DESMOPRESSIN STIMULATION TEST		version 4/11/2023		

Appointment Requests 	

	
	Interval	Defer Until	Duration	
	☑	Referral to IV Infusion Room	Once	S	1 treatment	
		Status: Future, Expected: S, Expires: S+365, Clinic Performed
	Urgency of Scheduling: Routine		

Nursing Orders 	

	
	Interval	Defer Until	Duration	
	☐	Nursing communication	Once	S	1 treatment	
		Ensure patient fasts from midnight.		
	☐	Insert Peripheral IV or Access Portacath	Once	S	1 treatment	
		No details available for preview		
	☐	sodium chloride 0.9% flush 10 mL	Once	S	1 treatment	
		10 mL, intravenous, PRN, line care, Starting when released, for 10 doses		
	☐	sodium chloride 0.9% infusion 250 mL	Once	S	1 treatment	
		250 mL, intravenous, at 30 mL/hr, PRN, Flush bag, Starting when released, Until Discontinued		
	☐	HEParin, porcine injection 500 Units	Once	S	1 treatment	
		500 Units, intra-catheter, once PRN, line care, Starting when released, Until Discontinued
	Heparin flush for Implanted Vascular Access Device Maintenance.		
	☐	Discontinue IV	Once	S	1 treatment	
		No details available for preview		

Pre-Injection 	

	
	Interval	Defer Until	Duration	
	☐	Weigh patient	Once	S	1 treatment	
		Clinic Performed, Normal
	And document		

Labs 	

	
	Interval	Defer Until	Duration	
	☐	Nursing communication	Once	S	1 treatment	
		MARK collection tubes with the following:
	1. Patient's name; 
	2. Date of test; 
	3. Time point (i.e. time=0, +15, etc.); 
	4. Actual clock time sample was collected.		
	☐	Nursing communication	Once	S	1 treatment	
		o Place each ACTH sample on ice and send to lab immediately. If arrives to lab past 2 hrs. from the draw, it will be discarded. 
	o Cortisol samples may be saved on unit and sent at one time at end of test.		

Baseline 	

	
	Interval	Defer Until	Duration	
	☐	Cortisol level, random	Once	S	1 treatment	
		STAT, Normal, Clinic Collect
	Obtain at 15 min before the test begins.		
	☐	Adrenocorticotropic hormone	Once	S	1 treatment	
		Routine, Normal, Clinic Collect
	Obtain at 15 min before the test begins.		

Medications 	

	
	Interval	Defer Until	Duration	
	☐	desmopressin (DDAVP) injection 10 mcg	Once	S	1 treatment	
		10 mcg, intravenous, once, Starting when released		

At 15 Minutes 	

	
	Interval	Defer Until	Duration	
	☐	Cortisol level, random	Once	S	1 treatment	
		STAT, Normal, Clinic Collect
	Check at 15 minutes POST DDAVP injection / stimulation.		
	☐	Adrenocorticotropic hormone	Once	S	1 treatment	
		Routine, Normal, Clinic Collect
	Check at 15 minutes POST DDAVP injection / stimulation.		

At 30 Minutes 	

	
	Interval	Defer Until	Duration	
	☐	Cortisol, 30 minutes	Once	S	1 treatment	
		STAT, Normal, Clinic Collect
	Check at 30 minutes POST DDAVP injection / stimulation.		
	☐	Adrenocorticotropic hormone	Once	S	1 treatment	
		Routine, Normal, Clinic Collect
	Check at 30 minutes POST DDAVP injection / stimulation.		

At 45 Minutes 	

	
	Interval	Defer Until	Duration	
	☐	Cortisol level, random	Once	S	1 treatment	
		STAT, Normal, Lab Collect
	Check at 45 minutes POST DDAVP injection / stimulation.		
	☐	Adrenocorticotropic hormone	Once	S	1 treatment	
		Routine, Normal, Clinic Collect
	Check at 45 minutes POST DDAVP injection / stimulation.		

At 60 Minutes 	

	
	Interval	Defer Until	Duration	
	☐	Cortisol, 60 minutes	Once	S	1 treatment	
		STAT, Normal, Clinic Collect
	Check at 60 minutes POST DDAVP injection / stimulation.		
	☐	Adrenocorticotropic hormone	Once	S	1 treatment	
		Routine, Normal, Clinic Collect
	Check at 60 minutes POST DDAVP injection / stimulation.		

At 90 Minute 	

	
	Interval	Defer Until	Duration	
	☐	Cortisol level, random	Once	S	1 treatment	
		STAT, Normal, Clinic Collect
	Checked at 90 minutes POST DDAVP injection / stimulation.		
	☐	Adrenocorticotropic hormone	Once	S	1 treatment	
		Routine, Normal, Clinic Collect
	Check at 90 minutes POST DDAVP injection / stimulation.		

At 120 Minutes 	

	
	Interval	Defer Until	Duration	
	☐	Cortisol level, random	Once	S	1 treatment	
		STAT, Normal, Clinic Collect
	Check at 120 minutes POST DDAVP injection / stimulation.		
	☐	Adrenocorticotropic hormone	Once	S	1 treatment	
		Routine, Normal, Clinic Collect
	Check at 120 minutes POST DDAVP injection / stimulation.		

Hypersensitivity 	

	
	Interval	Defer Until	Duration	
	☐	acetaminophen (TYLENOL) tablet 650 mg	Once	S	1 treatment	
		650 mg, oral, every 4 hours PRN, mild pain (score 1-3), Starting when released, Until Discontinued
	Maximum of 4 grams of acetaminophen per day from all sources. (Cirrhosis patients maximum: 2 grams per day from all sources).		
	☐	diphenhydrAMINE (BENADRYL) tablet 25 mg	Once	S	1 treatment	
		25 mg, oral, every 6 hours PRN, itching, Starting when released, Until Discontinued		
	☐	diphenhydrAMINE (BENADRYL) injection 25 mg	Once	S	1 treatment	
		25 mg, intravenous, once PRN, for minor infusion reaction, Starting when released, Until Discontinued		
	☐	diphenhydrAMINE (BENADRYL) injection 50 mg	Once	S	1 treatment	
		50 mg, intravenous, once PRN, for severe infusion reaction, Starting when released, Until Discontinued		
	☐	epINEPHrine (ADRENALIN) injection 1 mg/mL 0.5 mg	Once	S	1 treatment	
		0.5 mL, subcutaneous, once PRN, anaphylaxis, Starting when released, Until Discontinued		
	☐	hydrocortisone sodium succinate (Solu-CORTEF) injection 100 mg	Once	S	1 treatment	
		100 mg, intravenous, once PRN, for infusion reaction, Starting when released, Until Discontinued		
	☐	promethazine (PHENERGAN) tablet 25 mg	Once	S	1 treatment	
		25 mg, oral, every 6 hours PRN, nausea, vomiting, Starting when released, Until Discontinued		
	☐	sodium chloride 0.9% infusion 250 mL	Once	S	1 treatment	
		250 mL, intravenous, once PRN, Hydration, Starting when released, Until Discontinued		

Discharge Nursing Orders 	

	
	Interval	Defer Until	Duration	
	☐	Nursing communication	Once	S	1 treatment	
		Advise patient to restrict fluid intake to one liter / 1000 ml for 48 hr POST test.