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DOCTOR S ORDERS CRRT ORDERS WITH NXSTAGE SYSTEM ONE All orders will be implemented as checked off or modified DIALYSIS COMPANY DaVita Liberty MODALITY CVVH PARAMETERS SCUF CRRT Continuous 24 hrs SHIFT THERAPY 6 hrs/day 2 L/hr 30 ml/kg for 70kg pt None SCUF L/hr Therapy Fluid Rate 4 L/hr Ultrafiltration Rate Even Neg ml/hr Neg 250 ml/hr Blood Flow Rate 250-300 ml/min ml/min 300-350 ml/min THERAPY FLUID COMPOSITION with for anticoagulation ANTICOAGULATION NxStage RFP 400 no lactate Bicarbonate 35 mEq/L Potassium 2 mEq/L Sodium 140 mEq/L Calcium 3 mEq/L Magnesium 1 mEq/L Chloride 111 mEq/L Glucose 100 mg/dl None NS flushes as needed per weight-based nomogram ELECTROLYTES Potassium Magnesium Phosphorous Calcium OR units/hr KCI 40 mEq/100 ml NS IV over 2 hrs PRN for K 3. 6 mEq/L Magnesium Sulfate 2 gm/50 ml NS IV over 1 hr PRN for Magnesium 1. 9 mg/dl Na Phosphate 20 mmol/250 ml NS IV over 6 hrs PRN for Phosphorous 2. 5 mg/dl Ca Gluconate 3 gm/100ml D5W IV over 1 hr PRN for ICa / 1. 1 q 8 hrs Chem 7 ICa/Magnesium/Phos OR Patient with pre-filter check PTT/INR daily LABS I/Os q day weights with strict I/Os OR q weights with strict I/Os OTHER Instill 1000 units/ml 10 ml vial preferred per dialysis catheter dwell volume indicated on catheter every 72 hrs or as needed if not being used Instill 4 Citrate 2 ml preferred per dialysis catheter dwell volume indicated on catheter every 72 hrs or as needed if not being used If system fails between 2400-0600 restart ASAP Implement/continue IV Protocol as needed PHYSICIAN SIGNATURE DATE TIME PATIENT LABEL HR-01-123 11/09 1/12 Page 1 of 1. 6 mEq/L Magnesium Sulfate 2 gm/50 ml NS IV over 1 hr PRN for Magnesium 1. 9 mg/dl Na Phosphate 20 mmol/250 ml NS IV over 6 hrs PRN for Phosphorous 2. 5 mg/dl Ca Gluconate 3 gm/100ml D5W IV over 1 hr PRN for ICa / 1. 1 q 8 hrs Chem 7 ICa/Magnesium/Phos OR Patient with pre-filter check PTT/INR daily LABS I/Os q day weights with strict I/Os OR q weights with strict I/Os OTHER Instill 1000 units/ml 10 ml vial preferred per dialysis catheter dwell volume indicated on catheter every 72 hrs or as needed if not being used Instill 4 Citrate 2 ml preferred per dialysis catheter dwell volume indicated on catheter every 72 hrs or as needed if not being used If system fails between 2400-0600 restart ASAP Implement/continue IV Protocol as needed PHYSICIAN SIGNATURE DATE TIME PATIENT LABEL HR-01-123 11/09 1/12 Page 1 of 1.

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