Unique Plan Description: Pneumonia Community Acquired
Plan Selection Display: Pneumonia Community Acquired
PlanType: Medical                                 
Version: 4          
Begin Effective Date: 2022-02-22 12:13:16
End Effective Date: 2100-12-31 00:00:00
Last Updated Date: 2025-05-12 08:56:47
Available at all facilities: Yes

Pneumonia Community Acquired
Activity
	Activity-As Tolerated
		
	Up in Chair
		TIDWM
	Ambulate
		QID
Laboratory
	CBC with Diff
		Stat, spec type = Blood
	Comprehensive Metabolic Panel
		Stat, spec type = Blood
	hsCRP
		Stat, spec type = Blood
	Influenza A and B Screen PCR - JE
		Stat, spec type = Nasopharynx
	Influenza A and B Screen PCR
		Stat, spec type = Nasopharynx
	Procalcitonin
		Stat, spec type = Blood
	Respiratory Panel Flu-RSV-Covid
		T;N, Stat, spec type = Nasopharynx
Diagnostic Tests
	Chest 1 View
		Stat, Pneumonia
	Chest 2 View
		Pneumonia, Stat, Pneumonia
	ECG
		Stat, Indication: Pneumonia
Medications
Pain
	Tylenol
		650 mg, Tab, BY MOUTH, Q4H, PRN, pain-mild
Non ICU
		PREFERRED REGIMEN (select first choice)(NOTE)*
	Rocephin IVPB
		2,000 mg, Injection-Premix, IVPB, Q24H, Indication: Pneumonia-Community acquired, STAT
			Comment: If unable to obtain blood cultures on initial attempt, start antibiotics.
	Rocephin IVPB (FH)
		2,000 mg, INT, IVPB, Q24H, Indication: Pneumonia-Community acquired, STAT
			Comment: If unable to obtain blood cultures on initial attempt, start antibiotics.
	Zithromax IVPB
		500 mg, INT, IVPB, Q24H, Indication: Pneumonia-Community acquired, STAT
			Comment: If unable to obtain blood cultures on initial attempt, start antibiotics.
	Levaquin IVPB
		750 mg, Injection-Premix, IVPB, Q24H, Indication: Pneumonia-Community acquired, STAT
			Comment: If unable to obtain blood cultures on initial attempt, start antibiotics.
	Rocephin IVPB
		2,000 mg, Injection-Premix, IVPB, Q24H, Indication: Pneumonia-Community acquired, STAT
			Comment: If unable to obtain blood cultures on initial attempt, start antibiotics.
	Rocephin IVPB (FH)
		2,000 mg, INT, IVPB, Q24H, Indication: Pneumonia-Community acquired, STAT
			Comment: If unable to obtain blood cultures on initial attempt, start antibiotics.
	doxycycline IVPB
		100 mg, INT, IVPB, Q12H, Indication: Pneumonia-Community acquired, STAT
			Comment: If unable to obtain blood cultures on initial attempt, start antibiotics.
ICU
		PREFERRED REGIMEN (select first choice)(NOTE)*
	Rocephin IVPB
		2,000 mg, Injection-Premix, IVPB, Q24H, Indication: Pneumonia-Community acquired, STAT
			Comment: If unable to obtain blood cultures on initial attempt, start antibiotics.
	Rocephin IVPB (FH)
		2,000 mg, INT, IVPB, Q24H, Indication: Pneumonia-Community acquired, STAT
			Comment: If unable to obtain blood cultures on initial attempt, start antibiotics.
	Zithromax IVPB
		500 mg, INT, IVPB, Q24H, Indication: Pneumonia-Community acquired, STAT
			Comment: If unable to obtain blood cultures on initial attempt, start antibiotics.
		Beta-lactam allergy(NOTE)*
	Levaquin IVPB
		750 mg, Injection-Premix, IVPB, Q24H, Indication: Pneumonia-Community acquired, STAT
			Comment: If unable to obtain blood cultures on initial attempt, start antibiotics.
	Azactam IVPB
		2,000 mg, INT, IVPB, Q8H, Indication: Pneumonia-Community acquired, STAT
			Comment: If allergic to penicillin and cephalosporin.  If unable to obtain blood cultures on initial attempt, start antibiotics.
	Levaquin IVPB
		750 mg, Injection-Premix, IVPB, Q24H, Indication: Pneumonia-Community acquired, STAT
	Rocephin IVPB (FH)
		2,000 mg, INT, IVPB, Q24H, Indication: Pneumonia-Community acquired, STAT
			Comment: If unable to obtain blood cultures on initial attempt, start antibiotics.
	Rocephin IVPB
		2,000 mg, Injection-Premix, IVPB, Q24H, Indication: Pneumonia-Community acquired, STAT
Pseudomonal Risk(ICU & non-ICU)
		Risk factors: structural lung disease (bronchiectasis, chronic bronchitis, COPD, emphysema, interstitial lung disease, pulmonary fibrosis) with chronic steroids or multiple rounds of antibiotics.(NOTE)*
		PREFERRED REGIMEN (select first choice)(NOTE)*
	Levaquin IVPB
