{
    "section": "plan",
    "templateSet": "Urinary Frequency",
    "templates": [
        {
            "text": "Labs",
            "template": "{children}",
            "children": [
                {
                    "text": "Serum",
                    "template": "{children}",
                    "children": [
                        {
                            "text": "CBC",
                            "template": "CBC"
                        },
                        {
                            "text": "Metabolic panel, basic (BMP), serum",
                            "template": "Metabolic panel, basic (BMP), serum"
                        },
                        {
                            "text": "Metabolic panel, comprehensive (CMP), serum",
                            "template": "Metabolic panel, comprehensive (CMP), serum"
                        },
                        {
                            "text": "Hemoglobin A1c (HbA1c), blood",
                            "template": "Hemoglobin A1c (HbA1c), blood"
                        },
                        {
                            "text": "TSH (thyroid-stimulating hormone), serum",
                            "template": "TSH (thyroid-stimulating hormone), serum"
                        },
                        {
                            "text": "Thyroxine (T4), free, serum",
                            "template": "Thyroxine (T4), free, serum"
                        },
                        {
                            "text": "Beta-hCG, quantitative, serum",
                            "template": "Beta-hCG, quantitative, serum"
                        }
                    ]
                },
                {
                    "text": "Urine",
                    "template": "{children}",
                    "children": [
                        {
                            "text": "Urinalysis, complete (with micro)",
                            "template": "Urinalysis, complete (with micro)"
                        },
                        {
                            "text": "Urine dipstick for nitrites and leukocyte esterase",
                            "template": "Urine dipstick for nitrites and leukocyte esterase"
                        },
                        {
                            "text": "Culture, urine, bacterial",
                            "template": "Culture, urine, bacterial"
                        },
                        {
                            "text": "Toxicology screen, urine",
                            "template": "Toxicology screen, urine"
                        },
                        {
                            "text": "Electrolytes, urine",
                            "template": "Electrolytes, urine"
                        },
                        {
                            "text": "Osmolality, urine",
                            "template": "Osmolality, urine"
                        },
                        {
                            "text": "Cytology, urine",
                            "template": "Cytology, urine"
                        },
                        {
                            "text": "Beta-hCG, qualitative, urine",
                            "template": "Beta-hCG, qualitative, urine"
                        },
                        {
                            "text": "Neisseria gonorrhoeae (GC), nucleic acid amplification, urine",
                            "template": "Neisseria gonorrhoeae (GC), nucleic acid amplification, urine"
                        },
                        {
                            "text": "Neisseria gonorrhoeae (GC), nucleic acid amplification, urogenital swab",
                            "template": "Neisseria gonorrhoeae (GC), nucleic acid amplification, urogenital swab"
                        },
                        {
                            "text": "Neisseria gonorrhoeae (GC), nucleic acid amplification, rectal swab",
                            "template": "Neisseria gonorrhoeae (GC), nucleic acid amplification, rectal swab"
                        },
                        {
                            "text": "Chlamydia trachomatis, nucleic acid amplification, urine",
                            "template": "Chlamydia trachomatis, nucleic acid amplification, urine"
                        },
                        {
                            "text": "Chlamydia trachomatis, nucleic acid amplification, urogenital swab",
                            "template": "Chlamydia trachomatis, nucleic acid amplification, urogenital swab"
                        },
                        {
                            "text": "Chlamydia trachomatis, nucleic acid amplification, rectal swab",
                            "template": "Chlamydia trachomatis, nucleic acid amplification, rectal swab"
                        }
                    ]
                }
            ]
        },
        {
            "text": "Imaging",
            "template": "{children}",
            "children": [
                {
                    "text": "Imaging",
                    "template": "{children}",
                    "children": [
                        {
                            "text": "X-ray chest, PA and lateral",
                            "template": "X-ray chest, PA and lateral"
                        },
                        {
                            "text": "X-ray abdomen (KUB)",
                            "template": "X-ray abdomen (KUB)"
                        },
                        {
                            "text": "Intravenous pyelogram (IVP)",
                            "template": "Intravenous pyelogram (IVP)"
                        },
                        {
                            "text": "CT abdomen and pelvis w\/ contrast",
                            "template": "CT abdomen and pelvis w\/ contrast"
                        },
                        {
                            "text": "CT abdomen and pelvis w\/o contrast",
                            "template": "CT abdomen and pelvis w\/o contrast"
                        },
                        {
                            "text": "US renal and bladder",
                            "template": "US renal and bladder"
                        },
                        {
                            "text": "US bladder",
                            "template": "US bladder"
                        },
                        {
                            "text": "US urethra",
                            "template": "US urethra"
                        },
                        {
                            "text": "US renal",
                            "template": "US renal"
                        },
                        {
                            "text": "MRI pelvis w\/ contrast",
                            "template": "MRI pelvis w\/ contrast"
                        },
                        {
                            "text": "MRI pelvis w\/o contrast",
                            "template": "MRI pelvis w\/o contrast"
                        },
                        {
                            "text": "MRI pituitary and hypothalamus",
                            "template": "MRI pituitary and hypothalamus"
                        }
                    ]
                }
            ]
        },
        {
            "text": "Procedures",
            "template": "{children}",
            "children": [
                {
                    "text": "Procedures",
                    "template": "{children}",
                    "children": [
                        {
                            "text": "Post-void residual by ultrasound",
                            "template": "Post-void residual by ultrasound"
                        },
                        {
                            "text": "Post-void residual by catheter",
                            "template": "Post-void residual by catheter"
                        },
                        {
                            "text": "Urodynamic testing",
                            "template": "Urodynamic testing"
                        },
                        {
                            "text": "Cystoscopy",
                            "template": "Cystoscopy"
                        },
                        {
                            "text": "24-hour urine collection",
                            "template": "24-hour urine collection"
