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RESEARCH CTL H-37966 RELY-30	

Types:      Research Oncology Treatment, ONCOLOGY SUPPORTIVE CARE
Synonyms:  RESEARCH, CTL, H-37966, H37966, 37966, RELY30, RELY-30, RELY

RELY-30 H-37966	Repeat 1 time	Cycle length: 5 days	Consenting & Labwork	Perform every 1 day x1			Research tolerance: -0/+0 days	Appointment Requests
  	INFUSION APPOINTMENT REQUEST	Interval: --	Occurrences: --			Nursing Orders
  	RESEARCH - HEIGHT AND WEIGHT	Interval: --	Occurrences: --		  	VITAL SIGNS - T/P/R/BP	Interval: --	Occurrences: --		  	PULSE OXIMETRY	Interval: --	Occurrences: --		  	OK TO USE	Interval: --	Occurrences: --		  	ACCESS PORTACATH	Interval: --	Occurrences: --			Labs
  	CBC WITH PLATELET AND DIFFERENTIAL	Interval: --	Occurrences: --		  	COMPREHENSIVE METABOLIC PANEL	Interval: --	Occurrences: --		  	T4, FREE	Interval: --	Occurrences: --		  	THYROID STIMULATING HORMONE	Interval: --	Occurrences: --			Labs
  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --		  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --				Cyclophosphamide / Fludarabine Day #1	Perform every 1 day x1			Research tolerance: -0/+0 days	Appointment Requests
  	ONC INFUSION APPOINTMENT REQUEST 12	Interval: --	Occurrences: --			Nursing Orders
  	MEASURE WEIGHT	Interval: --	Occurrences: --		  	VITAL SIGNS - T/P/R/BP	Interval: --	Occurrences: --		  	PULSE OXIMETRY	Interval: --	Occurrences: --		  	OK TO USE	Interval: --	Occurrences: --		  	ACCESS PORTACATH	Interval: --	Occurrences: --			Nursing Orders
  	ONC NURSING COMMUNICATION 80	Interval: --	Occurrences: --	Comments:	Please see separate Cyclophosphamide and Fludarabine orders
				Cyclophosphamide / Fludarabine Day #2	Perform every 1 day x1			Research tolerance: -0/+0 days	Appointment Requests
  	ONC INFUSION APPOINTMENT REQUEST 12	Interval: --	Occurrences: --			Nursing Orders
  	MEASURE WEIGHT	Interval: --	Occurrences: --		  	VITAL SIGNS - T/P/R/BP	Interval: --	Occurrences: --		  	PULSE OXIMETRY	Interval: --	Occurrences: --		  	OK TO USE	Interval: --	Occurrences: --		  	ACCESS PORTACATH	Interval: --	Occurrences: --			Nursing Orders
  	ONC NURSING COMMUNICATION 80	Interval: --	Occurrences: --	Comments:	Please see separate Cyclophosphamide and Fludarabine orders
				Cyclophosphamide / Fludarabine Day #3	Perform every 1 day x1			Research tolerance: -0/+0 days	Appointment Requests
  	ONC INFUSION APPOINTMENT REQUEST 12	Interval: --	Occurrences: --			Nursing Orders
  	MEASURE WEIGHT	Interval: --	Occurrences: --		  	VITAL SIGNS - T/P/R/BP	Interval: --	Occurrences: --		  	PULSE OXIMETRY	Interval: --	Occurrences: --		  	OK TO USE	Interval: --	Occurrences: --		  	ACCESS PORTACATH	Interval: --	Occurrences: --			Nursing Orders
  	ONC NURSING COMMUNICATION 80	Interval: --	Occurrences: --	Comments:	Please see separate Cyclophosphamide and Fludarabine orders
				ATL Infusion	Perform every 1 day x1			Research tolerance: -0/+0 days	Appointment Requests
  	INFUSION APPOINTMENT REQUEST	Interval: --	Occurrences: --			Nursing Orders
  	MEASURE WEIGHT	Interval: --	Occurrences: --		  	VITAL SIGNS - T/P/R/BP	Interval: --	Occurrences: --	Comments:	(Include breath sounds) Pre-Infusion, During Infusion, and Post Infusion. 

