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XAVIER UNIVERSITY- ATENEO DE CAGAYAN

COLLEGE OF NURSING | SY 2017 – 2018


Summarized Patient Kardex with Special Endorsements

Head Nurse: Arasani, Gian Kaye F. Charge Nurse: Ambolode, Louie Jay G.
Clinical Instructor: Ma’am Leny V. Baguio, RN, MN Medication/IV Nurse:
Area: MRXUHI – Station 1A Bedside Nurse:

Room No. Patient Information Patient Monitoring


Name/Age: V/S: q
Cc/Dx: INO: q
IVF: #
Date & Time of Admission: GCS: q
Attending Physician: HGT: q
Diet::
Special Endorsements:

Name/Age: V/S: q
Cc/Dx: INO: q
IVF: #
Date & Time of Admission: GCS: q
Attending Physician: HGT: q
Diet::
Special Endorsements:

Name/Age: V/S: q
Cc/Dx: INO: q
IVF: #
Date & Time of Admission: GCS: q
Attending Physician: HGT: q
Diet::
Special Endorsements:

Name/Age: V/S: q
Cc/Dx: INO: q
IVF: #
Date & Time of Admission: GCS: q
Attending Physician: HGT: q
Diet::
Special Endorsements:

Name/Age: V/S: q
Cc/Dx: INO: q
IVF: #
Date & Time of Admission: GCS: q
Attending Physician: HGT: q
Diet::
Special Endorsements:

Name/Age: V/S: q
Cc/Dx: INO: q
IVF: #
Date & Time of Admission: GCS: q
Attending Physician: HGT: q
Diet::
Special Endorsements:

Name/Age: V/S: q
Cc/Dx: INO: q
IVF: #
Date & Time of Admission: GCS: q
Attending Physician: HGT: q
Diet::
Special Endorsements:
Name/Age: V/S: q
Cc/Dx: INO: q
IVF: #
Date & Time of Admission: GCS: q
Attending Physician: HGT: q
Diet::
Special Endorsements:

Name/Age: V/S: q
Cc/Dx: INO: q
IVF: #
Date & Time of Admission: GCS: q
Attending Physician: HGT: q
Diet::
Special Endorsements:

Name/Age: V/S: q
Cc/Dx: INO: q
IVF: #
Date & Time of Admission: GCS: q
Attending Physician: HGT: q
Diet::
Special Endorsements:

Name/Age: V/S: q
Cc/Dx: INO: q
IVF: #
Date & Time of Admission: GCS: q
Attending Physician: HGT: q
Diet::
Special Endorsements:

Name/Age: V/S: q
Cc/Dx: INO: q
IVF: #
Date & Time of Admission: GCS: q
Attending Physician: HGT: q
Diet::
Special Endorsements:

Name/Age: V/S: q
Cc/Dx: INO: q
IVF: #
Date & Time of Admission: GCS: q
Attending Physician: HGT: q
Diet::
Special Endorsements:

Name/Age: V/S: q
Cc/Dx: INO: q
IVF: #
Date & Time of Admission: GCS: q
Attending Physician: HGT: q
Diet::
Special Endorsements:

Name/Age: V/S: q
Cc/Dx: INO: q
IVF: #
Date & Time of Admission: GCS: q
Attending Physician: HGT: q
Diet::
Special Endorsements: