Unique Plan Description: Peds Admission Gastroenteritis-Dehydration (JE FH)
Plan Selection Display: Peds Admission Gastroenteritis-Dehydration (JE FH)
PlanType: Medical                                 
Version: 2          
Begin Effective Date: 2020-04-22 19:36:00
End Effective Date: 2100-12-31 00:00:00
Last Updated Date: 2023-01-26 08:40:56
Available at all facilities: No

Peds Admission Gastroenteritis-Dehydration (JE FH)
Admit/Discharge/Transfer
	Admit to Observation Status
		T;N
	Admit to Inpatient Status
		T;N, Anticipated LOS 2 midnight or more
Vital Signs
	Vital Signs
		Q4H-Sch
		Q6H-Sch
		Q8H-Sch
		Q12H-Sch
		Q4HAWAKE
Activity
	Activity-As Tolerated
		
Diet
	Regular Diet
		
	NPO
		
	Clear Liquid Diet
		Advance as Tolerated
			Comment: No Juices
	Breast Milk
		Feed Base: Mother Breast Milk, Special Instructions: Supplement with formula
		Feed Base: Mother Breast Milk, Special Instructions: No supplementation
	Formula
		Base Caloric Density: 20
	breast milk (maternal)
		mL, By Mouth, Q3H, for see comment
			Comment: per feeding protocol
	Infant Feeding
		
Laboratory
Today's Lab
	CBC with Diff
		Routine, spec type = Blood
	Basic Metabolic Panel
		Routine, spec type = Blood
	Comprehensive Metabolic Panel
		Routine, spec type = Blood
	Fecal Lactoferrin
		T;N, Routine, spec type = Stool
	Stool Pathogen Panel (PCR)
		T;N, Routine, spec type = Stool
	Occult Blood Stool - JE
		Routine, spec type = Stool
	Occult Blood - MH/WH/FH
		Routine, spec type = Stool
	Sputum Culture
		Routine, spec type = Sputum
	MRSA Nasal Screen Rapid - JE
		Routine, spec type = Swab
			Comment: used for nares
	MRSA/Staph Aureus Nasal Screen by PCR - FH
		Routine, spec type = Nasal
			Comment: used for nares
	Staph (Skin/Tissue) Rapid - JE
		Routine, spec type = Swab
			Comment: used for everything except nares
	MRSA Screen
		Routine, Swab in VTM, spec type = Miscellaneous
			Comment: used for everything except nares
Tomorrow's Lab
	CBC with Diff
		T+1;0400, Routine, spec type = Blood
	Basic Metabolic Panel
		T+1;0400, Routine, spec type = Blood
	Sed Rate
		T+1;0400, Routine, spec type = Blood
	hsCRP
		T+1;0400, Routine, spec type = Blood
	UA (Culture if Positive)
		T+1;0400, Routine, Routine, spec type = Urine
Diagnostic Tests

	Chest 1 View
		Stat, SOB
	Chest 2 View
		Stat, SOB
	KUB
		T;N, Stat
	CT Abd w & w/o Contrast
		T;N, Stat
	CT Chest w & w/o Contrast
		T;N, Stat
	CT Pelvis w & w/o Contrast
		T;N, Stat
	CT Head w & w/o Contrast
		T;N, Stat
	CT Mastoids w & w/o Contrast
		T;N, Stat
	CT Sinus w/o Contrast
		T;N, Stat
	US Pelvis Complete Non OB
		T;N, Stat
	US Renal Retro Complete
		T;N, Stat
In AM
	Chest 1 View
		T+1;0600, Routine
	Chest 2 View
		T+1;0600, Routine
	KUB
		T+1;0600, Routine
IV Solutions

		IV fluids for patient under 10kg should be based on mL/kg/24hr and over 10kg based upon mL/m2/24 hrs.(NOTE)*
	Dextrose 5% with 0.225% NaCl
		1,000 mL, IV, ml/hr
	Dextrose 5% with 0.225% NaCl w/KCl 10 mEq/1000 mL
		10 mEq, EVERY BAG
		1,000 mL, IV, ml/hr
	Dextrose 5% with 0.225% NaCl w/KCl 20 mEq/1000 mL
		1,000 mL, IV, ml/hr
		20 mEq, EVERY BAG
	Dextrose 5% with 0.45% NaCl
		1,000 mL, IV, ml/hr
	Dextrose 5% with 0.45% NaCl w/KCl 10 mEq
		1,000 mL, IV, ml/hr
	Dextrose 5% with 0.45% NaCl w/KCl 20 mEq
		1,000 mL, IV, ml/hr
	Sodium Chloride 0.9%
		1,000 mL, IV, ml/hr
	Dextrose 5% in Lactated Ringers
		1,000 mL, IV, ml/hr
	Sodium Chloride 0.9% Intravenous Solution (Bolus)
		20 mL/kg, IVPB, Once, STAT, 1 Dose(s)/Time(s), 1 hr
			Comment: Bolus in ED
Medications
		Antipyretics(NOTE)*
	Tylenol 325 mg/10.15 mL elixir (JE)
		15 mg/kg, Elixir, BY MOUTH, Q4H, PRN, fever
			Comment: temp >100.4
	acetaminophen 160 mg/5 mL oral liquid
		15 mg/kg, Elixir, By Mouth, Q4H, PRN for fever
			Comment: temp >100.4
	Tylenol
		325 mg, Tab, BY MOUTH, Q4H, PRN, fever
			Comment: temp >100.4
		15 mg/kg, Suppository, RECTALLY, Q4H, PRN, fever
			Comment: temp >100.4
	ibuprofen
		10 mg/kg, Suspension, BY MOUTH, Q6H, PRN, fever
			Comment: temp >100.4  For infants >6 months of age.
		200 mg, Tab, BY MOUTH, Q6H, PRN, fever
			Comment: temp >100.4
		Analgesics(NOTE)*
	lidocaine-prilocaine 2.5%-2.5% topical cream
		1 appl, Cream, TOPICAL, Once, PRN, pain-mild
			Comment: Apply 60 minutes prior to procedure
	Tylenol 325 mg/10.15 mL elixir (JE)
		15 mg/kg, Elixir, BY MOUTH, Q4H, PRN, pain-mild
	acetaminophen 160 mg/5 mL oral liquid
		15 mg/kg, Elixir, By Mouth, Q4H, PRN for pain-mild
	Tylenol
		325 mg, Tab, BY MOUTH, Q4H, PRN, pain-mild
		15 mg/kg, Suppository, RECTALLY, Q4H, PRN, pain-mild
	ibuprofen
		10 mg/kg, Suspension, BY MOUTH, Q6H, PRN, pain-mild
			Comment: For infants >6 months of age.
		200 mg, Tab, BY MOUTH, Q4H, PRN, pain-mild
		Miscellaneous(NOTE)*
	Ocean 0.65% nasal spray
		1 spray, Solution, NOSTRIL, AFFECTED, Q1H, PRN, congestion
Patient Care
	Resuscitation Status
		Full Code
		No Code
	Intake and Output
		Q12H-End of Shift
		Q4H-Sch
		Q6H-Sch
		Weigh diaper
	Notify MD
		Elevated temp. not responding to antipyretics. HR and RR below or above normal values and O2 sat below 92
Consults/Follow-up
	Consult Social Work
		T;N
	Consult General Surgery
		
