Unique Plan Description: Cards PFO ASD VSD Pre Op
Plan Selection Display: Cards PFO ASD VSD Pre Op
PlanType: Medical                                 
Version: 2          
Begin Effective Date: 2020-04-14 22:16:00
End Effective Date: 2100-12-31 00:00:00
Last Updated Date: 2023-11-02 08:41:45
Available at all facilities: Yes

Cards PFO ASD VSD Pre Op
Diet
	NPO
		After Midnight, Except for Medications
			Comment: May have sips of water up to 2 hours prior to procedure. No coumadin.
		After Midnight, Except for Medications
			Comment: No coumadin.
Laboratory
	INR - MH/WH/JE
		Stat, spec type = Blood
	Prothrombin Time (PT) - FH
		T;N, Stat, spec type = Diagnostic Blood
		T;N, Stat, spec type = Therapeutic Blood
	CBC with Diff
		Stat, spec type = Blood
	PTT - MH/WH/JE
		Stat, spec type = Blood
	Partial Thromboplastin Time (PTT) - FH
		T;N, Stat, spec type = Diagnostic Blood
	Comprehensive Metabolic Panel
		Stat, spec type = Blood
	Pregnancy Test Urine
		Routine, Routine, spec type = Urine
			Comment: if still menstruating and has not had not had hysterectomy or tubal ligation
	Protein S Free Antigen
		T;N, Routine, spec type = Blood
	Prothrombin (F2) G20210A Pathogenic Variant (PreAuth Req)
		T;N, Routine, spec type = Blood
Diagnostic Tests
	Chest 2 View
		Routine, Findings/Abnormal
	ECG
		
IV Solutions
	Sodium Chloride 0.9%
		1,000 mL, IV, 40 ml/hr
			Comment: Continue until d/c. Start in pre op in right arm if  possible, unless other fluid ordered.
		1,000 mL, IV, 75 ml/hr
			Comment: Continue until d/c. Start in pre op in right arm if  possible, unless other fluid ordered.
Medications
	aspirin
		324 mg, Tablet-Chew, By Mouth, PREOP, T;N
			Comment: Administer with Valium (diazepam) if no aspirin taken at home.
	Valium
		5 mg, Tab, By Mouth, PREOP, T;N
		10 mg, Tab, By Mouth, PREOP, T;N
	Ancef (MH/WH)
		2,000 mg, Syringe, IV Push, PREOP, Surgical prophylaxis, T;N
			Comment: to be started 1 hour prior to procedure, coordinate with cath lab.
	Ancef (FH)
		2,000 mg, Injection-Premix, IVPB, Once, Surgical prophylaxis
			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
			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
			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
	vancomycin IVPB
		15 mg/kg, Injection-Premix, IVPB, PREOP, Surgical prophylaxis
			Comment: to be started 1 hour prior to procedure, coordinate with cath lab
	vancomycin IVPB (FH)
		15 mg/kg, Injection-Premix, IVPB, PREOP, Surgical prophylaxis
			Comment: to be started 1 hour prior to procedure, coordinate with cath lab
	Plavix
		300 mg, Tab, By Mouth, Once, STAT
		600 mg, Tab, By Mouth, Once, STAT
		75 mg, Tab, BY MOUTH, DAILY, T+1;0900
Patient Care
	Obtain Consent/Permit for:
		PFO
		ASD
		VSD
	Notify MD of Lab results
		INR >1.7 and abnormal labs.
Therapies
	Continuous Pulse Oximetry Monitoring Check
		T;N, BID
			Comment: Keep O2 sat monitor on thumb of affected hand.

Hypercoagulation Tests
Laboratory
	INR - MH/WH/JE
		T;N, Routine, spec type = Blood
	Prothrombin Time (PT) - FH
		T;N, Routine, spec type = Diagnostic Blood
		T;N, Routine, spec type = Therapeutic Blood
	CBC with Diff
		T;N, Routine, spec type = Blood
	D-Dimer - MH/WH/JE
		T;N, Routine, spec type = Blood
	D-Dimer Level - FH
		T;N, Routine, spec type = Blood
	Creatinine
		T;N, Routine, spec type = Blood
	Uric Acid
		T;N, Routine, spec type = Blood
	Protein C Functional
		T;N, Routine, spec type = Blood
	Protein S Functional
		T;N, Routine, spec type = Blood
	Anti-Thrombin III Enzymatic (Activity)
		T;N, Routine, spec type = Blood
	Cardiolipin Antibodies IgG and IgM
		T;N, Routine, spec type = Blood
	Factor V Leiden Mutation  (PreAuth Req)
		T;N, Routine, spec type = Blood
	Homocysteine Total
		T;N, Routine, spec type = Blood
	Lupus Anticoagulant Panel
		T;N, Routine, spec type = Blood

*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