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Plan of care
1.
PLAN OF CARE
Date: StudentName: Outcome Patient1 Outcome Patient2 Outcome Patient3 Outcome Patient4 Outcome Patient5 Allergies____________ Code Status_________ IV _____________ ml/hr Activity_____________ Diet________________ Drains______________ VS_________________ Glucometer__________ Dressing_____________ Output______________ 02 __________________ LBM ________________ Dx: Med Hx: Allergies____________ Code Status _________ IV _____________ ml/hr Activity_____________ Diet________________ Drains______________ VS_________________ Glucometer__________ Dressing_____________ Output______________ 02 __________________ LBM ________________ Dx: Med Hx: Allergies____________ Code Status_________ IV _____________ ml/hr Activity_____________ Diet________________ Drains______________ VS_________________ Glucometer__________ Dressing_____________ Output______________ 02 __________________ LBM ________________ Dx: Med Hx: Allergies____________ Code Status_________ IV _____________ ml/hr Activity_____________ Diet________________ Drains______________ VS_________________ Glucometer__________ Dressing_____________ Output______________ 02 __________________ LBM ________________ Dx: Med Hx: Allergies____________ Code Status_________ IV _____________ ml/hr Activity_____________ Diet________________ Drains______________ VS_________________ Glucometer__________ Dressing_____________ Output______________ 02 __________________ LBM ________________ Dx: Med Hx: ReportInfo: ReportInfo: ReportInfo: ReportInfo: ReportInfo: Assessmentfindings: Assessmentfindings: Assessmentfindings: Assessmentfindings: Assessmentfindings:
2.
Labs and Meds: Pt:
1 Pt: 2 Pt: 3 Pt: 4 Pt: 5 Planof Care: Meds: Planof Care: Meds: Planof Care: Meds: Planof Care: Meds: Planof Care: Meds: 0700 0700 0700 0700 0700 0800 0800 0800 0800 0800 0900 0900 0900 0900 0900 1000 1000 1000 1000 1000 1100 1100 1100 1100 1100 1200 1200 1200 1200 1200 1300 1300 1300 1300 1300 1400 1400 1400 1400 1400 1500 1500 1500 1500 1500 1600 1600 1600 1600 1600 1700 1700 1700 1700 1700 1800 1800 1800 1800 1800 1900 1900 1900 1900 1900 SignificantLabValues: SignificantLabValues: SignificantLabValues: SignificantLabValues: SignificantLabValues:
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