Unique Plan Description: UROGYN Pelvic Reconstruction, Pre op
Plan Selection Display: UROGYN Pelvic Reconstruction, Pre op
PlanType: Medical                                 
Version: 1          
Begin Effective Date: 2012-11-05 08:34:22
End Effective Date: 2100-12-31 00:00:00
Last Updated Date: 2023-06-20 16:20:05
Available at all facilities: Yes

UROGYN Pelvic Reconstruction, Pre op
Admit/Discharge/Transfer
	Admit to Inpatient Status
		T;N, Anticipated LOS 2 midnight or more
	Admit to Observation Status
		T;N
Diet
	NPO
		
Laboratory
	Type and Screen (No Product on hold)
		Stat, spec type = Blood
	Type and Crossmatch (Product Available)
		T;N, Stat, For Possible Transfusion
	Hemoglobin and Hematocrit
		T;N, Stat, spec type = Blood
			Comment: if results not on chart.
	Pregnancy Test Urine
		T;N, Stat, Stat, spec type = Urine
			Comment: if not done in past 48 hours and appropriate.
Medications
	Ancef (JE)
		2,000 mg, Injection, IV Push, PREOP, Surgical prophylaxis
			Comment: OK to give if patient has penicillin allergy unless history of anaphylactic reaction.  Redose q3h during surgery
	Ancef (MH/WH)
		2,000 mg, Syringe, IV Push, PREOP, Surgical prophylaxis
			Comment: OK to give if patient has penicillin allergy unless history of anaphylactic reaction.  Redose q3h during surgery
		For penicillin allergic patients choose either Quinolone and Flagyl, or Quinolone and Clindamycin(NOTE)*
		Quinolone and Flagyl(NOTE)*
	Levaquin IVPB
		500 mg, Injection-Premix, IVPB, PREOP, Surgical prophylaxis
	Flagyl IVPB
		500 mg, Injection-Premix, IVPB, PREOP, Surgical prophylaxis
		Quinolone and Clindamycin:(NOTE)*
	Levaquin IVPB
		500 mg, Injection-Premix, IVPB, PREOP, Surgical prophylaxis
	Cleocin IVPB (MH/WH/FH)
		900 mg, IVPB, PREOP, Surgical prophylaxis
	Cleocin IVPB (JE)
		900 mg, IVPB, PREOP, Surgical prophylaxis
		If Patient Beta Lactam AND Quinolone allergic, Give BOTH Azactam and Clindamycin.(NOTE)*
	Azactam IVPB
		1,000 mg, IVPB, PREOP, Surgical prophylaxis
			Comment: give with clindamycin (Cleocin) if beta lactam allergic
	Cleocin IVPB (JE)
		900 mg, IVPB, PREOP, Surgical prophylaxis
	Cleocin IVPB (MH/WH/FH)
		900 mg, IVPB, PREOP, Surgical prophylaxis
	phenazopyridine
		200 mg, Tab, By Mouth, PREOP
			Comment: with sip of water
Patient Care
	Obtain Consent/Permit for:
		Abdominal Sacralcolpopexy
		Supracervical Hysterectomy
		Total Abdominal Hysterectomy
		Total Vaginal Hysterectomy
		Lap Assisted Vaginal Hysterectomy
		Bilateral Salpingoophorectomy
		Left  Salpingoophorectomy
		Right  Salpingoophorectomy
		Davinci Robot Assisted Abdominal Sacralcolpopexy
		Le Fort Colpocleisis
		Posterior Colporrhaphy
		Anterior Colporrhaphy
		Anterior and Posterior Colporrhaphy
		Sling and Cystoscopy
		Perineoplasty/Perineorrhaphy
		Laparotomy
		Davinci Assisted Hysterectomy
		Urethral Diverticulectomy
		Sphincteroplasty
		Fistula Repair

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