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Liceo de Cagayan University

Cagayan de Oro City


N104 RLE KARDEX

Name of Student: Group: Date:


Clinical Instructor: Shift: Hospital/Area:

PATIENT’S PROFILE IVF/BT SPECIAL CONSIDERATION LABORATORY REMARKS


Name:

Age:
Sex:
Religion:
Diagnosis:

AP:

Diet:

c/c:

GENERIC (Brand) DOSE/ROUTE FREQUENCY 15gtts/min = 1.00cc/min = 60cc/hr


20gtts/min = 1.33cc/min = 80cc/hr
25gtts/min = 1.66cc/min = 100cc/hr
30gtts/min = 2.00cc/min = 120cc/hr
35gtts/min = 2.33cc/min = 140cc/hr
40gtts/min = 2.66cc/min = 160cc/hr
45gtts/min = 3.00cc/min = 180cc/hr

10mgtts/min = 10cc/hr
15mgtts/min = 15cc/hr
20mgtts/min = 20cc/hr
30mgtts/min = 30cc/hr
1mL = 15 drops (60 mgtts)
1drop (gtt) = 4 micro drops (mgtts)

TIME LEVEL IVF & RATE TIME ORAL TUBE PARENTERAL TOTAL URINE TOTAL
: :00
: :00
: :00
: :00
: :00
: :00
: :00
: :00
: :00
: :00
: :00
: :00

Date TIME O2 Sat


VS :00 :00 :00 :00 :00 :00 :00 :00 :00 :00 :00
T :00
P :00
RR :00
BP :00
:00
U :00
S :00

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