|
Wellness type
• • •
|
|
|
FAINTING WITH NEEDLES/SHOTS?
|
PREGNANT?
|
|
PROGRESS NOTE
|
ALLERGIES (OTHER)
|
|
IV prepared
|
In sterile fashion draw each of the nutrients be
• • •
|
|
GLUTATHIONE (200 MG/ML)
|
Glutathione Dose
|
|
VITAMIN C (500 MG/ML)
|
Vitamin C Dose
|
|
Vita Complex
|
Mineral Blend
|
|
Amino Blend
|
Zinc
|
|
Biotin
|
Calcium Chloride
|
|
IV Push Medications
• • •
|
|
|
SITE OF IV
• • •
|
ANGIOCATH SIZE
• • •
|
|
TIME IV STARTED
|
TIME IV ENDED
|
|
STARTING BLOOD PRESSURE
|
STARTING HEART RATE
|
|
ENDING BLOOD PRESSURE
|
ENDING HEART RATE
|
|
STARTING TEMPERATURE
|
ENDING TEMPERATURE
|
|
INFUSION NOTE
|
ADDITIONAL INFUSION COMMENTS
|
|
IV DISCHARGE NOTE
|
ADDITIONAL DISCHARGE COMMENTS
|
|
PORTACATH NOTE
|
FOLLOW-UP
|
