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    Nursing Dummy Chart

    Uploaded by

    is_aradanas
    This document contains forms and sheets for a nursing student to document information for a patient such as patient history, vital signs, intake and output, medications, and nursing notes. It includes sections for patient identification, chief complaint, medical history, diagnosis, IV fluids, vital signs, intake and output, medications, nursing considerations, patient teaching, and nursing notes.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as DOC, PDF, TXT or read online from Scribd

    Nursing Dummy Chart

    Uploaded by

    is_aradanas
    597 views4 pages
    This document contains forms and sheets for a nursing student to document information for a patient such as patient history, vital signs, intake and output, medications, and nursing notes. It includes sections for patient identification, chief complaint, medical history, diagnosis, IV fluids, vital signs, intake and output, medications, nursing considerations, patient teaching, and nursing notes.

    Original Description:

    dummy chart for student nurses

    Copyright

    © Attribution Non-Commercial (BY-NC)

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    This document contains forms and sheets for a nursing student to document information for a patient such as patient history, vital signs, intake and output, medications, and nursing notes. It includes sections for patient identification, chief complaint, medical history, diagnosis, IV fluids, vital signs, intake and output, medications, nursing considerations, patient teaching, and nursing notes.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as DOC, PDF, TXT or read online from Scribd
    Download as doc, pdf, or txt
    597 views4 pages

    Nursing Dummy Chart

    Uploaded by

    is_aradanas
    This document contains forms and sheets for a nursing student to document information for a patient such as patient history, vital signs, intake and output, medications, and nursing notes. It includes sections for patient identification, chief complaint, medical history, diagnosis, IV fluids, vital signs, intake and output, medications, nursing considerations, patient teaching, and nursing notes.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as DOC, PDF, TXT or read online from Scribd
    Download as doc, pdf, or txt
    of 4

    Students Name: _____________________________________

    ______________________
    Clinical Area: ___________________ _______
    _________________________________
    NCM Level: _______
    Group: ___

    Date: ______________

    SUMMARY OF PATIENTS HISTORY

    Name: ______________________________
    Age: ______ Male ( )
    Female ( )
    Diet: _______________________________
    CHIEF COMPLAINT:
    _______________________________________
    _______________________________________
    _______________________________________
    HISTORY OF PRESENT ILLNESS:
    _______________________________________
    _______________________________________
    _______________________________________
    MEDICAL DIAGNOSIS:
    _______________________________________
    _______________________________________
    _______________________________________

    IV FLOW SHEET

    DATE

    SHIFT

    BOTT
    LE
    NO.

    IVF
    SOL
    N

    RAT
    E

    AMT
    INFUSE
    D

    AMT
    ENDORSE
    D

    Hospital:

    Clinical Instructor:
    Duty Schedule: _________________________

    TPR SHEET
    DATE
    BP

    TEMP
    40

    PR
    140

    RR

    39

    130

    38

    120

    70

    37

    110

    60

    36

    100

    50

    35

    90

    40

    80

    30

    70

    20

    60

    10

    PM
    4

    PM
    10

    12

    50
    URINE
    STOOL

    INTAKE AND OUTPUT MONITORING


    INTAKE SUMMARY
    DATE

    TIME
    3:00
    4:00
    4:00
    5:00
    5:00
    6:00
    6:00
    7:00
    7:00

    IVF
    -

    ORAL

    BLOO
    D

    IV
    MEDS

    OUTPUT SUMMARY
    MISC

    TOTA
    L

    TIME
    3:00
    4:00
    4:00
    5:00
    5:00
    6:00
    6:00
    7:00
    7:00

    NGT
    -

    BLOO
    D

    URINE

    VOMIT
    US

    MISC

    TOTAL

    8:00
    8:00 9:00
    9:00 10:00

    8:00
    8:00 9:00
    9:00 10:00

    MEDICATION
    MEDICATION

    FREQ

    ROUT
    E

    DRUG COMPUTATION

    DOSAG
    E

    DRUG 1

    DRUG 2

    DRUG 3

    DRUG 4

    DRUG 5

    DRUG 6

    NURSING
    CONSIDERATIO
    N

    PATIENT
    TEACHING

    DRUG STUDY
    MEDICATION
    (BRAND
    NAME/
    GENERIC
    NAME/
    DOSAGE/ROU
    TE)

    CLASSIFICATI
    ON

    MECHANISM
    OF ACTION

    INDICATION
    CONTRAINDICATI
    ON

    SIDE EFFECT /
    ADVERSE
    EFFECT

    DRUG 1

    DRUG 2

    DRUG 3

    DRUG 4

    DRUG 5

    NURSES NOTES
    DATE/TIM
    E

    FOCUS

    CUES

    D-A-R

    DATE/TIM
    E

    FOCUS

    CUES

    D-A-R

    REMARKS:

    EXCELLENT 91%

    PREPARED BY:

    ABOVE
    VERY GOOD 86% -

    GRADE:

    CLINICAL INSTRUCTOR:

    90%
    GOOD 80% - 85%
    FAIR 75% - 79%

    DATE:

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