ZOLEDRONIC ACID (ZOMETA) INFUSION		version 2/27/2025		

Appointment Requests 	

	
	Interval	Defer Until	Duration	
	☑	Referral to IV Infusion Room	Every 4 weeks	S	 treatments	
		Status: Future, Expected: S, Expires: S+365, Clinic Performed
	Urgency of Scheduling: Routine		

Provider Communication 	

	
	Interval	Defer Until	Duration	
	☐	Provider communication	Every visit	S	Until discont'd	
		Add Phosphorus and Magnesium in patients with history of hypoparathyroidism, thyroid surgery, parathyroid surgery, malabsorption syndromes, excision of small intestine.		

Labs 	

	
	Interval	Defer Until	Duration	
	☐	Vitamin D 25 hydroxy level	Once	S	1 treatment	
		STAT, Normal, Clinic Collect		
	☐	Basic metabolic panel	Every visit	S	Until discont'd	
		STAT, Normal, Clinic Collect		
	☐	Albumin level	Every visit	S	Until discont'd	
		STAT, Normal, Clinic Collect		
	☐	hCG qualitative, urine screen	Every visit	S	Until discont'd	
		STAT, Normal, Clinic Collect		

Nursing Orders 	

	
	Interval	Defer Until	Duration	
	☐	Insert Peripheral IV or Access Portacath	Every visit	S	Until discont'd	
		No details available for preview		
	☐	Vital signs - T/P/R/BP Per Unit Protocol	Every visit	S	Until discont'd	
		No details available for preview		
	☐	Nursing communication	Every visit	S	Until discont'd	
		o Verify lab results within last 14 days: Serum Ca2+ and Scr. 
	o Notify provider if corrected Ca level is less than or equal to 8.5 or CrCl LESS than 30 mL/min.		
	☐	Nursing communication	Every visit	S	Until discont'd	
		Proceed with treatment prior to Vitamin D resulting.		
	☐	Nursing communication	Every visit	S	Until discont'd	
		Verify patient is on calcium and vitamin D supplementation. Notify provider if the patient is not on calcium and vitamin D supplementation or the patient's calcium level is outside the normal range.		
	☐	Nursing communication: Observe patient for 30 minutes	Every visit	S	Until discont'd	
		No details available for preview		
	☐	Nursing communication: Monitor patient for signs of infusion reaction.  If patient has infusion reaction, stop infusion, notify physician, and administer emergency medications as ordered	Every visit	S	Until discont'd	
		No details available for preview		
	☐	sodium chloride 0.9% flush 10 mL	Every visit	S	Until discont'd	
		10 mL, intravenous, PRN, line care, Starting when released, Until Discontinued		
	☐	sodium chloride 0.9% infusion 250 mL	Every visit	S	Until discont'd	
		250 mL, intravenous, at 30 mL/hr, PRN, Flush bag, Starting when released, Until Discontinued		
	☐	Discontinue IV	Every visit	S	Until discont'd	
		No details available for preview		

Medications 	

	
	Interval	Defer Until	Duration	
	☐	zoledronic acid-mannitol-water (ZOMETA) injection 4 mg	Every 4 weeks	S	Until discont'd	
		4 mg, intravenous, once, Starting when released		

Hypersensitivity 	

	
	Interval	Defer Until	Duration	
	☐	diphenhydrAMINE (BENADRYL) injection 50 mg	PRN	S	Until discont'd	
		50 mg, intravenous, once PRN, for infusion reaction, Starting when released, Until Discontinued		
	☐	epINEPHrine (ADRENALIN) injection 1 mg/mL 0.5 mg	PRN	S	Until discont'd	
		0.5 mL, subcutaneous, PRN, anaphylaxis, Starting when released, for 2 doses		
	☐	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