Unique Plan Description: PCA Routine Patient Care Orders Subphase
Plan Selection Display: PCA Routine Patient Care Orders Subphase
PlanType: Medical                                 
Version: 3          
Begin Effective Date: 2100-12-31 00:00:00
End Effective Date: 2100-12-31 00:00:00
Last Updated Date: 2026-04-13 16:37:34
Available at all facilities: Yes

PCA Routine Patient Care Orders Subphase
Patient Care
	PCA Assessment
		T;N, Q15MIN, 4, Dose(s)/Time(s)
			Comment: Assessment to include vital signs, pain, RASS, resp rate, resp pattern and pump settings.  Stop PCA if patient somnolent with minimal or no response to stimuli or respiratory rate < 10 or systolic BP < 90 and immediately notify provider.
		T;N+60, Q1H, 4, Dose(s)/Time(s)
			Comment: Assessment to include vital signs, pain, RASS, resp rate, resp pattern and pump settings.  Stop PCA if patient somnolent with minimal or no response to stimuli or respiratory rate < 10 or systolic BP < 90 and immediately notify provider.
		T;N+420, Q2H-Sch
			Comment: Assessment to include vital signs, pain, RASS, resp rate, resp pattern and pump settings.  Stop PCA if patient somnolent with minimal or no response to stimuli or respiratory rate < 10 or systolic BP < 90 and immediately notify provider.
		T;N
			Comment: ongoing, with any patient controlled dose, or basal rate change or nurse administered bolus. Assessment to include vital signs, pain, RASS, resp rate, resp pattern and pump settings. If resp rate <10, or SBP <90 reassess patient q15min x4, then q1h x4, then q2h.  Stop PCA if patient somnolent with minimal or no response to stimuli or respiratory rate < 10 or systolic BP < 90 and immediately notify provider.
	Notify MD
		T;N, if respirations </= 10, or  systolic BP < 90.
	PCA Parameters
		T;N
			Comment: Notify provider for any concerns about dosing.  Do not titrate dose without a provider order. Notify provider if patient develops respiratory depression (respiratory quality is shallow, respiratory rate is < 12 bpm), RASS -2, patient is lethargic, frequently drowsy or drifts off to sleep during conversation and consider oxygen protocol.  Stop PCA if patient somnolent with minimal or no response to stimuli or respiratory rate < or = 10 or RASS -3 to -5  and/or systolic blood pressure < 90mm Hg.  Notify provider immediately if PCA is stopped.  Do not resume PCA without provider order.
		T;N
			Comment: Do not initiate any PCA (continuous or patient administered doses) in patients with sleep apnea (OSA) without verbal verification from physician.  Basal (continuous) PCA dosing should not be used for patients with history of sleep apnea (OSA), or respiratory problems (lung disease, heart failure). Do not use patient controlled doses of PCA unless patient is fully able to understand and comply with instruction -this includes restricting use for patients with dementia, delirium, confusion.
Therapies
	Continuous Pulse Oximetry Monitoring Check
		T;N, BID
			Comment: RT, while on PCA

*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