Nursing Flow Sheet
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1Scenario # CIRRIE 4
NURSING FLOW SHEET
Patient Name: Silva, Jose’
Diagnosis:
MR#: UB133134
Acute Coronary Syndrome
Age: 55
Gender: M
Hyperlipidemia
Height: 6’0”
Weight: 100kg
Date:
TIME
BLOOD PRESSURE
PULSE
RESP RATE
TEMP
SCORE
LOCATION
CHARACTER
OXYGEN
OXIMETER
DIET / % EATEN
SUPP FEEDING
PO
IV
URINE
DRAINS
PROBLEM / EVENT DOCUMENTATION
DATE/TIME
SIGNATURE
15
Adapted from template developed by Medical Simulation Design (2/11)
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