		750 mg, Injection-Premix, IVPB, Q24H, Indication: Pneumonia-Community acquired, STAT
			Comment: If unable to obtain blood cultures on initial attempt, start antibiotics.
	Zosyn IVPB
		4.5 gm, Injection-Premix, IVPB, Q8H, Indication: Pneumonia-Community acquired, STAT
			Comment: If not allergic to penicillin.  If unable to obtain blood cultures on initial attempt, start antibiotics.
	Zosyn IVPB (FH)
		4.5 gm, INT, IVPB, Q8H, Indication: Pneumonia-Community acquired, STAT
			Comment: If not allergic to penicillin.  If unable to obtain blood cultures on initial attempt, start antibiotics.
		Quinolone alternative/allergy(NOTE)*
	Zosyn IVPB
		4.5 gm, Injection-Premix, IVPB, Q8H, Indication: Pneumonia-Community acquired, STAT
			Comment: If not allergic to penicillin.  If unable to obtain blood cultures on initial attempt, start antibiotics.
	Zosyn IVPB (FH)
		4.5 gm, INT, IVPB, Q8H, Indication: Pneumonia-Community acquired, STAT
			Comment: If not allergic to penicillin.  If unable to obtain blood cultures on initial attempt, start antibiotics.
	Zithromax IVPB
		500 mg, INT, IVPB, Q24H, Indication: Pneumonia-Community acquired, STAT
			Comment: If unable to obtain blood cultures on initial attempt, start antibiotics.
	gentamicin
		5 mg/kg, INT, IVPB, Q24H, Indication: Pneumonia-Community acquired, STAT
			Comment: Pharmacy to dose.  If unable to obtain blood cultures on initial attempt, start antibiotics.
	Zithromax IVPB
		500 mg, INT, IVPB, Q24H, Indication: Pneumonia-Community acquired, STAT
	cefepime IVPB
		2,000 mg, INT, IVPB, Q8H, Indication: Pneumonia-Community acquired, STAT
	cefepime (FH/WH)
		2,000 mg, INT, IVPB, Q8H, Indication: Pneumonia-Community acquired, STAT
			Comment: If not allergic to penicillin.  If unable to obtain blood cultures on initial attempt, start antibiotics.
		Beta-lactam allergy(NOTE)*
	Levaquin IVPB
		750 mg, Injection-Premix, IVPB, Q24H, Indication: Pneumonia-Community acquired, STAT
			Comment: If unable to obtain blood cultures on initial attempt, start antibiotics.
	Azactam IVPB
		2,000 mg, INT, IVPB, Q8H, Indication: Pneumonia-Community acquired, STAT
			Comment: If allergic to penicillin and cephalosporin.  If unable to obtain blood cultures on initial attempt, start antibiotics.
MRSA Risk
		Pneumonia requiring admission to ICU, necrotizing/cavity infiltrates, empyema, end stage renal disease, injection drug abuse, influenza prior to illness, prior anitbiotic therapy, diabetes mellitus, head trauma, smokers, COPD, HIV, hospitalization/nursing(NOTE)*
		In addition to the antibiotics chosen above:(NOTE)*
	vancomycin - Pharmacy to Dose
		Pharmacy to Dose, IVPB, PHARMACY TO DETERMINE, Pneumonia-Community acquired
	Zyvox IVPB
		600 mg, Injection-Premix, IVPB, Q12H, Indication: Pneumonia-Community acquired
Therapies
Respiratory Therapy
	Bronchodilator Therapy per Respiratory Protocol (FH)
		T;N
	Pulse Oximetry Spot Check RT
		T;N, BID
	Continuous Pulse Oximetry Monitoring Check
		T;N, BID
	Incentive Spirometer
		Q1HAWAKE
	Aerosol Treatment for sputum induction
		T;N
	albuterol-ipratropium 2.5 mg-0.5 mg/3 mL inhalation solution
		3 mL, Solution-Nebulization, NEBULIZED, QID
		3 mL, Solution-Nebulization, NEBULIZED, Q2H, PRN for wheezing and/or shortness of breath
	albuterol concentrate 2.5mg/0.5mL (0.5%) inh soln
		0.5 mL, Solution-Nebulization, NEBULIZED, Q2H, PRN for wheezing and/or shortness of breath
	sodium chloride 0.9% inhalation solution
		3 mL, Solution-Nebulization, Inhalation, Q2H, PRN for wheezing and/or shortness of breath
	levalbuterol 1.25 mg/3 ml inhalation solution
		3 mL, Solution-Nebulization, NEBULIZED, Q8H
		3 mL, Solution-Nebulization, NEBULIZED, Q4H, PRN for wheezing and/or shortness of breath
	Consult Pulmonary Rehab: Inpatient
		Pneumonia
	Smoking Cessation Education
		T;N
	Smoking Cessation Education RT (FH)
		T;N
	Consult Respiratory Therapy-Assess and Treat
		T;N
Consults/Follow-up

	Consult Pulmonologist
		Reason for Referral: Pneumonia
	Consult Infectious Disease
		Reason for Referral: Pneumonia

*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