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SURNAME AGE HOSPITAL NO.

/__/__/__/__/__/

GIVEN SEX  WARD NO.


NAME [] M   [] F
DOCTORS’ ORDER/ NURSES COMPLIANCE SHEET
(Authenticate all orders)
C – Carried                   A – Administered                  R – Request Made
           E – Endorsed                                    D - Discontinue

ORDER Time 
Date C A R E D Posted
Time Signature
March 17, 2021 - Please admit under the service of Dr.
7:30am
LU

- Consent to care

- NPO when in active labor

- Start venoclysis with D5LR iL:


incorporate 10 units of oxytocin to run
at 30gtts/min
Diagnostics / Laboratories:
- CBC, BT and platelet count
- Urinalysis
- Hooked to EFM
- Monitor Fetal Heart Tone (FHT) every
hour and monitor progress of labor
- V/S q 4H
- Refer accordingly

J.

Bisnar
Dr. Bisnar

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