Unique Plan Description: OB Inpatient Methotrexate Ectopic (WHJE)
Plan Selection Display: OB Inpatient Methotrexate Ectopic (WHJE)
PlanType: Medical                                 
Version: 1          
Begin Effective Date: 2021-11-15 10:59:42
End Effective Date: 2100-12-31 00:00:00
Last Updated Date: 2021-12-21 10:22:47
Available at all facilities: Yes

OB Inpatient Methotrexate Ectopic (WHJE)
Laboratory
	Type and Screen (No Product on hold)
		Stat, spec type = Blood
	Comprehensive Metabolic Panel
		Stat, spec type = Blood
	CBC with Diff
		Stat, spec type = Blood
	Beta-HCG Quantitative - Pregnancy
		T;N, Stat, spec type = Blood
	Kleihauer-Betke
		Stat, spec type = Blood
	Rhogam Workup
		T;N, Stat, spec type = Blood
Diagnostic Tests
	US OB Transvaginal 1st Trimester
		Stat, Pelvic Pain
	US OB Transvaginal
		Stat, Pelvic Pain
Medications
	methotrexate
		50 mg/m2, Injection, IM-Intramuscular, Once, T;N
			Comment: If total volume to be administered is over 2.5mL, dose will be split into two separate syringes by pharmacy.
	Rho (D) immune globulin 1500 intl units (300mcg)
		1,500 intl_units, Solution, IM-Intramuscular, Once, STAT
			Comment: 1500 intl units = 300 mcg = 1 Each
Patient Care
	Notify MD
		If ultrasound report not on chart prior to administration
	Hazardous Drug Precautions
		Follow extremely hazardous drug policy/procedure for administration and disposal
	Obtain Consent/Permit for:
		Methotrexate Injection

*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