                        }
                    ]
                }
            ]
        },
        {
            "text": "Medications",
            "template": "{children}",
            "children": [
                {
                    "text": "Antispasmodics",
                    "template": "{children}",
                    "children": [
                        {
                            "text": "oxybutynin 5 mg tab",
                            "template": "oxybutynin 5 mg tab"
                        },
                        {
                            "text": "oxybutynin 5 mg ER tab",
                            "template": "oxybutynin 5 mg ER tab"
                        },
                        {
                            "text": "trospium 20 mg tab",
                            "template": "trospium 20 mg tab"
                        },
                        {
                            "text": "Detrol 2 mg tab",
                            "template": "Detrol 2 mg tab"
                        },
                        {
                            "text": "Detrol LA 4 mg ER cap",
                            "template": "Detrol LA 4 mg ER cap"
                        },
                        {
                            "text": "Enablex 7.5 mg ER tab",
                            "template": "Enablex 7.5 mg ER tab"
                        },
                        {
                            "text": "Toviaz 4 mg ER tab",
                            "template": "Toviaz 4 mg ER tab"
                        },
                        {
                            "text": "Vesicare 5 mg tab",
                            "template": "Vesicare 5 mg tab"
                        }
                    ]
                },
                {
                    "text": "Estrogen supplementation",
                    "template": "{children}",
                    "children": [
                        {
                            "text": "Estring 2 mg ring",
                            "template": "Estring 2 mg ring"
                        },
                        {
                            "text": "EstroGel 0.06% gel",
                            "template": "EstroGel 0.06% gel"
                        }
                    ]
                }
            ]
        },
        {
            "text": "Patient instructions",
            "template": "{children}",
            "children": [
                {
                    "text": "Medication-related",
                    "template": "{children}",
                    "children": [
                        {
                            "text": "Stop taking offending medications",
                            "template": "Stop taking offending medications"
                        }
                    ]
                },
                {
                    "text": "Overactive bladder",
                    "template": "{children}",
                    "children": [
                        {
                            "text": "Bladder training instructions given (scheduled voiding\/urge suppression)",
                            "template": "Bladder training instructions given (scheduled voiding\/urge suppression)"
                        },
                        {
                            "text": "Pelvic floor muscle strengthening techniques given (Kegel exercises)",
                            "template": "Pelvic floor muscle strengthening techniques given (Kegel exercises)"
                        },
                        {
                            "text": "Avoid exacerbating foods (carbonated drinks, aspartame, spicy food, caffeine,\n                                citrus)\n                            ",
                            "template": "Avoid exacerbating foods (carbonated drinks, aspartame, spicy food, caffeine,\n                                citrus)\n                            "
                        },
                        {
                            "text": "Restrict fluids after 6 p.m. to improve nocturia",
                            "template": "Restrict fluids after 6 p.m. to improve nocturia"
                        }
                    ]
                },
                {
                    "text": "Psychogenic polydipsia",
                    "template": "{children}",
                    "children": [
                        {
                            "text": "Restrict free water intake to 1.5 L\/day",
                            "template": "Restrict free water intake to 1.5 L\/day"
                        },
                        {
                            "text": "Consider cognitive behavioral therapy",
                            "template": "Consider cognitive behavioral therapy"
                        }
                    ]
                }
            ]
        },
        {
            "text": "Follow-up, Referrals",
            "template": "{children}",
            "children": [
                {
                    "text": "Return visits",
                    "template": "{children}",
                    "children": [
                        {
                            "text": "Return visit as needed",
                            "template": "Return visit as needed"
                        },
                        {
                            "text": "Return visit in 24 hours",
                            "template": "Return visit in 24 hours"
                        },
                        {
                            "text": "Return visit in 3-5 days",
                            "template": "Return visit in 3-5 days"
                        },
                        {
                            "text": "Return visit in 5-7 days",
                            "template": "Return visit in 5-7 days"
                        },
                        {
                            "text": "Return visit in 7-10 days",
                            "template": "Return visit in 7-10 days"
                        },
                        {
                            "text": "Return visit in 2 weeks",
                            "template": "Return visit in 2 weeks"
                        },
                        {
                            "text": "Return visit in 3 weeks",
                            "template": "Return visit in 3 weeks"
                        },
                        {
                            "text": "Return visit in 4 weeks",
                            "template": "Return visit in 4 weeks"
                        },
                        {
                            "text": "Return visit in 6 months",
                            "template": "Return visit in 6 months"
                        },
                        {
                            "text": "Phone follow-up as needed",
                            "template": "Phone follow-up as needed"
                        }
                    ]
                },
                {
                    "text": "Admit to ER\/inpatient care",
                    "template": "{children}",
                    "children": [
                        {
                            "text": "Admit to ER",
                            "template": "Admit to ER"
                        },
                        {
                            "text": "Admit to hospital",
                            "template": "Admit to hospital"
                        }
                    ]
                },
                {
                    "text": "Referrals",
                    "template": "{children}",
                    "children": [
                        {
                            "text": "Refer to Endocrinology",
                            "template": "Refer to Endocrinology"
                        },
                        {
                            "text": "Refer to OB\/Gyn",
                            "template": "Refer to OB\/Gyn"
                        },
                        {
                            "text": "Refer to Psychiatry",
                            "template": "Refer to Psychiatry"
                        },
                        {
                            "text": "Refer to Psychology",
                            "template": "Refer to Psychology"
                        },
                        {
                            "text": "Refer to Urology",
                            "template": "Refer to Urology"
                        }
                    ]
                }
            ]
        }
    ]
}