Unique Plan Description: Subphase - Anesthesia Adult Perioperative
Plan Selection Display: Subphase - Anesthesia Adult Perioperative
PlanType: Medical
Version: 2
Begin Effective Date: 12/31/2100 12:00 AM
End Effective Date: Current
Available at:	MMC

Subphase - Anesthesia Adult Perioperative     
Patient Care
   	IV Fluids (Specify-nsg)
    Nurse may administer 250 mL bolus of 0.9% NaCl/LR/Normosol IV infusion PRN symptomatic hypotension of SBP < 100 mmHg., If ineffective, give appropriate vasopressive agent see PRN phenylephrine and ephedrine orders.  Use Protocol 086.G005 to determine IV s
Medications
Shivering in PACU
   	ANESTHESIA ONLY - Meperidine IVPush (POST-OP)
    12.5 mg, IVPush, Inject, q5min, PRN Shivering, NOW, 2 dose/occurrence
 Comments: POST-OP
Antihypertensives
   	ANESTHESIA ONLY - Labetalol IVPush (POST-OP)
    5 mg, IVPush, Inject, q5min, PRN Hypertension, NOW
 Comments: For Hypertension - if Heart Rate greater than 60.May give up to 40 mg. POST-OP
   	ANESTHESIA ONLY- HydrALAZINE IVPush (POST-OP)
    2.5 mg, IVPush, Inject, q10min, PRN Hypertension, NOW
 Comments: For Hypertension if Heart Rate less than 60. May give up to 20 mg. POST-OP
Hypotension
   	ANESTHESIA ONLY - Ephedrine IVPush (PRE-OP and POST-OP)
    5 mg, IVPush, Syringe, q5min, PRN Hypotension, NOW
 Comments: For symptomatic hypotension of SBP <100 mmHg - if HR <60 BPM and not responsive to fluid bolus.  May give up to 25 mg of Ephedrine.  See IV Fluids (Specify-nsg) fluid bolus order.  If SBP remains <100 mmHg, contact anesthesia provider. PRE-OP &  POST-OP
   	ANESTHESIA ONLY - Phenylephrine IVPush (POST-OP)
    100 mcg, IVPush, Inject, q5min, PRN Hypotension, NOW
 Comments: For symptomatic hypotension of SBP <100 mmHg - If heart rate > 60 BPM and not responsive to fluid bolus.  May give up to 500 mcg of Phenylephrine.  See IV Fluids (Specify-nsg) fluid bolus order.  If SBP remains < 100 mmHg, contact anesthesia provider. POST-OP
   	ANESTHESIA ONLY - Atropine IVPush (PRE-OP and POST-OP)
    0.5 mg, IVPush, Inject, q5min, PRN Hypotension, NOW
 Comments: For Hypotension - IF HR less than 40 BPM with SBP < 90 mmHg or 3rd degree AV block. PRE-OP &  POST-OP
Antiemetics
   	ANESTHESIA ONLY - Ondansetron IVPush (POST-OP)
    4 mg, IVPush, Inject, PRN, PRN Nausea and/or Vomiting, NOW, 1 dose/occurrence
 Comments: Give x 1 dose if patient has not received ondansetron in the last 4 hours. If patients has received ondansetron go to promethazine orders. POST-OP
   	ANESTHESIA ONLY - Promethazine IVPush (POST-OP)
    6.25 mg, IVPush, Inject, PRN, PRN Nausea and/or Vomiting, 2 dose/occurrence
 Comments: Give x 1 dose if patient has not received ondansetron in the last 4 hours. If patients has received ondansetron go to promethazine orders. POST-OP
   	ANESTHESIA ONLY - Dexamethasone IVPush (POST-OP)
    10 mg, IVPush, Inject, PRN, PRN Nausea and/or Vomiting, NOW, 1 dose/occurrence
 Comments: Give if no relief from promethazine in 15 minutes or has received promethazine in the last 6 hours and patient has not received dexamethasone. If patient has received dexamethasone go to metoclopramide orders. POST-OP
   	ANESTHESIA ONLY - Metoclopramide IVPush (POST-OP)
    10 mg, IVPush, Inject, PRN, PRN Nausea and/or Vomiting, NOW, 1 dose/occurrence
 Comments: Give if no relief from dexamethasone in 15 minutes or has received dexamethasone and patient has not received metoclopramide.  If no relief in 15 minutes page the float anesthesiologist. POST-OP

*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