Unique Plan Description: Pulm Tunneled Pleural Catheter
Plan Selection Display: Pulm Tunneled Pleural Catheter
PlanType: Medical                                 
Version: 1          
Begin Effective Date: 2026-01-20 08:16:00
End Effective Date: 2100-12-31 00:00:00
Last Updated Date: 2026-01-20 08:17:24
Available at all facilities: No

Pulm Tunneled Pleural Catheter Preop
Admit/Discharge/Transfer
	Admit to Observation Status
		T;N
	Admit to Inpatient Status
		T;N, Anticipated LOS 2 midnight or more
Diet
	NPO
		T;N, After Midnight
Laboratory
	Basic Metabolic Panel
		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
	CBC with Diff
		T;N, Stat, spec type = Blood
	Comprehensive Metabolic Panel
		T;N, Stat, spec type = Blood
	INR - MH/WH/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
	PTT - MH/WH/JE
		T;N, Stat, spec type = Blood
	Partial Thromboplastin Time (PTT) - FH
		T;N, Stat, spec type = Diagnostic Blood
	Magnesium Level
		T;N, Stat, spec type = Blood
	Platelet Function Assay - MH/WH/JE
		T;N, Stat, spec type = Blood
	Anti-Factor Xa LMWH Lovenox
		T;N, Routine, spec type = Blood
Diagnostic Tests
	ECG
		T;N, Stat, Indication: Pre-op Release, DO NOT repeat if done within 2 weeks
Radiology
	Chest 1 View
		T;N, Stat, Pleural Effusion
IV Solutions

	Dextrose 5% in Water
		1,000 mL, IV, 40 ml/hr
	Dextrose 5% with 0.45% NaCl
		1,000 mL, IV, 40 ml/hr
	Dextrose 5% in Lactated Ringers
		1,000 mL, IV, 40 ml/hr
	Dextrose 5% with 0.9% NaCl
		1,000 mL, IV, 40 ml/hr
Medications
	Ancef IVPB
		1,000 mg, Injection-Premix, IVPB, PREOP, Indication: Surgical prophylaxis, T;N
			Comment: to be given within 60 minutes prior to insertion
	Ancef IVPB (FH)
		1,000 mg, INT, IVPB, PREOP, Indication: Surgical prophylaxis, T;N
			Comment: to be given within 60 minutes prior to insertion
	Cleocin IVPB
		600 mg, Injection-Premix, IVPB, PREOP, Indication: Surgical prophylaxis, T;N
			Comment: to be given within 60 minutes prior to insertion
	Unasyn IVPB
		3,000 mg, Injection-Premix, IVPB, PREOP, Indication: Surgical prophylaxis, T;N
			Comment: to be given within 60 minutes prior to insertion
	Unasyn IVPB (FH)
		3,000 mg, INT, IVPB, PREOP, Indication: Surgical prophylaxis, T;N
			Comment: to be given within 60 minutes prior to insertion
	vancomycin IVPB
		15 mg/kg, Injection-Premix, IVPB, PREOP, Indication: Surgical prophylaxis, T;N
	vancomycin IVPB (FH)
		15 mg/kg, INT, IVPB, PREOP, Indication: Surgical prophylaxis, T;N
			Comment: to be given within 60 minutes prior to insertion
Patient Care
	Obtain Consent/Permit for:
		T;N, Right tunneled pleural catheter insertion under moderate sedation
		T;N, Left tunneled pleural catheter insertion under moderate sedation
		T;N, Bilateral tunneled pleural catheter insertion under moderate sedation
	Isolation Precautions
		T;N

Pulm Tunneled Pleural Catheter Post Op
Admit/Discharge/Transfer
	Discharge Conditional
		Conditions to be met: Vital signs stable, weaned from oxygen if not chronic, and able to swallow. Call when discharge conditions met., T;N
Vital Signs
	Vital Signs
		T;N, Q15MIN, 4, Dose(s)/Time(s)
		T;N+60, Q30MIN, 2, Dose(s)/Time(s)
		T;N+120, Q1H, 2, Dose(s)/Time(s)
		T;N+240, Q4H
Diet
	NPO
		T;N, Until gag reflex returns
Diagnostic Tests
Radiology
	Chest 1 View
		T;N, Stat, Post Op F/U
			Comment: Pt in PACU
Medications

	acetaminophen
		1,000 mg, Tab, By Mouth, Q6H, PRN pain-mild
	oxyCODONE
		5 mg, Tab, By Mouth, Q4H, PRN pain-moderate
	HYDROmorphone Injectable
		0.4 mg, Injection, IV Push, Q4H, PRN pain-severe
	albuterol-ipratropium 2.5 mg-0.5 mg/3 mL inhalation solution
		3 mL, Solution-Nebulization, NEBULIZED, Once, STAT
	albuterol 2.5 mg/3 mL (0.083%) inh soln
		3 mL, Solution-Nebulization, NEBULIZED, Once, T;N
			Comment: If on Spiriva at home
Patient Care
	Notify MD
		T;N, pulse >130 or <60, respirations >32 or <8, BP systolic >180 or <90, oxygen saturation <90% If FIO2 >50%, or oxygen saturation <90%
	Bladder Scan
		T;N, PRN, unable to void
Therapies
	Oxygen Set Up-MH/JE
		T;N, Stat
			Comment: Orders per Respiratory Protocol
	Oxygen Therapy
		T;N, Via Nasal Cannula, Titrate/wean to keep: > or = to 90%
			Comment: Orders per Respiratory Protocol
	Pulse Oximetry Spot Check RT
		T;N, Keep Sats >/= (%): 90%, BID, 1, Dose(s)/Time(s), Up walking on room air prior to discharge.
	Continuous Pulse Oximetry Monitoring Check
		T;N, BID
	End Tidal CO2 (ETCO2) Monitoring in PACU
		T;N, Chart with Vital Signs

*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