Patient Care Plan 4 Per Page
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1
2RM#
Name:
Age:
MD
IV #
/
NG
Meds/Notes
@
cc/HR
JP
Admit Date/DX:
PMH:
G Tube
Trach
CT
Cardio
Tele 0700 1500
Neuro AAOx
FC
PERRLA
Labs/TX/Test
RESP
O2
V/S
FSBS
GI
Last BM
DIET
Skin/Wound
BS
GU VOO
FOLEY
Activity:
RM#
Name:
Age:
MD
IV #
/
NG
Meds/Notes
@
cc/HR
JP
Admit Date/DX:
PMH:
G Tube
Trach
CT
Cardio
Tele 0700 1500
Neuro AAO x
FC
PERRLA
Labs/TX/Test
MAE
RESP
O2
V/S
FSBS
GI
Last BM
DIET
Skin/Wound
BS- quads
GU VOO
FOLEY
Activity:
RM#
Name:
Age:
MD
IV #
/
NG
Meds/Notes
@
cc/HR
JP
Admit Date/DX:
PMH:
G Tube
Trach
CT
Cardio
Tele 0700 1500
Neuro AAOx
FC
PERRLA
Labs/TX/Test
MAE
RESP
O2
V/S
FSBS
GI
Last BM
DIET
Skin/Wound
BS-quads
GU VOO
FOLEY
Activity:
RM#
Name:
Age:
MD
IV #
/
NG
Meds/Notes
@
cc/HR
JP
Admit Date/DX:
PMH:
G Tube
Trach
CT
Cardio
Tele
0700 1500
Neuro AAO x
FC
PERRLA
Labs/TX/Test
MAE
RESP
O2
V/S
FSBS
GI
Last BM
DIET
Skin/Wound
BS quads
GU VOO
FOLEY
Activity:
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