IVF/ BLOOD

SPECIAL LABORATORY/DIAGNOST
DIET Name Ordered Tim Leve Amt. IVF to NURSING DIAGNOSES
ENDORSEMENT IC EXAMS AND RESULTS
& Regulation e l Consumed follow
Vol.

CAPITOL UNIVERSITY
COLLEGE F NURSING
ENDORSEMENT KARDEX

Name of Patient: ___________________________ Religion: ___________ Date of Admission: _______

Age: ______ Marital Status: ________________ Chief Complaints: __________________________
Mental Status: ____________________________ Medical Diagnosis: _________________________
Attending Physician: _______________________

 arxe 
 MEDICATIONS VITAL SIGNS

Nursing Precautions/
Generic Name Responsibilities
Brand Name Before and During TIME BP HR RR TEMP O2 sat
Dosage
Timing and
# of stocks frequency administration
Route
Frequency

1 2 1 2
 INTAKE OUTPUT
TIME
ORAL IV URINE OTHERS
1

NAME OF PATIENT: ______________________ NAME OF STUDENT: ____________________ 2

DATE: _________________
1