Day of Surgery Standing Orders

PLACE LABEL HERE

DAY OF SURGERY

STANDING ORDERS

Nurse initiated standing order based on medical staff approved policy (6602-01 and 6602-02).

Orders with a “q” are indicator choices and are NOT implemented unless checked. Initial bottom of each page.

1. Initiate bundle (Colon / Hysterectomy / Orthopedic) as indicated by surgical procedure

DIAGNOSTICS:

2. Urine or serum hCG within 4 days of surgery for all menstruating females ≥ 12 yrs

3. If patient is diabetic, obtain blood glucose level and initiate Perioperative Blood Glucose Control Orders (form # 21383)

IV START & IV FLUIDS:

4. May use Xylocaine (lidocaine) 0.5%, 0.1-0.5 ml for intradermal injection or lidocaine 4% cream transdermal to start IV

5. IVF: LR 1,000 ml, administer 500 ml bolus then KVO

or q If patient is < 45 kg &/or eye surgery &/or had IV fluids overnight, use LR 500 ml at KVO

or q If patient has renal insufficiency (GFR <40), use NS 500 ml at KVO

6. For thoracic, bariatric, prostate, and GYN robotic surgery patients:

Start 2nd IV, LR 1,000 ml KVO

Type, screen and HOLD 2 units packed cells

7. For Craniotomy surgery patients:

Start IV, NS 1,000 ml at KVO

_______ _______ _________________________ _________________________ ___________

Date Time Nurse Signature Physician Signature PID Number

Copy to pharmacy

*1-35050* FORM 1-35050 REV. 11/2017 Page 1 of 1