Unique Plan Description: ONC Taxol Carboplatin Inpt (MH)
Plan Selection Display: ONC Taxol Carboplatin Inpt (MH)
PlanType: Medical                                 
Version: 1          
Begin Effective Date: 2022-09-08 13:14:00
End Effective Date: 2100-12-31 00:00:00
Last Updated Date: 2024-04-18 12:21:20
Available at all facilities: No

ONC Taxol Carboplatin Inpt (MH)
IV Solutions
	Sodium Chloride 0.9%
		250 mL, IV, 20 ml/hr
			Comment: Infuse at 20 mL/hr and use to flush line between meds.
Medications
Premeds
	ondansetron/dexamethasone/NS 50mL
		0.15 mg/kg, IVPB, Once, infuse over 15 min(s), 200 ml/hr, T;N+90
		20 mg, EVERY BAG
		50 mL, EVERY BAG
	diphenhydrAMINE
		50 mg, Injection, IV Push, Once, T;N+90
			Comment: Administer 30 minutes prior to chemotherapy
		25 mg, Injection, IV Push, Once, T;N+90
			Comment: Administer 30 minutes prior to chemotherapy
	famotidine
		20 mg, Injection, IV Push, Once, T;N+90
			Comment: Administer 30 minutes prior to chemotherapy
	LORazepam
		0.5 mg, Tab, By Mouth, Once, PRN nausea, duration: 1 Dose(s)/Time(s)
			Comment: and/or anxiety
		1 mg, Tab, By Mouth, Once, PRN nausea, duration: 1 Dose(s)/Time(s)
			Comment: and/or anxiety
	LORazepam Injectable
		0.5 mg, Injection, IV Push, Once, PRN nausea, duration: 1 Dose(s)/Time(s)
		1 mg, Injection, IV Push, Once, PRN nausea, duration: 1 Dose(s)/Time(s)
Chemotherapy Agent
	PACLitaxel/NS 500 mL
		175 mg/m2, IVPB, Once, T;N+120, Infuse Over 3 hr
		50 mL, EVERY BAG
		500 mL, EVERY BAG
	CARBOplatin/NS 250 mL
		4 AUC(Carboplatin), IVPB, Once, T;N+300, Infuse Over 60 min(s)
		25 mL, EVERY BAG
		250 mL, EVERY BAG
		5 AUC(Carboplatin), IVPB, Once, T;N+300, Infuse Over 60 min(s)
		25 mL, EVERY BAG
		250 mL, EVERY BAG
		6 AUC(Carboplatin), IVPB, Once, T;N+300, Infuse Over 60 min(s)
		25 mL, EVERY BAG
		250 mL, EVERY BAG
Chemotherapy PostMedications
	ondansetron IVPB
		0.15 mg/kg, Injection-Premix, IVPB, Q4H, T;N+360, 2 Dose(s)/Time(s)
Patient Care

	Notify MD
		T;N, For additional orders if patient experiences reaction to treatment.
	Initiate MD Plan for:
		T;N, Allergy Reaction protocol if patient experiences reaction to treatment.

CHEMO Reaction Protocol
Vital Signs
	Vital Signs
		Assess vital signs every 2 to 5 minutes until the patient is stable. Place patient into a recumbent position with elevation of the lower extremities if hypotensive
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		Reassess vital signs every 15 minutes x 2, then q30min x 2, or more frequently as needed, I&O, etc until stable
Activity
	Position Patient
		T;N
			Comment: If hypotensive, keep patient supine with legs elevated or bed in Trendelenburg.
IV Solutions
	Sodium Chloride 0.9% IVPB
		500 mL, IV Large Volume, IVPB, DAILY, PRN for see comment, 999 ml/hr
			Comment: for reaction to chemotherapy
		1,000 mL, IV Large Volume, IVPB, DAILY, PRN for see comment, 999 ml/hr
			Comment: for reaction to chemotherapy
Medications
	Benadryl
		50 mg, Injection, IV Push, DAILY, PRN see comment
			Comment: for moderate to severe reaction to chemotherapy
		25 mg, Injection, IV Push, DAILY, PRN see comment
			Comment: for moderate to severe reaction to chemotherapy
	Decadron (MH/WH)
		20 mg, Injection, IV Push, DAILY, PRN see comment
			Comment: for moderate to severe reaction to chemotherapy, 1st choice steroid
	SOLU-Medrol
		125 mg, Injection, IV Push, DAILY, PRN see comment
			Comment: for moderate to severe reaction to chemotherapy, 2nd choice steroid
	Solu-CORTEF
		100 mg, Injection, IV Push, DAILY, PRN see comment
			Comment: for moderate to severe reaction to chemotherapy, 3rd choice steroid
	EPINEPHrine
		0.5 mg, Injection, SUBCUTANEOUS, DAILY, PRN see comment
			Comment: for hypersensitivity reaction not resolved by diphenhydramine and/or anaphylactic				reactions to chemotherapy, may repeat every 10 minutes for up to 3 doses
		0.5 mg, Injection, IM-Intramuscular, DAILY, PRN see comment
			Comment: for hypersensitivity reaction not resolved by diphenhydramine and/or anaphylactic				reactions to chemotherapy, may repeat every 10 minutes for up to 3 doses
	meperidine
		25 mg, Syringe, IV Push, Once, PRN for see comment
			Comment: For chills and rigors
	morphine  IV
		2 mg, Syringe, IV PUSH, Once, PRN for see comment
			Comment: For chills and rigors
Patient Care
	Notify MD
		T;N, Contact the oncologist if any of the reaction protocol medications are administered to the patient.

*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