Unique Plan Description: OB Chorioamnionitis EKM
Plan Selection Display: OB Chorioamnionitis
PlanType: Medical                                 
Version: 2          
Begin Effective Date: 2020-04-22 19:17:00
End Effective Date: 2100-12-31 00:00:00
Last Updated Date: 2021-12-14 09:06:47
Available at all facilities: Yes

Ante Partum Phase
Laboratory
	Basic Metabolic Panel
		T;N, Stat, Once, spec type = Blood
	Tissue Request Placenta
		T;N, Stat, gross and micro Plac, Evaluation of placenta for suspected Chorioamnionitis, Stat
IV Solutions
	Sodium Chloride 0.9%
		1,000 mL, IV, 20 ml/hr
Medications
	gentamicin IVPB
		5 mg/kg, INT, IVPB, Once, Gyn infection
			Comment: In NS.
	gentamicin IVPB (FH)
		5 mg/kg, INT, IVPB, Once, Gyn infection
	ampicillin IVPB
		2,000 mg, Solution, Injection, IVPB, Q6H, Other- type in, Chorioamnionitis
	ampicillin IVPB (FH)
		2,000 mg, INT, IVPB, Q6H, Other- type in, Chorioamnionitis
		Low Risk Penicillin Allergy--If patient has a Penicillin allergy and is at low risk for anaphylaxis, give in place of ampicillin(NOTE)*
	Ancef IVPB
		1,000 mg, Injection-Premix, IVPB, Q8H, Other- type in, Chorioamnionitis
	Ancef IVPB (FH)
		1,000 mg, INT, IVPB, Q8H, Other- type in, Chorioamnionitis
		High Risk Penicillin Allergy with sensitivity--If patient has a Penicillin allergy and is a high risk for anaphylaxis, give in place of ampicillin(NOTE)*
	vancomycin IVPB
		1,000 mg, Injection-Premix, IVPB, Q12H, Other- type in, Chorioamnionitis
	vancomycin IVPB (FH)
		1,000 mg, Injection-Premix, IVPB, Q12H, Other- type in, Chorioamnionitis
		For C Sections: Consider adding:(NOTE)*
	Flagyl IVPB
		500 mg, Injection-Premix, IVPB, Once, Gyn infection
			Comment: Give after Primary Antibiotic coverage given
Patient Care
	Notify MD
		Notify Physician If patient's SCr is > 1 or Urine Output is < 300mL in 4 hours prior to initiating Gentamicin
Consults/Follow-up
	Pharmacy Consult
		For renal adjustment of antibiotics if needed.
	Consult Neonatologist
		Reason for Referral: NICU to attend delivery, Refer to/Consult with: Neonatologist or NNP on call.

Post Partum Phase
IV Solutions
	Sodium Chloride 0.9%
		1,000 mL, IV, 20 ml/hr
Medications
	gentamicin IVPB
		5 mg/kg, INT, IVPB, Once, Gyn infection
			Comment: 24 hours after last dose
	gentamicin IVPB (FH)
		5 mg/kg, INT, IVPB, Once, Gyn infection
			Comment: 24 hours after last dose
	ampicillin IVPB
		2,000 mg, Solution, Injection, IVPB, Once, Other- type in, Chorioamnionitis
			Comment: 6 hours after last dose
	ampicillin IVPB (FH)
		2,000 mg, INT, IVPB, Once, Other- type in, Chorioamnionitis
			Comment: 6 hours after last dose
		If Penicillin allergic (Not Anaphylactic), give in place of ampicillin(NOTE)*
	Ancef IVPB
		1,000 mg, Injection-Premix, IVPB, Once, Other- type in, Chorioamnionitis
			Comment: 8 hours after last dose
	Ancef IVPB (FH)
		1,000 mg, INT, IVPB, Once, Other- type in, Chorioamnionitis
			Comment: 8 hours after last dose
		If Penicillin allergic Anaphylactic, give in place of ampicillin(NOTE)*
	vancomycin IVPB
		1,000 mg, Injection-Premix, IVPB, Once, Other- type in, Chorioamnionitis
			Comment: 12 hours after last dose
	vancomycin IVPB (FH)
		1,000 mg, Injection-Premix, IVPB, Once, Other- type in, Chorioamnionitis
Consults/Follow-up
	Pharmacy Consult
		For proper scheduling of post partum antibiotic

*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