Unique Plan Description: NICU Admission Delivery at MH (MH)
Plan Selection Display: NICU Admission Delivery at MH (MH)
PlanType: Medical                                 
Version: 1          
Begin Effective Date: 2024-07-11 15:35:51
End Effective Date: 2100-12-31 00:00:00
Last Updated Date: 2024-07-11 16:45:42
Available at all facilities: Yes

NICU Admission Delivery at MH (MH)
Admit/Discharge/Transfer
	Admit to Inpatient Status
		T;N, Anticipated LOS 1 midnight or less
	Discharge
		T;N, to: Childrens Hospital
Laboratory
	Newborn Screen Nebraska
		T;N, Stat, spec type = Blood Spot
	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)
		Lab Collect, Stat, spec type = Blood
	Lactate
		Stat, spec type = Blood
	Glucose POC - RN
		Once
	Blood Gases Cord Arterial
		Stat, spec type = Cord Blood Arterial
			Comment: Lab Collected
	Blood Gases Cord Venous
		Stat, spec type = Cord Blood Venous
			Comment: Lab Collected
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 10% in Water
		250 mL, IV, 1 ml/hr
	Dextrose 10% in water NICU syringe
		50 mL, IV, 1 ml/hr
			Comment: prepare in 50mL syringe
	Dextrose 10% 250 mL w/HEParin 0.5 units/mL
		125 units, EVERY BAG
		250 mL, UVC, 1 ml/hr
		Arterial Line Solutions: UAC(NOTE)*
	Sodium Chloride 0.9% w/HEParin 1 unit/mL (NICU)
		50 units, EVERY BAG
		50 mL, UAC, Routine, T;N, 0.5 ml/hr
Medications
	Versed 2mg/2ml
		0.1 mg/kg, Injection, IV Push, Q1H, PRN, agitation
	morphine IV (NICU)
		0.1 mg/kg, Solution-Injection, IV Push, Q1H, PRN for 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
		1 appl, Ointment, EYE, BOTH, Once
	vecuronium
		0.1 mg/kg, Injection, IV Push, Once, STAT
Patient Care
	Resuscitation Status
		Full Code
		No Code

NICU POC Labs
	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

CODE PINK
IV Solutions
	Sodium Chloride 0.9% Intravenous Solution (NICU Bolus)
		10 mL/kg, Solution, IV Push, Once, NOW
			Comment: Bolus over 20 minutes.
		20 mL/kg, Solution, IV Push, Once, NOW
			Comment: Bolus over 20 minutes.
	Dextrose 10% intravenous soln (Bolus)
		2 mL/kg, Soln, IV PUSH, Once, NOW
Medications
	EPINEPHrine 0.1 mg/mL injectable solution
		0.2 mL/kg, Syringe, IV Push, Q5MIN, PRN, see comment
			Comment: resuscitation, Administer via umbilical vein
		1 mL/kg, Syringe, Endotracheal, Q5MIN, PRN, see comment
			Comment: resuscitation
	sodium bicarbonate 4.2% (NICU)
		1 mEq/kg, Syringe, IV Push, Once, NOW
			Comment: Administer no faster than 1mEq/kg/min. Lungs must be adequately inflated.
		2 mEq/kg, Syringe, IV Push, Once, NOW
			Comment: Administer no faster than 1mEq/kg/min. Lungs must be adequately inflated.
	atropine
		0.02 mg/kg, Syringe, IV PUSH, Once, NOW
			Comment: May repeat x 1. Maximum single dose is 0.5mg.
		0.05 mg/kg, Syringe, Endotracheal, Once, NOW
			Comment: May repeat x 1. Maximum single dose is 0.5mg.
	adenosine injection
		0.1 mg/kg, Injection, IV Push, Once, NOW
			Comment: Initial dose. To be given via rapid IV Push, and followed immediately with saline 			flush.
		0.2 mg/kg, Injection, IV Push, Once, NOW
			Comment: Subsequent dose. To be given via rapid IV Push, and followed immediately with 			saline flush.
	calcium gluconate
		100 mg/kg, Solution, IV Push, Once, NOW
			Comment: Administer via central line if possible, may repeat in 10 minutes if necessary.
	magnesium 1000mg/2mL
		25 mg/kg, Injection, IV Push, Once, NOW
			Comment: Infuse as a bolus if no pulse present. Administer over 10-20 minutes if pulse present.
		50 mg/kg, Injection, IV Push, Once, NOW
			Comment: Infuse as a bolus if no pulse present. Administer over 10-20 minutes if pulse present.
	naloxone
		0.1 mg/kg, Injection, IV PUSH, Once, NOW
			Comment: For full reversal. Do not give to newborns of mothers suspected of having chronic 			narcotic exposure.
		0.015 mg/kg, Injection, IV PUSH, Once, NOW
			Comment: For partial reversal. Do not give to newborns of mothers suspected of having chronic narcotic exposure.

*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