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Brain Sheet2011

This document contains three patient charts with fields for patient name, room number, demographic information, physician, code status, allergies, diagnosis, weight, height, IV status, blood glucose checks, foley catheter status, activity level, diet, and vitals to be recorded at regular intervals over a 24 hour period. Sections are also included for abnormal labs and tasks to be done.

Uploaded by

nursekatie
Copyright
© Attribution Non-Commercial (BY-NC)
Available Formats
Download as XLSX, PDF, TXT or read online on Scribd
49 views

Brain Sheet2011

This document contains three patient charts with fields for patient name, room number, demographic information, physician, code status, allergies, diagnosis, weight, height, IV status, blood glucose checks, foley catheter status, activity level, diet, and vitals to be recorded at regular intervals over a 24 hour period. Sections are also included for abnormal labs and tasks to be done.

Uploaded by

nursekatie
Copyright
© Attribution Non-Commercial (BY-NC)
Available Formats
Download as XLSX, PDF, TXT or read online on Scribd
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Name: Name: Name:

RM #: RM #: RM #:
Sex/Age/DOB: Sex/Age/DOB: Sex/Age/DOB:
Physician: Physician: Physician:
CODE STATUS: CODE STATUS: CODE STATUS:
Allergies: Allergies: Allergies:

Dx: Dx: Dx:

Wt: Ht: Wt: Ht: Wt: Ht:


IV: Accu Checks: IV: Accu Checks: IV: Accu Checks:
Foley: Foley: Foley:
Activity: Activity: Activity:
Diet: Diet: Diet:
Vitals Vitals Vitals

0700/1900 0700/1900 0700/1900

0800/2000 0800/2000 0800/2000

0900/2100 0900/2100 0900/2100

1000/2200 1000/2200 1000/2200

1100/2300 1100/2300 1100/2300

1200/0000 1200/0000 1200/0000

1300/0100 1300/0100 1300/0100

1400/0200 1400/0200 1400/0200

1500/0300 1500/0300 1500/0300

1600/0400 1600/0400 1600/0400

1700/0500 1700/0500 1700/0500

1800/0600 1800/0600 1800/0600

Abnormal Labs Abnormal Labs Abnormal Labs

TO DO TO DO TO DO

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