Unique Plan Description: Anes Pre-operative Testing and Medications
Plan Selection Display: Anes Pre-operative Testing and Medications
PlanType: Medical                                 
Version: 3          
Begin Effective Date: 2022-01-18 13:14:26
End Effective Date: 2100-12-31 00:00:00
Last Updated Date: 2024-08-22 13:23:16
Available at all facilities: Yes

Anes Pre-operative Testing and Medications
Diet
	NPO
		T;N
			Comment: NPO 8 hours for patients who are diabetic, pregnant, obese with a hiatal hernia, esophageal reflux, ileus, bowel obstruction, any bowel preps, N&V, external tube feedings, trauma, previous difficult intubation.
	Clear Liquid Diet
		T;N
			Comment: Allowed until 4 hours before surgery
Laboratory
Today's Lab
	CBC with Diff
		Stat, spec type = Blood
	Hematocrit
		Stat, spec type = Blood
	INR - MH/WH/JE
		Stat, spec type = Blood
		**Note**Select this order for patients on Heparin(NOTE)*
	Heparin Anti-Xa Heparin
		Stat, spec type = Blood
		**Note** Select this order for patients on Lovenox(NOTE)*
	Anti-Factor Xa LMWH Lovenox
		Stat, spec type = Blood
	Basic Metabolic Panel
		Stat, spec type = Blood
	Comprehensive Metabolic Panel
		Stat, spec type = Blood
	Glucose POC - RN
		T;N, Once
	Hepatic Function Panel
		Stat, spec type = Blood
	Pregnancy Test Urine
		Stat, Stat, spec type = Urine
	UA (Culture if Positive)
		T;N, Stat, Stat, spec type = Urine
	Pregnancy Test Whole Blood - JE
		T;N, Stat, spec type = Blood
	Prothrombin Time (PT) - FH
		T;N, Stat, spec type = Diagnostic Blood
		T;N, Stat, spec type = Therapeutic Blood
	Partial Thromboplastin Time (PTT) - FH
		T;N, Stat, spec type = Diagnostic Blood
	Platelet Function Analysis (PFA) - FH
		T;N, Stat, spec type = Blood
	Blood Gases Arterial (ABG) - MH/WH/JE
		T;N, Stat, spec type = Blood
	Blood Gases Arterial (ABG) - FH
		T;N, Stat, spec type = Blood
	HIV 1/2 Screen w/ p24 Antigen - FH
		T;N, Stat, spec type = Blood
Diagnostic Tests

	ECG
		T;N, Routine, Indication: Pre-op Release
	Chest 2 View
		Routine, Chest Pain
IV Solutions
	Lactated Ringers Injection
		1,000 mL, IV, 20 ml/hr
		Enter sodium chloride order below for dialysis and heart failure patients.(NOTE)*
	Sodium Chloride 0.9%
		500 mL, IV, 20 ml/hr
		1,000 mL, IV, 50 ml/hr
Medications
Routine
	lidocaine 1% preservative-free injectable solution
		0.1 mL, IntraDermal, Once, STAT
	sodium chloride bacteriostatic 0.9% injectable soln
		0.1 mL, Injection, IntraDermal, Q1H, PRN, see comment
			Comment: For IV start
	Peridex 0.12% oral rinse (MH/WH)
		15 mL, Soln, MOUTHWASH, PREOP, STAT
	Pepcid
		20 mg, Injection, IV PUSH, PREOP, PRN, see comment, STAT
			Comment: h/o acid reflux, notify anesthesia prior to administration. Always administer for pre-op C-section & notify anesthesia if given less than 1 hour before surgery.
	Bicitra oral soln
		30 mL, Soln, BY MOUTH, PREOP, PRN, see comment, STAT
			Comment: Give Bicitra for full stomach, notify anesthesia prior to administration. Always administer within 30 minutes prior to C-section.
Antiemetics
	ondansetron
		4 mg, Injection, IV PUSH, PREOP, PRN for see comment, STAT
			Comment: nausea/vomiting pre-op, notify anesthesia prior to administration
	Transderm-Scop 1 mg patch
		1 mg, Patch, TOPICAL, PREOP, PRN for see comment, STAT
			Comment: h/o post-op nausea/vomiting, notify anesthesia prior to administration
	scopolamine Patch Removal
		Patch Removal, Patch, TOPICAL, Q3D, T+3;0900
	dexAMETHasone
		4 mg, IV PUSH, PREOP, STAT
	aprepitant
		40 mg, By Mouth, PREOP, STAT
	aprepitant 32 mg/4.4 mL intravenous emulsion
		32 mg, Injection, IV Push, PREOP, STAT
			Comment: Inject over 30 seconds; Flush line with NS before and after administration.
Analgesics/adjuncts & Anti-Anxiety
	acetaminophen
		1,000 mg, By Mouth, PREOP, STAT
	gabapentin
		300 mg, Capsule, BY MOUTH, PREOP, STAT
			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 54.5-63kg (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 54.5-63kg (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.
	pregabalin
		50 mg, By Mouth, PREOP, STAT
		100 mg, By Mouth, PREOP, STAT
		150 mg, By Mouth, PREOP, STAT
	cloNIDine
		0.1 mg, Tab, SUBLINGUAL, PREOP, STAT
		0.1 mg, Tab, By Mouth, PREOP, STAT
	CeleBREX
		100 mg, By Mouth, PREOP, STAT
			Comment: Any post-operative NSAID dose should be given no sooner than 12hr after pre-op dose unless otherwise directed by Anesthesia.
		200 mg, By Mouth, PREOP, STAT
			Comment: Any post-operative NSAID dose should be given no sooner than 12hr after pre-op dose unless otherwise directed by Anesthesia.
	meloxicam
		7.5 mg, By Mouth, PREOP, STAT
			Comment: consider for sulfa allergic patients needing a cox-2 inhibitor.  Any post-operative NSAID dose should be given no sooner than 12hr after pre-op dose unless otherwise directed by Anesthesia.
		15 mg, By Mouth, PREOP, STAT
			Comment: consider for sulfa allergic patients needing a cox-2 inhibitor.  Any post-operative NSAID dose should be given no sooner than 12hr after pre-op dose unless otherwise directed by Anesthesia.
	lidocaine-prilocaine 2.5%-2.5% topical cream
		1 appl, Cream, TOPICAL, Once, PRN, pain-mild, STAT, 4 hr
	Dilaudid Injectable
		0.2 mg, Injection, IV PUSH, Once, PRN, pain-mild, 2 hr
		0.4 mg, Injection, IV PUSH, Once, PRN, pain-moderate, 4 hr
	fentaNYL
		50 mcg, Injection, IV Push, PREOP, PRN, pain-severe, 4 hr
	morphine
		3 mg, IV Push, PREOP, PRN, pain-severe, 4 hr
	Ativan
		1 mg, Injection, IV PUSH, Once, PRN, anxiety, STAT, 4 hr
		2 mg, Injection, IV PUSH, Once, PRN, anxiety, STAT, 4 hr
	magnesium sulfate IVPB
		2 gm, IVPB, PREOP, STAT
			Comment: For patients < 91kg (200lb); administer over 2hr in OR
		3 gm, IVPB, PREOP, STAT
			Comment: For patients > 91kg (200lb); administer over 2hr in OR
	Exparel
		266 mg = 20 mL, Suspension, NERVE BLOCK, Once, T;N
		133 mg = 10 mL, Suspension, NERVE BLOCK, Once, T;N
Consults/Follow-up

	Pharmacy Consult - Review meds for Pre op (JE)

*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