Unique Plan Description: Vasc Surg AAA Repair, Pre op
Plan Selection Display: Vasc Surg AAA Repair, Pre op
PlanType: Medical                                 
Version: 2          
Begin Effective Date: 2016-09-07 11:11:00
End Effective Date: 2100-12-31 00:00:00
Last Updated Date: 2021-12-21 12:32:35
Available at all facilities: Yes

Vasc Surg AAA Repair, 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
		After Midnight, NPO Except for: Medications
Laboratory
	CBC with Diff
		Stat, spec type = Blood
	Comprehensive Metabolic Panel
		Stat, spec type = Blood
	Type and Crossmatch (Product Available)
		T;N, Stat, For Possible Transfusion
	UA (Culture if Positive)
		Stat, Stat, spec type = Urine, when foley inserted
		Stat, Stat, spec type = Urine, when foley inserted
Diagnostic Tests
	ECG
		Stat, Indication: Pre-op Release
Medications
	Ancef (MH/WH)
		2,000 mg, Syringe, IV Push, PREOP, Surgical prophylaxis
	Ancef (JE)
		2,000 mg, Injection, IV Push, PREOP, Surgical prophylaxis
		If allergic to cephalosporin enter vancomycin order(NOTE)*
	vancomycin IVPB
		1,000 mg, Injection-Premix, IVPB, PREOP, Surgical prophylaxis
			Comment: For patients weighing < 80kg, infuse over 60 minutes; document reason for vancomycin; give only if anaphylactic reaction to penicillin or if cephalosporin allergy.
		1,500 mg, Injection-Premix, IVPB, PREOP, Surgical prophylaxis
			Comment: For patients weighing 80 - 120 kg, infuse over 90 minutes; document reason for vancomycin; give only if anaphylactic reaction to penicillin or if cephalosporin allergy.
		2,000 mg, Injection-Premix, IVPB, PREOP, Surgical prophylaxis
			Comment: For patients weighing > 120kg, infuse over 90 minutes; document reason for vancomycin; give only if anaphylactic reaction to penicillin or if cephalosporin allergy.
	No Antibiotic Prophylaxis Indicated
		
Patient Care
	Obtain Consent/Permit for:
		Abdominal Aortic Aneurysm Repair Endovascular with Possible Open Repair
		Abdominal Aortic Aneurysm Repair
	Notify MD
		PCP of admission
	No ACE (angiotensin converting enzyme) inhibitors
		
	No ARB (angiotensin receptor blocker)
		
	No NSAIDS (non steroidal anti-inflamatory)
		
	Patient Education
		Stop Coumadin 5 days before surgery
		Stop Xarelto 3 days before surgery
		Stop Eliquis 2 days before surgery
		Stop Pradaxa 3 days before surgery
		Do Not stop Plavix or Aspirin unless instructed to do so by your physician
	Pre-op bath/shower
		T;2000
			Comment:  Patient to shower with chlorhexadine gluconate evening before surgery
		T+1;0500
			Comment: Patient to shower with chlorhexadine gluconate morning of surgery
	Foley Catheter
		Obtain UA for C&S at time of insertion, Pt. undergoing abdominal/pelvic surgery

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

*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