Professional Documents
Culture Documents
Date of Admission:
Code Status:
Allergies:
Pain Management:
PCA:
O2 _------------------------ L/min
Other:
Date/Abnormal Test Result Normal Range Client Specific Rationale for abnormal values
Others:
Psychological: Psychological:
Neuro-Muscular: Neuro-Muscular:
Skin: (include Back and Buttocks) Skin: (include Back and Buttocks)
Cardiovascular Cardiovascular
Respiratory Respiratory
Gastrointestinal Gastrointestinal
Elimination Pattern
Sleep-Rest Pattern
Instructor Feedback
Highlight name if
medication
discontinued prior to
giving