Patient Care Plan 2 Per Page

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RM
NAME:
AGE/SEX:
CODE:
DX:
TEAM:
HX:
ALLERGIES:
RHYTHM:
IV:
Ca
Mg
VANCO
ADL:
PT
PTT
INR
Diet:
O2:
REPORT: VS
MD ORDERS:
TO DO:
Pain:
Neuro:
Card:
Pulm:
GI:
GU:
Skin:
Other:
PT SUM
MD COM
OTHER NOTES
MONITOR
VS
BG
ASSESSMENT
MONITOR
VS
BG
REASSESSMENT
VS
BG
MONITOR
IV
TUBES
EPIDURAL
I&O
CP
EDUCATION
IV
TUBES
EPIDURAL
I&O
RM
NAME:
AGE/SEX:
CODE:
DX:
TEAM:
HX:
ALLERGIES:
RHYTHM:
IV:
Ca
Mg
VANCO
ADL:
PT
PTT
INR
Diet:
O2:
REPORT: VS
MD ORDERS:
TO DO:
Pain:
Neuro:
Card:
Pulm:
GI:
GU:
Skin:
Other:
PT SUM
MD COM
OTHER NOTES
MONITOR
VS
BG
ASSESSMENT
MONITOR
VS
BG
REASSESSMENT
VS
BG
MONITOR
IV
TUBES
EPIDURAL
I&O
CP
EDUCATION
IV
TUBES
EPIDURAL
I&O

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