{
    "section": "plan",
    "templateSet": "Postpartum Visit",
    "templates": [
        {
            "text": "Ordered Labs",
            "template": "Ordered Labs{children}",
            "children": [
                {
                    "text": "Blood Chemistry\/Hematology",
                    "template": "{children}",
                    "children": [
                        {
                            "text": "Beta-hCG, qualitative, serum",
                            "template": "Beta-hCG, qualitative, serum"
                        },
                        {
                            "text": "CBC",
                            "template": "CBC"
                        },
                        {
                            "text": "Glucose, fingerstick",
                            "template": "Glucose, fingerstick"
                        },
                        {
                            "text": "Glucose, fasting, plasma",
                            "template": "Glucose, fasting, plasma"
                        },
                        {
                            "text": "Hemoglobin A1c (HbA1c), blood",
                            "template": "Hemoglobin A1c (HbA1c), blood"
                        },
                        {
                            "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": "Urine tests",
                    "template": "{children}",
                    "children": [
                        {
                            "text": "Beta-hCG, qualitative, urine",
                            "template": "Beta-hCG, qualitative, urine"
                        },
                        {
                            "text": "Culture, urine, bacterial",
                            "template": "Culture, urine, bacterial"
                        },
                        {
                            "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": "Ordered Imaging",
            "template": "Ordered Imaging{children}",
            "children": [
                {
                    "text": "CT",
                    "template": "{children}",
                    "children": [
                        {
                            "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": "MRI",
                    "template": "{children}",
                    "children": [
                        {
                            "text": "MRI pelvis w\/ contrast",
                            "template": "MRI pelvis w\/ contrast"
                        },
                        {
                            "text": "MRI pelvis w\/o contrast",
                            "template": "MRI pelvis w\/o contrast"
                        }
                    ]
                },
                {
                    "text": "Plain Films",
                    "template": "{children}",
                    "children": [
                        {
                            "text": "X-ray abdomen (KUB)",
                            "template": "X-ray abdomen (KUB)"
                        }
                    ]
                },
                {
                    "text": "Ultrasound",
                    "template": "{children}",
                    "children": [
                        {
                            "text": "US bladder",
                            "template": "US bladder"
                        },
                        {
                            "text": "US pelvis",
                            "template": "US pelvis"
                        },
                        {
                            "text": "US renal",
                            "template": "US renal"
                        },
                        {
                            "text": "US urethra",
                            "template": "US urethra"
                        }
                    ]
                },
                {
                    "text": "Other",
                    "template": "{children}",
                    "children": [
                        {
                            "text": "Intravenous pyelogram (IVP)",
                            "template": "Intravenous pyelogram (IVP)"
                        }
                    ]
                }
            ]
        },
        {
            "text": "Ordered Medications",
            "template": "Ordered Medications{children}",
            "children": [
                {
                    "text": "Antibiotics",
                    "template": "{children}",
                    "children": [
                        {
                            "text": "Cipro XR 500 mg ER tab",
                            "template": "Cipro XR 500 mg ER tab"
                        },
                        {
                            "text": "Clindamycin 2% vaginal cream",
                            "template": "Clindamycin 2% vaginal cream"
                        },
                        {
                            "text": "ciprofloxacin 250 mg tab",
                            "template": "ciprofloxacin 250 mg tab"
                        },
                        {
                            "text": "Levaquin 250 mg tab",
                            "template": "Levaquin 250 mg tab"
                        },
                        {
                            "text": "nitrofurantoin 100 mg ER cap",
                            "template": "nitrofurantoin 100 mg ER cap"
                        },
                        {
                            "text": "ofloxacin 200 mg tab",
                            "template": "ofloxacin 200 mg tab"
                        },
                        {
                            "text": "trimethoprim\/sulfamethoxazole 160 mg\/800 mg tab",
                            "template": "trimethoprim\/sulfamethoxazole 160 mg\/800 mg tab"
                        }
                    ]
                },
                {
                    "text": "OTC pain relievers",
                    "template": "{children}",
                    "children": [
                        {
                            "text": "Take OTC acetaminophen prn",
                            "template": "Take OTC acetaminophen prn"
                        },
                        {
                            "text": "Take OTC ibuprofen prn",
