INTAKE PARENTERAL `07 `08 `09 10 11 12 13 14 15 `16 17 18 19 20 21 22 23 `00 `01 `02 `03 `04 `05 `06

INTAKE ENTERAL : SUSU

JUS (.....................)
BUBUR SARING .........
KONTROL PEMBERIAN OBAT TOTAL
START NAMA TANDA
NAMA OBAT (DIISI OLEH DOKTER) DOSIS ROUTE (TGL) DOKTER TANGAN
PARENTERAL

ENTERAL

TOTAL INTAKE / 24 JAM

OUTPUT
DRAIN KIRI
DRAIN KANAN
WATER SEAL DRAINAGE (WSD) / CHEST TUBEST TUBE KANAN
WATER SEAL DRAINAGE (WSD) / CHEST TUBE KIRI
CAIRAN LAMBUNG YANG KELUAR VIA NGT
BUANG AIR BESAR / BAB (FESES)
BUANG AIR KECIL / BAK (URINE)
INSENSIBLE WATER LOSS (IWL) / 24 JAM
TOTAL OUTPUT / 24 JAM
BALANCE
ICU/HCU