MEDICAL CENTER MANILA – 8th Main

December 15,2010(6:00 AM-2:00PM)

IV FLUID MONITORING SHEET

AMOUNT
LEVEL
RECEIVED IVF
HOURS RATE TIME ENDORSED AMOUNT
RM No. BOTTLE No. IVF DUE TIME FROM CHECK
TO RUN (gtts/min) STRARTED TO NEXT INFUSED
LAST TIME
SHIFT
SHIFT
15-16
803-1 3 D5NM1L 16 5:00am 9:00 pm FC 8am-12nn 800
gtts/min
Shift to
803-2 -------------- ------------- ----------- --------- 8am ----------- -----------
heplock

804-2 --------- Hold 12/15/10 Dislodge ---------- ---------- 8am ---------- ----------
------------
805-1 -------- ------------ -------- ------------ NO IVF -------- 8am --------- -------
807-1 -------- ------------ -------- ----------- NO IVF ---------- 8am ----------- -------
808 ----------- ------- --------- ------- NO STUDENT ALLOWED ----------- -------

To consume
15-16
810-1 10 PNSS 1L 16 7:00 am 11:00pm 500cc 8am-12nn NO IVF
gtts/min
@1:00pm

811-1 ----------- ------- ---------- ------- NO IVF ----------- 8am ----------- -------
816-1 3 D5NM 1L KVO 10 gtts/min 6:00am 6:00pm FC 8am-12nn ----------- -------
817-1 ----------- ------- ---------- ------- NO IVF --------- 8am ----------- -------
D50.3 NaCl
818-1 4 KVO 10 gtts/min 8:00am 8:00am FC 8am-12nn 800
1L
31-32
820-1 3 D5 NR 1L 8 8:00am 4:00pm 550 cc 8am-12nn 300
gtts/min
700
8am-12nn
13-14
821-1 3 D5NM 1L 18 4:30 am 10:30pm 900cc
gtts/min
 D5IMB 500 35-36
822-1 3 3:00 am 400cc 8am-12nn 200
ml gtts/min
823-1 ----------- ------- ---------- ------- NO IVF -------- 8am ----------- -------
D5NSS 1L
824-2 4 24-KVO 10gtts/min 4:00 am 4:00 pm 500cc 8am-12nn 300

31-32
825-1 1 D5NR 1L 8 7:00am 3: pm FC 8am-12nn 700
gttts/min
20- 21
825-2 2 PNSS 1L 12 10:00PM 10:00am 400 8am-12nn Discharge
gtts/min
-

Prepared by: Noted by:

Ceriola,Joan Jacques/ Esmillo, Kharlene

Chart Nurse Head Nurse
 MEDICAL CENTER MANILA – 8th Main
December 15,2010(6:00 AM-2:00PM)

VITAL SIGNS RECORDING SYSTEM

04:00PM 08:00 INTAK OU

PM E TP
UT
Plotted Plotted
RM BP T P R BP T P R IV ORAL URINE STOOL
No.

803-1 done
100/60 36 76 14 100/7 36.3 72 16 200 400cc 200 0
0
803-2 done
120/90 36.2 72 20 110/8 36 64 20 400cc 600 0
0
804-2 done 0
(P) 36 98 21 (P) 36 98 21 200cc 500cc
805-1 done ---- ---- ---- ---- ---- ---- --- ---- -----
90/70 36.5 82 22
807-1 done D I S C H A R G E
120/70 36.9 74 18
808 NO STU DENT A L L O W E D
810-1 done
130/70 36 70 20 130/9 36 70 20 - 150 6DC 0
0
811-1 100/60 done D I S C H A R G E
36 85 23
816-1 (P) done 20 210 500 0
36 89 23 (P) 36 85 20
817-1 D I S C H A R G E
110/70 36 80 21
818-1
(P) 36 85 21 (P) 36 85 21 200 420 210 1
820-1 110/80 110/7 300 105 F.C 1
36 80 16 0 36 80 17
821-1 1
(P) 36 110 21 (P) 36 120 26 250 3 o.z 5x
822-1 (P) 36 122 27 306 210 3DC 1
(P) 36 120 21
823-1 22 110/8 36 70 22 -- 300 --- 0
110/80 36 70 0
824-2 170/80 36 70 20 160/9 36 72 24 --- 420 4x 1
0
825-1 110/8 36 70 18 800 400 --- ---
0
825-2 120/70 36 70 20 D I S C H A R G E

Prepared by: Noted by:

Ceriola,Joan Jacques/ Esmillo, Kharlene

Chart Nurse Head Nurse
MEDICAL CENTER MANILA – 6th Main
November 23 2009(6:00-2:00pm)

8 HOURS NURSING SHEET

 AM PM NOC AM PM NOC

CENSUS 18 PRE-OP

ADMISSION 1 POST-OP

DISCHARGE 5

TRANSFER 0
TOTAL 18 TOTAL

Special Procedures
Patient’s
Room No. Procedure Schedule
Initials
803-1 R.A Hemoptysis monitoring

810-1 T.Q CBG

Prepared by: Noted by:

Ceriola,Joan Jacques/ Esmillo, Kharlene

Chart Nurse Head Nurse