                            "template": "Take OTC ibuprofen prn"
                        },
                        {
                            "text": "Take OTC naproxen prn",
                            "template": "Take OTC naproxen prn"
                        },
                        {
                            "text": "Take OTC capsaicin cream (chronic OA)",
                            "template": "Take OTC capsaicin cream (chronic OA)"
                        },
                        {
                            "text": "acetaminophen 500 mg tab",
                            "template": "acetaminophen 500 mg tab"
                        }
                    ]
                },
                {
                    "text": "Anti-inflammatories",
                    "template": "{children}",
                    "children": [
                        {
                            "text": "ibuprofen 400 mg tab",
                            "template": "ibuprofen 400 mg tab"
                        },
                        {
                            "text": "ibuprofen 600 mg tab",
                            "template": "ibuprofen 600 mg tab"
                        },
                        {
                            "text": "ibuprofen 800 mg tab",
                            "template": "ibuprofen 800 mg tab"
                        },
                        {
                            "text": "naproxen 500 mg tab",
                            "template": "naproxen 500 mg tab"
                        }
                    ]
                },
                {
                    "text": "Opioids",
                    "template": "{children}",
                    "children": [
                        {
                            "text": "hydrocodone\/acetaminophen 5 mg\/500 mg tab",
                            "template": "hydrocodone\/acetaminophen 5 mg\/500 mg tab"
                        },
                        {
                            "text": "hydrocodone\/ibuprofen 7.5 mg\/200 mg tab",
                            "template": "hydrocodone\/ibuprofen 7.5 mg\/200 mg tab"
                        },
                        {
                            "text": "oxycodone\/acetaminophen 5 mg\/325 mg tab",
                            "template": "oxycodone\/acetaminophen 5 mg\/325 mg tab"
                        }
                    ]
                },
                {
                    "text": "Stool softeners",
                    "template": "{children}",
                    "children": [
                        {
                            "text": "Take OTC stool softeners prn",
                            "template": "Take OTC stool softeners prn"
                        },
                        {
                            "text": "docusate sodium 100 mg cap",
                            "template": "docusate sodium 100 mg cap"
                        },
                        {
                            "text": "docusate sodium 250 mg cap",
                            "template": "docusate sodium 250 mg cap"
                        },
                        {
                            "text": "docusate calcium 240 mg cap",
                            "template": "docusate calcium 240 mg cap"
                        }
                    ]
                },
                {
                    "text": "Oral contraceptives",
                    "template": "{children}",
                    "children": [
                        {
                            "text": "Monophasic OCPs",
                            "template": "Monophasic OCPs"
                        },
                        {
                            "text": "Biphasic OCPs",
                            "template": "Biphasic OCPs"
                        },
                        {
                            "text": "Triphasic OCPs",
                            "template": "Triphasic OCPs"
                        },
                        {
                            "text": "Progestin-only OCPs",
                            "template": "Progestin-only OCPs"
                        },
                        {
                            "text": "Brevicon 35 mcg\/0.5 mg [28 day] pack",
                            "template": "Brevicon 35 mcg\/0.5 mg [28 day] pack"
                        },
                        {
                            "text": "Lo Loestrin Fe monophasic [28 day] pack",
                            "template": "Lo Loestrin Fe monophasic [28 day] pack"
                        },
                        {
                            "text": "Loestrin 24 Fe 20 mcg\/1 mg [28 day] pack",
                            "template": "Loestrin 24 Fe 20 mcg\/1 mg [28 day] pack"
                        },
                        {
                            "text": "Lo\/Ovral-28 monophasic [28 day] pack",
                            "template": "Lo\/Ovral-28 monophasic [28 day] pack"
                        },
                        {
                            "text": "Modicon 35 mcg\/0.5 mg [28 day] pack",
                            "template": "Modicon 35 mcg\/0.5 mg [28 day] pack"
                        },
                        {
                            "text": "Ocella 3 mg\/30 mcg [28 day] pack",
                            "template": "Ocella 3 mg\/30 mcg [28 day] pack"
                        },
                        {
                            "text": "Ortho-Cyclen 35 mcg\/0.25 mg [28 day] pack",
                            "template": "Ortho-Cyclen 35 mcg\/0.25 mg [28 day] pack"
                        },
                        {
                            "text": "Ortho-Novum 1\/35 35 mcg\/1 mg [28 day] pack",
                            "template": "Ortho-Novum 1\/35 35 mcg\/1 mg [28 day] pack"
                        },
                        {
                            "text": "Yasmin monophasic [28 day] pack",
                            "template": "Yasmin monophasic [28 day] pack"
                        },
                        {
                            "text": "Yaz 3 mg\/20 mcg [28 day] pack",
                            "template": "Yaz 3 mg\/20 mcg [28 day] pack"
                        },
                        {
                            "text": "Necon 10\/11 biphasic [28 day] pack",
                            "template": "Necon 10\/11 biphasic [28 day] pack"
