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MD ORDER
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FAINTING WITH NEEDLES/SHOTS?
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PROGRESS NOTE
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ALLERGIES
• • •
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IV PREPARED BY:
• • •
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|
In sterile fashion draw each of the nutrients be
• • •
|
ALLERGIES (OTHER)
|
|
GLUTATHIONE (200 MG/ML) - 5 ML = 1000 MG
|
PREGNANT?
|
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GLUTATHIONE (200 MG/ML) - 10 ML = 2000 MG
|
|
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GLUTATHIONE (200 MG/ML) - 15 ML = 3000 MG
|
|
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SITE OF IV
• • •
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ANGIOCATH SIZE
• • •
|
IV STARTED BY:
• • •
|
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TIME IV STARTED
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TIME IV ENDED
|
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STARTING BLOOD PRESSURE
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STARTING HEART RATE
|
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ENDING BLOOD PRESSURE
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ENDING HEART RATE
|
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STARTING TEMPERATURE
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ENDING TEMPERATURE
|
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INFUSION NOTE
|
ADDITIONAL INFUSION COMMENTS
|
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IV DISCHARGE NOTE
|
ADDITIONAL DISCHARGE COMMENTS
|
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PORTACATH NOTE
|
FOLLOW-UP
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