Unique Plan Description: MH IR Lumbar Puncture, Pre Op
Plan Selection Display: MH IR Lumbar Puncture, Pre Op
PlanType: Medical                                 
Version: 2          
Begin Effective Date: 2025-12-09 09:35:00
End Effective Date: 2100-12-31 00:00:00
Last Updated Date: 2026-01-06 07:10:33
Available at all facilities: Yes

MH IR Lumbar Puncture, Pre Op
Laboratory
	CBC with Diff
		Stat, spec type = Blood
	Comprehensive Metabolic Panel
		T;N, Routine, spec type = Blood
	Glucose Level
		Nurse Collect, T;N, Stat, spec type = Blood
	TSH
		T;N, Routine, spec type = Blood
	Free T4
		T;N, Routine, spec type = Blood
	Folate
		T;N, Routine, spec type = Blood
	Vitamin B1 Whole Blood
		T;N, Routine, spec type = Blood
	Vitamin B6 Assay
		T;N, Routine, spec type = Blood
			Comment: Collect specimen after an overnight fast
	Vitamin B12 Level
		T;N, Routine, spec type = Blood
	Vitamin E Level
		T;N, Routine, spec type = Blood
			Comment: Patient should fast for 12 hours and abstain from alcohol for 24 hours prior to
	Copper Level
		T;N, Routine, spec type = Blood
			Comment: Diet, medication, and nutritional supplements may introduce interfering substances. Patients should be encouraged to discontinue nutritional supplements, vitamins, minerals, and non-essential over-the-counter medications (upon the advice of their physician).
	Angiotensin Converting Enzyme
		T;N, Routine, spec type = Blood
	Protein Electrophoresis Serum w/Reflex to Immunofixation
		T;N, Routine, spec type = Blood
	Methylmalonic Acid
		T;N, Routine, spec type = Blood
	Borrelia burgdorferi(Lyme)Abs Rflx IgM-IgG
		T;N, Routine, spec type = Blood
	Varicella Zoster Virus Antibody IgM
		T;N, Stat, spec type = Blood
	Varicella Zoster Virus IgG
		T;N, Stat, spec type = Blood
	Syphilis Total Antibodies
		T;N, Routine, spec type = Blood
	Acute Hepatitis Panel with Rflx to Hepatitis C Confirm
		T;N, Stat, spec type = Blood
			Comment: For Hepatitis Panel testing, draw 2 separate tubes. If additional testing, draw
	HIV-1/2 Ag/Ab Combo - MH/WH/JE
		T;N, Routine, spec type = Blood
	HTLV I/II Reflex to Confirmation
		T;N, Routine, spec type = Blood
	Myelin Oligo Glyco Ab (MOG) Rflx to Titer
		T;N, Routine, spec type = Blood
	Aquaporin-4 Receptor (NMO) Antibody, IgG With Rflx to Titer
		T;N, Routine, spec type = Blood
	ANA Screen
		T;N, Routine, spec type = Blood
	Protein CSF
		T;N, Stat, spec type = Cerebrospinal Fluid
	Glucose CSF
		T;N, Stat, spec type = Cerebrospinal Fluid
	Cell Count and Diff CSF
		T;N, Stat, spec type = Cerebrospinal Fluid
	Oligoclonal Band Profile
		T;N, Routine, spec type = Blood/CSF
		NOTE: Oligoclonal Band Profile requires both Blood and CSF(NOTE)*
	Unlisted Laboratory Body Fluid Procedure
		T;N, Routine, spec type = Cerebrospinal Fluid, Neuron Specific Enolase
			Comment: ARUP 3004314
	Unlisted Laboratory Procedure
		T;N, Stat, spec type = Cerebrospinal Fluid, NMO IgG CSF (AQP4 Ab IgG RFLX Titer)
			Comment: ARUP 2011699
	ACE CSF
		T;N, Stat, spec type = Cerebrospinal Fluid
	Protein 14-3-3 (CJD)
		Stat, spec type = Cerebrospinal Fluid
			Comment: Immediately call infection control and the lab when this test is ordered, page via hospital operator if necessary.  Specimens must be hand delivered to the lab immediately. Do not send specimens via pneumatic tube system.
	Encephalopathy Autoimmune Evaluation CSF
		T;N, Stat, spec type = Cerebrospinal Fluid
	Culture Routine
		T;N, Stat, spec type = Cerebrospinal Fluid
	Fungal Smear
		T;N, Stat, spec type = Cerebrospinal Fluid
	Culture Fungus
		T;N, Stat, spec type = Cerebrospinal Fluid
	Cryptococcal Antigen CSF
		T;N, Stat, spec type = Cerebrospinal Fluid
	VDRL CSF Reflex to titer
		T;N, spec type = Cerebrospinal Fluid
	Herpes Simplex Virus 1/2 PCR. Other than blood
		T;N, Routine, spec type = Cerebrospinal Fluid
	Epstein Bar Virus DNA PCR Body Fluid
		T;N, Stat, spec type = Cerebrospinal Fluid
	Varicella Zoster DNA Detection other than blood
		T;N, Stat, spec type = Cerebrospinal Fluid
	Enterovirus by PCR
		T;N, Stat, spec type = Cerebrospinal Fluid, Borrelia (LYME) PCR
			Comment: ARUP 005570
	West Nile Virus Ab Panel CSF
		T;N, Stat, spec type = Cerebrospinal Fluid
	Toxoplasma Gondii by PCR
		T;N, Stat, spec type = Cerebrospinal Fluid
	JC Virus PCR
		T;N, Stat, spec type = Cerebrospinal Fluid
		T;N, Stat, spec type = Blood
		T;N, Stat, spec type = Urine
	Unlisted Laboratory Body Fluid Procedure
		T;N, Routine, spec type = Cerebrospinal Fluid
			Comment: HTLV - ½ Ab Screen with Confirmation: Mayo HTLVC, CSF
	Paraneoplastic Eval CSF
		T;N, Stat, spec type = Cerebrospinal Fluid
	Non Gyn Cytology Request
		T;N, Routine, Cytology, CSF, AP Specimen, Routine
	Cell Surface Markers
		T;N, Stat, spec type = Cerebrospinal Fluid
	Unlisted Laboratory Body Fluid Procedure
		T;N, Routine, spec type = Cerebrospinal Fluid, Xanthochromia (Bilirubin, CSF)
			Comment: ARUP 2005248
Patient Care
	Obtain Consent/Permit for:
		T;N, Lumbar puncture
	Obtain supplies/equipment
		T;N, Have at bedside: lumbar puncture tray, betadine, sterile gloves 7 ½ & 8 at bedside
	Discontinue Medication
		T;N, Anticoagulants
	Activity-Position
		Flat, 1, hr
			Comment: Then discharge to home
	Discharge
		T;N, to: Home
			Comment: Call 402-354-2000 with questions

*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