	Consult Urology
		
	Consult Care Management
		T;N
			Comment: Discharge Planning

CSF Panel (Pediatric) (FH JE)
Laboratory
	Protein CSF
		T;N, Stat, spec type = Cerebrospinal Fluid
			Comment: Save CSF
	Glucose CSF
		T;N, Stat, spec type = Cerebrospinal Fluid
			Comment: Save CSF
	Cell Count and Diff CSF
		T;N, Stat, spec type = Cerebrospinal Fluid
	Enterovirus by PCR
		T;N, Stat, spec type = Cerebrospinal Fluid
	Herpes Simplex Virus 1/2 PCR. Other than blood
		T;N, Stat, spec type = Cerebrospinal Fluid
	Culture Routine
		T;N, Stat, Body Fluid, spec type = Cerebrospinal Fluid
			Comment: Save CSF

Peds Nausea (JE/FH)
Medications
		Proceed to next choice if ineffective during dosing interval(NOTE)*
	ondansetron
		0.1 mg/kg, Injection, IV PUSH, Q24H, PRN for nausea and/or vomiting
			Comment: > 1 month old. Maximum dose is 4mg
		0.1 mg/kg, Liquid, By Mouth, Q24H, PRN for nausea and/or vomiting
			Comment: > 1 month old. Maximum dose is 4mg
	prochlorperazine
		0.1 mg/kg, Injection, IM-Intramuscular, Q6H, PRN for nausea and/or vomiting
			Comment: >= 2 years old.  Maximum dose is 10mg
		2.5 mg, Tab, BY MOUTH, BID, PRN, nausea and/or vomiting
			Comment: 9-13 kg
		2.5 mg, Tab, BY MOUTH, TID, nausea and/or vomiting
			Comment: 9-13 kg
		5 mg, Tab, BY MOUTH, BID, PRN, nausea and/or vomiting
			Comment: 9-13 kg
	Reglan
		0.1 mg/kg, Injection, IV PUSH, Q6H, PRN, nausea and/or vomiting
			Comment: <6 years old; Maximum dose is 2.5mg
		2.5 mg, Injection, IV PUSH, Q6H, PRN for nausea and/or vomiting
			Comment: 6-14 years old
		5 mg, Injection, IV PUSH, Q6H, PRN for nausea and/or vomiting
			Comment: 6-14 years old
		10 mg, Injection, IV PUSH, Q6H, PRN for nausea and/or vomiting
			Comment: >14 years old
	Phenergan rectal suppository
		12.5 mg, Suppository, RECTALLY, Q4H, nausea and/or vomiting
		25 mg, Suppository, RECTALLY, Q4H, nausea and/or vomiting
	Phenergan oral tablet
		0.25 mg/kg, Tab, BY MOUTH, Q4H, nausea and/or vomiting
	Benadryl
		1 mg/kg, Injection, IV PUSH, Q6H, PRN, nausea and/or vomiting
			Comment: > 1 month old.  Maximum dose is 12.5mg
		1 mg/kg, Injection, IM-Intramuscular, Q6H, PRN, nausea and/or vomiting
			Comment: > 1 month old.  Maximum dose is 12.5mg
Patient Care
	Notify MD
		T;N, If symptoms persists, notify primary care physician or ordering prescriber.

Peds IV Insert Peripheral lock with flush
Medications
	sodium chloride 0.9% flush injectable soln
		3 mL, Syringe, IV PUSH, BID
		3 mL, Syringe, IV PUSH, Q5MIN, PRN, IV line flush
		3 mL, Syringe, IV PUSH, Q5MIN, PRN, blood sampling or tpn administration
Patient Care
	Peripheral Lock-Insert
		T;N

Blood Culture Set
Laboratory
	.Blood Culture.
		T;N, Stat, spec type = Blood
		T;N, Routine, spec type = Blood
		T+1;0400, Routine, spec type = Blood
	.Blood Culture
		T;N, Stat, spec type = Blood
		T;N, Routine, spec type = Blood
		T+1;0400, Routine, spec type = Blood

*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