Pines City Colleges

(Owned and operated by THORNTONS INTERNATIONAL STUDIES,

INC.)

College of nursing

MONITORING SHEET

PATIENT’S NAME: Mrs. Kim Maro AGE; 28 SEX; Female

HOSPITA
L
PHYSICIAN: NUMBE ROOM
R

DATE
/ O2
SA ADDITIONAL PARAMETERS
AS ORDERED
TIM TEMP PR/CR RR BP T URINE STOOL
E

120/7
7;00 am 36.7 78 15 95%
0
 INTAKE AND OUTPUT SHEET

PATIENT’S NAME: Mrs. Kim Maro HOSPITAL NUMBER

INTAK OUTPU
E T
DATE / DATE /
KIND OF FLUID AMOUN KIND OF FLUID AMOUNT
TIME TIME
T
7;00
PNSS 1L + 10 U Oxytoxin 200ml
am

TOTA TOTAL
L

TOTA TOTAL
L
TOTA TOTAL
L
TOTAL FOR 24 HOURS TOTAL FOR 24 HOURS