TRANSIENT HEMODIALYSIS THERAPY PLAN		version 6/23/2014		

Dialysis Medications 	

	
	Interval	Defer Until	Duration	
	☐	sodium chloride 0.9 % bolus 100 mL	Every visit	S	Until discont'd	
		100 mL, intravenous, once, Starting when released		

Dialysis Treatment Orders 	

	
	Interval	Defer Until	Duration	
	☐	Hemodialysis inpatient	Every visit	S	Until discont'd	
		Once Starting when released		
	☐	Oxygen therapy - Nasal Cannula; 2 LPM	Every visit	S	Until discont'd	
		Routine, As needed Starting when released Until Specified
	Initial Device: Nasal Cannula
	Initial Rate in liters per minute: 2 LPM		

Dialysis Medications - Heparin (standard) 	

	
	Interval	Defer Until	Duration	
	☐	heparin (porcine) injection 1,000-2,000 Units	Every visit	S	Until discont'd	
		1,000-2,000 Units, intravenous, at 1-2 mL/hr, continuous, Starting when released, for 12 hours		
	☐	heparin (porcine) injection	Every visit	S	Until discont'd	
		1,000-2,000 Units/hr, intravenous, PRN, Starting when released, for 12 hours
	Initial BOLUS to begin hemodialysis		

Dialysis Medications - Heparin (mini dose) 	

	
	Interval	Defer Until	Duration	
	☐	heparin (porcine) injection 500-1,000 Units	Every visit	S	Until discont'd	
		500-1,000 Units, intravenous, PRN, Starting when released, for 12 hours
	Initial BOLUS to begin hemodialyis		
	☐	heparin (porcine) injection	Every visit	S	Until discont'd	
		intravenous, continuous, Starting when released, for 12 hours
	Infusion (mini dose) 500-900 units/hr		

Dialysis Medications PRN 	

	
	Interval	Defer Until	Duration	
	☐	acetaminophen (TYLENOL) tablet 650 mg	PRN	S	Until discont'd	
		650 mg, oral, every 4 hours PRN, mild pain, moderate pain, headaches, Starting when released, for 12 hours
	Maximum of 4 grams of acetaminophen per day from all sources. (Cirrhosis patients maximum: 2 grams per day from all sources).		
	☐	nitroglycerin (NITROSTAT) SL tablet 0.4 mg	PRN	S	Until discont'd	
		0.4 mg, sublingual, every 5 min PRN, chest pain, Starting when released, for 12 hours
	May administer up to 3 doses per episode.
	Sublingual administration ONLY- Do NOT crush, split, chew or swallow.