                        },
                        {
                            "text": "Ortho Tri-Cyclen Lo triphasic [28 day] pack",
                            "template": "Ortho Tri-Cyclen Lo triphasic [28 day] pack"
                        },
                        {
                            "text": "Ortho Tri-Cyclen triphasic [28 day] pack",
                            "template": "Ortho Tri-Cyclen triphasic [28 day] pack"
                        },
                        {
                            "text": "TriNessa triphasic [28 day] pack",
                            "template": "TriNessa triphasic [28 day] pack"
                        },
                        {
                            "text": "Ortho Micronor 0.35 mg [28 day] pack",
                            "template": "Ortho Micronor 0.35 mg [28 day] pack"
                        }
                    ]
                },
                {
                    "text": "Oral contraceptives extended cycle",
                    "template": "{children}",
                    "children": [
                        {
                            "text": "Jolessa monophasic [91 day] pack",
                            "template": "Jolessa monophasic [91 day] pack"
                        },
                        {
                            "text": "Lybrel monophasic [28 day] pack",
                            "template": "Lybrel monophasic [28 day] pack"
                        },
                        {
                            "text": "Seasonique biphasic [91 day] pack",
                            "template": "Seasonique biphasic [91 day] pack"
                        },
                        {
                            "text": "Seasonale 30 mcg\/0.15 mg [91 day] pack",
                            "template": "Seasonale 30 mcg\/0.15 mg [91 day] pack"
                        }
                    ]
                },
                {
                    "text": "Contraceptive patch, ring, IUD, injection",
                    "template": "{children}",
                    "children": [
                        {
                            "text": "medroxyprogesterone acetate INJ",
                            "template": "medroxyprogesterone acetate INJ"
                        },
                        {
                            "text": "Depo-Provera INJ",
                            "template": "Depo-Provera INJ"
                        },
                        {
                            "text": "NuvaRing 0.12 mg\/0.015 mg per day ring",
                            "template": "NuvaRing 0.12 mg\/0.015 mg per day ring"
                        },
                        {
                            "text": "Mirena 52 mg IUD",
                            "template": "Mirena 52 mg IUD"
                        },
                        {
                            "text": "Ortho Evra 150 mcg\/20 mcg per 24h patch",
                            "template": "Ortho Evra 150 mcg\/20 mcg per 24h patch"
                        }
                    ]
                }
            ]
        },
        {
            "text": "Ordered Procedures",
            "template": "Ordered Procedures{children}",
            "children": [
                {
                    "text": "Ordered Procedures",
                    "template": "{children}",
                    "children": [
                        {
                            "text": "Dilation and Curettage",
                            "template": "Dilation and Curettage"
                        }
                    ]
                }
            ]
        },
        {
            "text": "Postpartum Depression Recommedations",
            "template": "Postpartum Depression Recommendations{children}",
            "children": [
                {
                    "text": "Postpartum Depression Screening",
                    "template": "{children}",
                    "children": [
                        {
                            "text": "Re-evaluate in 1-2 weeks",
                            "template": "Re-evaluate in 1-2 weeks"
                        },
                        {
                            "text": "Refer to mental health provider",
                            "template": "Refer to mental health provider"
                        },
                        {
                            "text": "Refer to general practitioner",
                            "template": "Refer to general practitioner"
                        }
                    ]
                }
            ]
        },
        {
            "text": "Partner Violence Recomendations",
            "template": "Partner Violence Recommendations{children}",
            "children": [
                {
                    "text": "Intimate Partner Violence Screening",
                    "template": "{children}",
                    "children": [
                        {
                            "text": "Refer to mental health",
                            "template": "Refer to mental health"
                        },
                        {
                            "text": "Refer to general practitioner",
                            "template": "Refer to general practitioner"
                        },
                        {
                            "text": "Encourage patient to create a safety or escape plan",
                            "template": "Encourage patient to create a safety or escape plan"
                        },
                        {
                            "text": "Refer to social service for financial, legal, shelter or advocacy",
                            "template": "Refer to social service for financial, legal, shelter or advocacy"
                        },
                        {
                            "text": "Additional further assessment needed",
                            "template": "Additional further assessment needed"
                        }
                    ]
                }
            ]
        },
        {
            "text": "Education\/Recommendations",
            "template": "Education\/Recommendations{children}",
            "children": [
                {
                    "text": "General",
                    "template": "{children}",
                    "children": [
                        {
