LONG 10-HOUR IOHEXOL (OMNIPAQUE) CLEARANCE FOR MEASURING GFR		version 3/20/2024		

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		

Treatment Conditions 	

	
	Interval	Defer Until	Duration	
	☐	Provider communication	Once	S	1 treatment	
		o If the patient has ascites, pleural effusion or significant edema (3+ or 4+), use of plasma iohexol clearance for measuring GFR is NOT appropriate. 
	o The LONG (10 hour) protocol is recommended for patients where the GFR is expected to be less than 30 mL/min/1.73 m².		

Nursing Orders 	

	
	Interval	Defer Until	Duration	
	☐	Insert Peripheral IV or Access Portacath	Once	S	1 treatment	
		Insert 2 PIV in contralateral arms. 1 for blood draw and 1 for contrast.		
	☐	sodium chloride 0.9% flush 10 mL	Once	S	1 treatment	
		10 mL, intravenous, PRN, line care, Starting when released, for 10 doses		
	☐	Vital signs - T/P/R/BP	Once	S	1 treatment	
		Clinic Performed, Normal		
	☐	Nursing communication	Once	S	1 treatment	
		If PIV is not drawing blood, use butterfly needle to draw blood instead.		

Discharge Nursing Orders 	

	
	Interval	Defer Until	Duration	
	☐	Discontinue IV	Once	S	1 treatment	
		No details available for preview		

Hypersensitivity 	

	
	Interval	Defer Until	Duration	
	☐	acetaminophen (TYLENOL) tablet 650 mg	PRN	S	Until discont'd	
		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	PRN	S	Until discont'd	
		25 mg, oral, every 6 hours PRN, itching, Starting when released, Until Discontinued		
	☐	diphenhydrAMINE (BENADRYL) injection 25 mg	PRN	S	Until discont'd	
		25 mg, intravenous, once PRN, minor infusion reaction, Starting when released, Until Discontinued		
	☐	diphenhydrAMINE (BENADRYL) injection 50 mg	PRN	S	Until discont'd	
		50 mg, intravenous, once PRN, severe infusion reaction, Starting when released, Until Discontinued		
	☐	epINEPHrine (ADRENALIN) injection 1 mg/mL 0.5 mg	PRN	S	Until discont'd	
		0.5 mg, subcutaneous, once PRN, anaphylaxis, Starting when released, Until Discontinued		
	☐	hydrocortisone sodium succinate (Solu-CORTEF) injection 100 mg	PRN	S	Until discont'd	
		100 mg, intravenous, once PRN, for infusion reaction, Starting when released, Until Discontinued		
	☐	promethazine (PHENERGAN) tablet 25 mg	PRN	S	Until discont'd	
		25 mg, oral, every 6 hours PRN, nausea, vomiting, Starting when released, Until Discontinued		
	☐	sodium chloride 0.9% infusion 250 mL	PRN	S	Until discont'd	
		250 mL, intravenous, once PRN, hydration, Starting when released, Until Discontinued		

Pre Infusion Lab 	

	
	Interval	Defer Until	Duration	
	☐	Basic metabolic panel	Once	S	1 treatment	
		Routine, Normal, Clinic Collect		
	☐	Cystatin C with eGFR	Once	S	1 treatment	
		Routine, Normal, Clinic Collect		

Medications 	

	
	Interval	Defer Until	Duration	
	☐	iohexoL (OMNIPAQUE) 300 mg iodine/mL 5 mL	Once	S	1 treatment	
		5 mL, intravenous, once, Starting when released
	Draw up 5 mL of Omnipaque into plastic syringe just prior to use. Do not use solution if particulates or discoloration of solution is present. No filter is required for infusion. Slowly, but within 2 minutes, inject 5 mL of Omnipaque (300 mg iodine/mL). Then flush with 10 mL of normal saline. Zero time is at the end of the bolus infusion.		

Labs 	

	
	Interval	Defer Until	Duration	
	☐	Extended iohexol clearance, serum	Once	S	1 treatment	
		STAT, Normal, Clinic Collect
	Zero time is at the end of the iohexol bolus. 
	Draw blood at: 240 minutes. 
	Draw blood at: 120 minutes. 
	Draw blood at: 600 minutes (10 hours).