Unique Plan Description: Cards Peripheral Intervention/Angiogram pre op
Plan Selection Display: Cards Peripheral Intervention/Angiogram pre op
PlanType: Medical                                 
Version: 1          
Begin Effective Date: 2012-11-04 20:26:13
End Effective Date: 2100-12-31 00:00:00
Last Updated Date: 2021-12-20 09:46:57
Available at all facilities: No

Cards Peripheral Intervention/Angiogram pre op
Admit/Discharge/Transfer
	Admit to Observation Status
		T;N
Vital Signs
	Vital Signs
		
Diet
	Clear Liquid Diet
		
	NPO
		
Laboratory
	CBC with Diff
		Stat, spec type = Blood
			Comment: If not done within last 14 days
	Basic Metabolic Panel
		Stat, spec type = Blood
			Comment: If not done within last 7 days
	Lipid Panel
		Stat, spec type = Blood
			Comment: If not done within last 6 weeks
	INR - MH/WH/JE
		Stat, spec type = Blood
			Comment: If patient on coumadin
	Creatinine
		Stat, spec type = Blood
			Comment: If not drawn at JE
	Pregnancy Test Urine
		Stat, Stat, spec type = Urine
			Comment: If patient still menstruating and no history of hysterectomy or tubal ligation
IV Solutions
	Sodium Chloride 0.45%
		1,000 mL, IV, 125 ml/hr
			Comment: Start 6 hours prior to procedure unless IV is infusing
		Choose the following two orders if GFR<60mL/min(NOTE)*
	Sodium Chloride 0.9%
		250 mL, IV, 1 Dose(s)/Time(s), 500 ml/hr
			Comment: Renal Protocol if GFR<60
Medications
	Plavix
		300 mg, Tab, BY MOUTH, PREOP
			Comment: On arrival if Plavix is not currently ordered
	Valium
		10 mg, Tab, By Mouth, PREOP
			Comment: 1 hour prior to procedure
	aspirin
		324 mg, Tablet-Chew, BY MOUTH, PREOP
			Comment: Give with Valium; Give if ASA not currently ordered
Patient Care
	Obtain Consent/Permit for:
		Aortogram
		Aortogram with Runoff
		PTA
		Vertebroplasty
		Renal Angiogram
		Unilateral Extremity Angiogram
		IVC Filter Placemen
		Bilateral Extremity Angiogram
	Notify
		Notify Cath Lab if eGFR<60mL/min and/or INR>1.5
	Notify MD
		Contact Admitting MD: give insulin as directed  (if patient receiveing insulin as inpatient)
	Initiate MD Plan for:
		Cardiology Contrast/Shellfish Allergy Protocol if allergic to contrast or shellfish
	Discontinue Medication
		Metformin containing medications 48 hours pre and post procedure.  Hold Lovenox 8 hours, Heparin 2 hours, and Arixtra 24 hours before procedure.  Hold all anti-hypertensives for 24 hours if having a renal angioram/ angioplasty.
	Foley Catheter
		Insert
	Cardiac Telemetry Monitoring

*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