                            "text": "Breastfeeding: ensure proper nutrition\/hydration\/vitamin",
                            "template": "Breastfeeding: ensure proper nutrition\/hydration\/vitamin"
                        },
                        {
                            "text": "Engage in bonding activities with infant",
                            "template": "Engage in bonding activities with infant"
                        },
                        {
                            "text": "Follow a healthy diet rich in vegetables and low in salt\/saturated fat",
                            "template": "Follow a healthy diet rich in vegetables and low in salt\/saturated fat"
                        },
                        {
                            "text": "Get regular exercise (3x\/week or more)",
                            "template": "Get regular exercise (3x\/week or more)"
                        },
                        {
                            "text": "Reviewed the effects of pain medication",
                            "template": "Reviewed the effects of pain medication"
                        },
                        {
                            "text": "Hemorrhoid relief (stiz baths\/witch hazel pads\/top. anesth. oint)",
                            "template": "Hemorrhoid relief (stiz baths\/witch hazel pads\/top. anesth. oint)"
                        }
                    ]
                },
                {
                    "text": "Reproductive",
                    "template": "{children}",
                    "children": [
                        {
                            "text": "Discuss birth control options",
                            "template": "Discuss birth control options"
                        },
                        {
                            "text": "Contraceptive options during breastfeeding",
                            "template": "Contraceptive options during breastfeeding"
                        },
                        {
                            "text": "Permanent birth control options",
                            "template": "Permanent birth control options"
                        }
                    ]
                }
            ]
        },
        {
            "text": "Follow up\/Referrals",
            "template": "Follow up\/Return Referrals{children}",
            "children": [
                {
                    "text": "Referrals",
                    "template": "{children}",
                    "children": [
                        {
                            "text": "Refer to Dietician",
                            "template": "Refer to Dietician"
                        },
                        {
                            "text": "Refer to Nutrition",
                            "template": "Refer to Nutrition"
                        },
                        {
                            "text": "Refer to OB\/Gyn",
                            "template": "Refer to OB\/Gyn"
                        },
                        {
                            "text": "Refer to Psychiatry",
                            "template": "Refer to Psychiatry"
                        },
                        {
                            "text": "Refer to Lactation Consultant",
                            "template": "Refer to Lactation Consultant"
                        },
                        {
                            "text": "Refer to Urology",
                            "template": "Refer to Urology"
                        },
                        {
                            "text": "Refer to tobacco cessation program",
                            "template": "Refer to tobacco cessation program"
                        },
                        {
                            "text": "Refer to Public Health Department nurse",
                            "template": "Refer to Public Health Department nurse"
                        },
                        {
                            "text": "Refer to Child Protective Services",
                            "template": "Refer to Child Protective Services"
                        },
                        {
                            "text": "Refer to Social Services",
                            "template": "Refer to Social Services"
                        },
                        {
                            "text": "Refer to Women, Infants, and Children Program (WIC)",
                            "template": "Refer to Women, Infants, and Children Program (WIC)"
                        }
                    ]
                },
                {
                    "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": "Return visits",
                    "template": "{children}",
                    "children": [
                        {
                            "text": "Return visit as needed",
                            "template": "Return visit as needed"
                        },
                        {
                            "text": "Return visit in 1 week",
                            "template": "Return visit in 1 week"
                        },
                        {
                            "text": "Return visit in 2 weeks",
                            "template": "Return visit in 2 weeks"
                        },
                        {
                            "text": "Return visit in 1 month",
                            "template": "Return visit in 1 month"
                        },
                        {
                            "text": "Return visit in 2 months",
                            "template": "Return visit in 2 months"
                        },
                        {
                            "text": "Return visit in 3 months",
                            "template": "Return visit in 3 months"
                        },
                        {
                            "text": "Return visit in 6 months",
                            "template": "Return visit in 6 months"
                        },
                        {
                            "text": "Return visit in 1 year",
                            "template": "Return visit in 1 year"
                        }
                    ]
                }
            ]
        }
    ]
}