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    PMHX: / PSHX: Neuro:: Ett: - / - CM Atl

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    novikane
    This document contains clinical information for a patient including their name, allergies, date of birth, age, physician, code status, and consults. It also lists the patient's past medical and surgical history, diagnoses, and clinical notes on their neurologic, cardiac, respiratory, gastrointestinal, genitourinary, skin, and intravenous status at various times throughout the day. Contact information is provided for the person to contact regarding the patient.

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    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd

    PMHX: / PSHX: Neuro:: Ett: - / - CM Atl

    Uploaded by

    novikane
    47 views1 page
    This document contains clinical information for a patient including their name, allergies, date of birth, age, physician, code status, and consults. It also lists the patient's past medical and surgical history, diagnoses, and clinical notes on their neurologic, cardiac, respiratory, gastrointestinal, genitourinary, skin, and intravenous status at various times throughout the day. Contact information is provided for the person to contact regarding the patient.

    Original Description:

    sample

    Original Title

    Report Sheet

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    This document contains clinical information for a patient including their name, allergies, date of birth, age, physician, code status, and consults. It also lists the patient's past medical and surgical history, diagnoses, and clinical notes on their neurologic, cardiac, respiratory, gastrointestinal, genitourinary, skin, and intravenous status at various times throughout the day. Contact information is provided for the person to contact regarding the patient.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    47 views1 page

    PMHX: / PSHX: Neuro:: Ett: - / - CM Atl

    Uploaded by

    novikane
    This document contains clinical information for a patient including their name, allergies, date of birth, age, physician, code status, and consults. It also lists the patient's past medical and surgical history, diagnoses, and clinical notes on their neurologic, cardiac, respiratory, gastrointestinal, genitourinary, skin, and intravenous status at various times throughout the day. Contact information is provided for the person to contact regarding the patient.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    of 1

    NAME:

    ALLERGIES:

    DOB:
    AGE:
    PHYSICIAN:

    CODE STATUS:
    CONSULTS:

    DIAGNOSIS:

    PMHx: / PSHx:

    Contact Person:

    NEURO:
    O700/1900

    CARDIAC:
    O800/2000

    O900/2100

    RESPIRATORY:

    1000/2200

    ETT:_______/________cm ATL

    DIAGNOSTIC STUDIES:
    1100/2300

    AC______/TV________/Fi02_______/PEEP_______
    Sp02:_________ ETC02:________ PIP:________

    1200/2400

    GI:
    1300/0100
    Tube Feed:_________________@______cc/hr

    ACCU CHECKS:
    _________________

    Goal Rate:__________

    _________________
    __________________
    __________________

    GU:

    _________________

    Notes:
    SKIN:

    1400/0200

    1500/0300

    Ht:_______Wt:________
    1600/0400

    IV:
    1700/0500

    1800/0600

    DO NOT FILE WORKSHEET IN CHART NOT PART OF MEDICAL RECORD

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