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ICU Sheet 02

This document contains medical information about a patient including their room number, code status, care team, allergies, diagnoses, history, surgeries, fall risk, prophylaxis measures, neurological checks, gastrointestinal information, diet, cardiovascular information, GU information, respiratory information, orthopedic information, skin/wounds, IVs/drips, labs, diagnostics, medications, vital signs, issues, family members, personal equipment, notes, and transfer/discharge plans. The document provides an overview of the patient's medical situation and treatment in a hospital.

Uploaded by

Jan Marcus
Copyright
© © All Rights Reserved
Available Formats
Download as PDF, TXT or read online on Scribd
322 views

ICU Sheet 02

This document contains medical information about a patient including their room number, code status, care team, allergies, diagnoses, history, surgeries, fall risk, prophylaxis measures, neurological checks, gastrointestinal information, diet, cardiovascular information, GU information, respiratory information, orthopedic information, skin/wounds, IVs/drips, labs, diagnostics, medications, vital signs, issues, family members, personal equipment, notes, and transfer/discharge plans. The document provides an overview of the patient's medical situation and treatment in a hospital.

Uploaded by

Jan Marcus
Copyright
© © All Rights Reserved
Available Formats
Download as PDF, TXT or read online on Scribd
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S Pt Info

Room

Code Status Care Team
Isolation

Allergies
C/O 1
st
Dx 2
nd
Dx

B History Surgeries





Fall Level PU Risk

Core Measures


Prophylaxis
GI
DVT
Vaccines: PNA / FLU
Precautions
A Neurological Checks WNL



GI PEG NGT Ostomy LBM ______ WNL



Diet NPO


Cardiovascular Daily Wt WNL


EKG
GU FOLEY WNL

Intake Output
Respiratory BIPAP/CPAP Trach WNL



Ortho WNL Mobility/Activity Endocrine/Accuchek
Skin/Wounds/Wound Care/PU WNL










IVT/Drips
`


Labs




Diagnostics To Collect
Medications







PRN Pain/N&V/BP T
BP
HR
O2
RR
ICU Protocols

Issues/Family Members



Personal Equipment
R Notes/To do









Transfer/Discharge Plans

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