Unique Plan Description: NICU Adm Gastroschisis (WH) EKM
Plan Selection Display: NICU Adm Gastroschisis (WH)
PlanType: Medical                                 
Version: 2          
Begin Effective Date: 2022-03-22 17:15:32
End Effective Date: 2100-12-31 00:00:00
Last Updated Date: 2024-12-09 13:11:40
Available at all facilities: Yes

NICU Adm Gastroschisis (WH) EKM
Admit/Discharge/Transfer
	Admit to Inpatient Status
		T;N, To NICU, Level 3, Anticipated LOS 1 midnight or less
Vital Signs
	Vital Signs
		Q1hr, until stable
Diet
	NPO
		T;N
Laboratory
		Order if Mother RH Negative(NOTE)*
	Cord Blood Panel
		T;N, Routine, spec type = Cord Blood
	Newborn Screen Nebraska
		T;N, Stat, spec type = Blood Spot
	CBC with Diff
		Stat, spec type = Blood
	Comprehensive Metabolic Panel
		Stat, spec type = Blood
	hsCRP
		Stat, spec type = Blood
	Blood Gases Arterial (ABG) - MH/WH/JE
		Stat, spec type = Blood
	Blood Gases Capillary (CBG) - MH/WH/JE
		Stat, spec type = Blood
	Blood Gases VENOUS (VBG)
		Stat, spec type = Blood
	Lactate
		Stat, spec type = Blood
	Type and Screen (No Product on hold)
		Stat, spec type = Blood
	.Blood Culture
		Stat, spec type = Blood
	Glucose POC - NICU
		Once
		T;N+60, Q1H, 2, Dose(s)/Time(s)
		T;N+240, Once
Diagnostic Tests
Radiology
	Chest 1 View
		Stat, Tube Placement F/U
	Chest 1 View include Abd
		Stat
	KUB
		Stat, Tube Placement F/U
IV Solutions

	Dextrose 5% with 0.45% NaCl NICU Syringe
		50 mL, IV, 1 ml/hr
	DOPamine 40 mg/D5W 25 mL Syringe (NICU)-Standard
		40 mg, EVERY BAG, 2.5 mcg/kg/min
		25 mL, IV
	Dextrose 10% intravenous soln (Bolus)
		2 mL/kg, Syringe, IV Push, Once, NOW
	Sodium Chloride 0.9% Intravenous Solution (NICU Bolus)
		10 mL/kg, Injection, IV Push, Once, NOW
			Comment: Bolus over 20 minutes.
		Arterial Line Flushes(NOTE)*
	heparin flush 1 units/mL intravenous solution
		1 units, Syringe, IV Push, Q5MIN, PRN IV line flush
	sodium chloride 0.9% flush injectable soln
		1 mL, Syringe, IV PUSH, Q5MIN, PRN for IV line flush
Medications
	ampicillin IVPB (NICU)
		100 mg/kg, Solution-Injection, IVPB, TID, Other- type in, Gastroschisis, 36 hr
	gentamicin IVPB (NICU)
		5 mg/kg, Injection, IVPB, Once, Indication: Other- type in, Gastroschisis
			Comment: < 30 weeks: 5 mg/kg q48h> =30 weeks: 5 mg/kg q36h
	fentanyl (NICU)
		1 mg/kg, Syringe, IV Push, Q1H, PRN agitation
	Versed 2mg/2ml
		0.1 mg/kg, Injection, IV Push, Q1H, PRN agitation
	Infasurf
		3 mL/kg, Suspension, Endotracheal, Once
	Vitamin K
		1 mg, Injection, IM-Intramuscular, Once
			Comment: for birth weight => 1.5kg
		0.5 mg/kg, Injection, IM-Intramuscular, Once
			Comment: for birth weight <1.5kg
	erythromycin ophth 0.5% oint 1gm
		
	Sucrose 24%
		0.2 mL, Liquid, By Mouth, Q5MIN, PRN discomfort
			Comment: As needed for mild pain or discomfort. Place on tongue.
	caffeine citrate 20 mg/mL intravenous solution
		20 mg/kg, Injection, IVPB, Once, Infuse Over 30 min(s)
Patient Care
	Resuscitation Status
		Full Code
		No Code
	Intake and Output
		Weigh diaper
			Comment: record urine output q4h
	Isolation Precautions
		T;N
	Enteral Tube (NICU)
		Insert | Connect to low continuous suction
			Comment: (60-80mmHg) suction
	Communication to HOSPITAL RN
		Use tape rather than neobar for ETT
	Position Patient
		
Therapies
	Oxygen Saturation Alarm Limits - NICU
		T;N, Alarm limits: 90 - 95%
			Comment: if on room air, high alarm can be 100%
	Oxygen Saturation Target - NICU
		T;N, Oxygen Sat Target Standard (85-95%)
			Comment: if on room air, high alarm can be 100%
	Mechanical Ventilation NICU
		
	Mechanical Ventilation (HFOV) NICU
		
	Heated, Humidified, High Flow Nasal Cannula - NICU
		
	Nasal Cannula Oxygen (< 1L/min flow rate) NICU

NICU POC Labs
Patient Care
	Blood Gas 1 Nurse Collect - RN
		T;N, Once
		T;N, Q2H-Sch
		T;N, Q4H
		T;N, Q6H
	Blood Gas 2 Nurse Collect - RN
		T;N, Once
		T;N, Q2H-Sch
		T;N, Q4H
		T;N, Q6H
	Chem 7 Nurse Collect - RN
		T;N, Once
		T;N, Q2H-Sch
		T;N, Q4H
		T;N, Q6H
	WB Triage Panel Nurse Collect - RN
		T;N, Once
		T;N, Q2H-Sch
		T;N, Q4H
		T;N, Q6H
	Glucose POC - NICU
		T;N, Once
		T;N, Q2H-Sch
		T;N, Q4H
		T;N, Q6H
		If patient has arterial line, order POC WB Glucose Nurse Collect - NICU(NOTE)*
	POC WB Glucose Nurse Collect - NICU
		T;N, Once
		T;N, Q2H-Sch
		T;N, Q4H
		T;N, Q6H

*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