Following Post Infusion: Monitor Every 30 minutes x 4, Then Every 1 hour x 1.

Total monitoring period is 3 hours.
		  	RESEARCH -  PULSE OXIMETRY	Interval: --	Occurrences: --	Comments:	Continuous Pulse Oximetry during and post-infusion
		  	INSERT PERIPHERAL IV OR ACCESS PORTACATH	Interval: --	Occurrences: --	Comments:	Start peripheral IV, if no central line. Use 3-way stopcock and tubing.
		  	RESEARCH - SUPPLIES/KIT TO BEDSIDE	Interval: --	Occurrences: --	Comments:	Must be at bedside prior to infusion: Oxygen and suction set up, normal saline flushes, red caps, and syringes with needles (1mL and 3 mL).
		  	RESEARCH - ASSESS	Interval: --	Occurrences: --	Comments:	Patient for immediate reactions: 1) Allergic reactions (anaphylaxis) 2) Decreased oxygenation (due to migration of lymphocytes to lungs).
			Labs
  	C-REACTIVE PROTEIN	Interval: --	Occurrences: --	Comments:	To be completed PRIOR to infusion.
			Labs
  	CBC WITH PLATELET AND DIFFERENTIAL	Interval: --	Occurrences: --		  	COMPREHENSIVE METABOLIC PANEL	Interval: --	Occurrences: --			Labs
  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --		  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --			Line Care
  	INSERT PERIPHERAL IV OR ACCESS PORTACATH	Interval: --	Occurrences: --		  	sodium chloride 0.9% flush 20 mL	Dose: 20 mL	Route: intravenous	PRN	Start: S					Hydration
  	sodium chloride 0.9 % infusion 250 mL	Dose: 250 mL	Route: intravenous	once @ 30 mL/hr for 1 dose	Start: S			Instructions:	To keep vein open			Pre-Medications
  	acetaminophen (TYLENOL) tablet 650 mg	Dose: 650 mg	Route: oral	once for 1 dose			Offset: 0 Hours	Instructions:	Give 30 minutes prior to product administration.		  	diphenhydrAMINE (BENADRYL) injection 25 mg	Dose: 25 mg	Route: intravenous	once for 1 dose			Offset: 0 Hours	Instructions:	Give 30 minutes prior to product administration.			Nursing Orders
  	ONC NURSING COMMUNICATION 100	Interval: --	Occurrences: --	Comments:	Cells to be administered by physician (generally by syringe injection with 0.9% Normal Saline flush)

Verify cell dose and patient information on Component Infusion Form. Record infusion start and stop time on form and place in patient's medical record.

Clinic nurse to remain at bedside during the entire infusion

Ensure informed consent is obtained
			Labs
  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --			Emergency Medications
  	TRANSFUSION REACTION EVALUATION	Interval: Once	Occurrences: --	Comments:	Emergency Medications: Anaphylactic precautions: Keep medications at the bedside to administer per physician's orders.
		  	diphenhydrAMINE (BENADRYL) injection 50 mg	Dose: 50 mg	Route: intravenous	once PRN	Start: S			Instructions:	Keep at the bedside to administer per physician's orders.		  	hydrocortisone sodium succinate (Solu-CORTEF) injection 250 mg	Dose: 250 mg	Route: intravenous	once PRN	Start: S			Instructions:	Keep at the bedside to administer per physician's orders.		  	epINEPHrine (ADRENALIN) 1 mg/1 mL injection 0.3 mg	Dose: 0.3 mg	Route: subcutaneous	once PRN	Start: S			Instructions:	Keep at the bedside to administer per physician's orders.			Discharge Nursing Orders
☑	sodium chloride 0.9 % flush 20 mL	Dose: 20 mL	Route: intravenous	PRN					☑	HEParin, porcine (PF) injection 500 Units	Dose: 500 Units	Route: intra-catheter	once PRN	Start: S			Instructions:	Concentration: 100 units/mL. Heparin flush for Implanted Vascular Access Device maintenance.			Discharge Nursing Orders
  	ONC NURSING COMMUNICATION 76	Interval: --	Occurrences: --	Comments:	Discontinue IV post monitoring period