Unique Plan Description: URO Minor, Pre Op
Plan Selection Display: URO Minor, Pre Op
PlanType: Medical                                 
Version: 2          
Begin Effective Date: 2020-04-16 15:23:00
End Effective Date: 2100-12-31 00:00:00
Last Updated Date: 2023-01-24 14:17:11
Available at all facilities: No

URO Minor, Pre Op
Admit/Discharge/Transfer
	Admit to Observation Status
		T;N
	Admit to Inpatient Status
		
Diet
	NPO
		After Midnight
Laboratory
	UA (Culture if Positive)
		Stat, Stat, spec type = Urine
	CBC with Diff
		Stat, spec type = Blood
	Basic Metabolic Panel
		Stat, spec type = Blood
Medications
	Ancef (JE)
		1,000 mg, Injection, IV Push, PREOP, Surgical prophylaxis, T;N
	Ancef (MH/WH)
		2,000 mg, Syringe, IV Push, PREOP, Surgical prophylaxis, T;N
	Ancef (FH)
		2,000 mg, Injection-Premix, IVPB, Once, Surgical prophylaxis, T;N
			Comment: 80-120kg.  Give 1 hr preop.  OK to give if pt allergic to penicillin unless history of anaphylactic reaction.  Redose every 3 hours during surgery
		1,000 mg, INT, IVPB, Once, Surgical prophylaxis, T;N
			Comment: :< 80kg.  Give 1 hr preop.  OK to give if pt allergic to penicillin unless history of anaphylactic reaction.  Redose every 3 hours during surgery
		3,000 mg, Injection-Premix, IVPB, PREOP, Surgical prophylaxis, T;N
			Comment: > 120kg.  give 1 hr Preop.  OK to give if pt allergic to penicillin unless history of anaphylactic reaction.  Redose every 3 hours during surgery
	Cipro IVPB
		400 mg, Injection-Premix, IVPB, PREOP, Surgical prophylaxis, T;N
			Comment: Not to exceed 400 mg (10 mg/kg) for patients under age 18.
	Levaquin IVPB
		500 mg, Injection-Premix, IVPB, PREOP, Surgical prophylaxis, T;N
	lidocaine 1% preservative-free injectable solution
		50 mL, Injection, TOPICAL, PREOP, duration: 1 Dose(s)/Time(s)
			Comment: For bladder instillation in preop
Patient Care
	Obtain Consent/Permit for:
		Ureteroscopy
		Cystoscopy
	Foley Catheter
		T;N, Once
			Comment: Pre op. Insert foley, inject Lidocaine into patient's bladder at least 30 mins prior to surgery start, DO NOT inject any air following medication administration. Remove foley and catheter bag, leaving the medication in the patient bladder, where it will remain until it is drained back in the surgical room.
	Discontinue Urinary Catheter
		T;N, Preop
			Comment: Discontinue foley catheter once bladder instillation is completed.

VTE Prophylaxis Pre Op
Medications
	HEParin 5000 units/mL SUBCUTANEOUS
		5,000 units, Injection, SUBCUTANEOUS, PREOP, T;N
	Lovenox
		40 mg, Syringe, SUBCUTANEOUS, PREOP, T;N
		30 mg, Syringe, SUBCUTANEOUS, PREOP, T;N
Patient Care
	Sequential Compression Device Pre Procedure
		T;N, Apply, Once
			Comment: knee high
	Anti Embolism Stockings Pre Procedure
		T;N, Apply, Once
			Comment: knee high

Multi-Modal Pre-Op Analgesics
Medications
	gabapentin
		300 mg, Capsule, BY MOUTH, PREOP
			Comment: Administer 1-2 hr prior to surgery; contact Anesthesia if not given. Give 300mg if patient < or = 60 years old and > or = 63.6kg (140 lbs); pharmacy to modify dose to 200mg if patient 61-70 years old or weighs 54.5-63.5kg (120-139 lbs); pharmacy to modify dose to 100mg if patient 71-75 years old or weighs < 54.5kg (< 120 lbs).  If patient 76 years old or older, discontinue order.
		200 mg, Capsule, BY MOUTH, PREOP
			Comment: If 61-70 years old or weighs 54.5-63.5kg (120-139 lbs); administer 1-2 hr prior to surgery; contact Anesthesia if not given.
		100 mg, Capsule, BY MOUTH, PREOP
			Comment: If 71-75 years old or weighs <54.4kg ( < 120 lbs); administer 1-2 	hr prior to surgery; contact Anesthesia if not given.
	meloxicam
		7.5 mg, Tab, BY MOUTH, PREOP
			Comment: Do not use if CrCl < 30ml/min or if systolic blood pressure <90mmHg; administer 1-2hr prior to surgery; contact Anesthesia if not given. Any post-operative NSAID dose should be given no sooner than 12hr after pre-op dose unless otherwise directed by Anesthesia.
		15 mg, Tab, By Mouth, PREOP
			Comment: Comment: Do not use if CrCl < 30ml/min or if systolic blood pressure <90mmHg; administer 1-2hr prior to surgery; contact Anesthesia if not given. Any post-operative NSAID dose should be given no sooner than 24hr after pre-op dose unless otherwise directed by Anesthesia.
	acetaminophen
		1,000 mg, Tab, BY MOUTH, PREOP
			Comment: For case duration < 6 hrs.
	acetaminophen 10 mg/mL intravenous solution
		1,000 mg, Solution-Injection, IVPB, Once, PRN for see comment, duration: 1 Dose(s)/Time(s)
			Comment: Use only if strict NPO for all oral medications pre-op; Anesthesia to determine dose timing - pre-op or intra-op.

*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