Class notes ADN

Name: Name: Name:
Age: M/F Code: Age: M/F Code: Age: M/F Code:
A/D: Diet: A&O X: A/D: Diet: A&O X: A/D: Diet: A&O X:
A/Dx: ACHS: Y / N A/Dx: ACHS: Y / N ACHS: Y / N
A/Dx:
Allergies: Allergies: Allergies:

ISO: ISO: ISO:
Incont: Y / N Incont: Y / N Incont: Y / N
Hx: Bowel / Bladder Hx: Bowel / Bladder Bowel / Bladder
Hx:
LBM: LBM: LBM:
Activity: Activity: Activity:
IV: IV: IV:
Fluids: Fluids: Fluids:

Lines/Drains/Foley: Lines/Drains/Foley: Lines/Drains/Foley:


Labs: Tele: Y / N #: Labs: Tele: Y / N #: Labs: Tele: Y / N #:
Rythm: Rythm: Rythm:
Skin/Wounds: Skin/Wounds: Skin/Wounds:


O2: RA / NC / HFNC / FM/ O2: RA / NC / HFNC / FM/ O2: RA / NC / HFNC / FM/
BIPAP ______ L/M BIPAP ______ L/M BIPAP ______ L/M
AC AC AC HS AC AC AC HS AC AC AC HS


Procedures: Procedures: Procedures:
Notes: Notes: Notes: