once, NOW
Diagnostic Tests
	Nasogastric Tube Placement IR
		Stat, NG Tube Placement
IV Solutions
	Sodium Chloride 0.9%
		1,000 mL, IV, 75 ml/hr
			Comment: start at least one hour before start of interventional radiology procedure if patient has no IV order, if patient diabetic for lung biopsy, place 18 gauge IV cath, preferably in arm or antecubital.
Medications
	Ancef (JE)
		2,000 mg, Injection, IV Push, PREOP, Surgical prophylaxis
			Comment: on call to OR to be given on entry to IR procedure
	Ancef (MH/WH)
		2,000 mg, Syringe, IV Push, PREOP, Surgical prophylaxis
			Comment: on call to OR to be given on entry to IR procedure
	Ancef (FH)
		2,000 mg, Injection-Premix, IVPB, Once, Surgical prophylaxis
			Comment: 80-120kg.  Give 1 hr preop.  OK to give if pt allergic to penicillin unless history of anaphylactic reaction.  Redose every 3 hours during surgery.
		1,000 mg, INT, IVPB, Once, Surgical prophylaxis
			Comment: < 80kg.  Give 1 hr preop.  OK to give if pt allergic to penicillin unless history of anaphylactic reaction.  Redose every 3 hours during surgery.
		3,000 mg, Injection-Premix, IVPB, PREOP, Surgical prophylaxis
			Comment: > 120kg.  give 1 hr Preop.  OK to give if pt allergic to penicillin unless history of anaphylactic reaction.  Redose every 3 hours during surgery.
	Cipro
		400 mg, Injection-Premix, IVPB, PREOP, Surgical prophylaxis
			Comment: on call to OR to be given on entry to IR procedure
	Levaquin IVPB
		500 mg, Injection-Premix, IVPB, PREOP, Surgical prophylaxis
			Comment: on call to OR to be given on entry to IR procedure
	Mefoxin (JE)
		1,000 mg, Injection, IV Push, PREOP, Surgical prophylaxis
	Mefoxin Syringe
		1,000 mg, Syringe, IV Push, PREOP, Surgical prophylaxis
			Comment: on call to OR to be given on entry to IR procedure
	Mefoxin (FH)
		1,000 mg, INT, IVPB, PREOP, Surgical prophylaxis
			Comment: on call to OR to be given on entry to IR procedure
	vancomycin IVPB
		1,000 mg, Injection-Premix, IVPB, PREOP, Surgical prophylaxis
			Comment: on call to OR to be given on entry to IR procedure
	vancomycin IVPB (FH)
		1,000 mg, Injection-Premix, IVPB, PREOP, Surgical prophylaxis
			Comment: on call to OR to be given on entry to IR procedure
	clindamycin IVPB
		600 mg, Injection-Premix, IVPB, PREOP, Surgical prophylaxis
			Comment: on call to OR to be given on entry to IR procedure
		900 mg, Injection-Premix, IVPB, PREOP, Surgical prophylaxis
			Comment: on call to OR to be given on entry to IR procedure
	ketorolac injectable
		30 mg, Injection, IV Push, PREOP
			Comment: procedure uterine artery embolization; PRN if taking meds by mouth.
Patient Care
	Resuscitation Status
		T;N, Full Code
		T;N, No Code
	Obtain Consent/Permit for:
		Diagnostic cerebral angiogram, possible closure device
		Cerebral angiogram with aneurysm embolization, possible closure device
	Foley Catheter
		T;N, Insert, Pt. undergoing abdominal/pelvic surgery, Pre op
	Limb Alert
		Upper right extremity. DO NOT use for lines. NeuroSurgery may use for arterial access

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