Republic of the Philippines

Isabela State University

Echague, Isabela

COLLEGE OF NURSING

TPR Monitoring Sheet

Name of the Leader: _________________________________ Date:___________________ Shift:________________

Patient Name: Patient Name:

Rm.No.: Rm.No.:
Intravenous Fluid: Intravenous Fluid:
Received level: Received level:
Endorsed level: Endorsed level:
Time Temp HR R BP Intake Output Time Temp HR R BP Intake Output
R R

Patient Name: Patient Name:

Rm.No.: Rm.No.:
Intravenous Fluid: Intravenous Fluid:
Received level: Received level:
Endorsed level: Endorsed level:
Time Temp HR R BP Intake Output Time Temp HR R BP Intake Output
R R

Patient Name: Patient Name:

Rm.No.: Rm.No.:
Intravenous Fluid: Intravenous Fluid:
Received level: Received level:
Endorsed level: Endorsed level:
Time Temp HR R BP Intake Output Time Temp HR R BP Intake Output
R R