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Patient Check-in
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PMH and Allergies Reviewed - No Contraindications
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IV Consent Signed
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Overall goals for this infusion / specific focus
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Orders
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Infusion Vitals
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IV placed using aseptic technique, no complications, secured and free flowing.
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Location of IV
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Number of Attempts:
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IV Gauge
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Total Infusion Time
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Patient tolerated the injection well, no complications, VSS, IV removed upon discharge and without any s/s or erythema/infection
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Complication Details
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Education
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Patient educated on recommended dosing and frequency for particular medication/focus and was offered to book for future services
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Education Details
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Nervana Contact Information
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Standard Wellness IV
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Antioxidant Booster
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Brianiac
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Energy + Metabolism
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Hangover Recovery
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Immunity + Vitality
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Inner Glow
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Standard Meyer's
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Weekend Warrior / Athletic Survival
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Premium IV
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Athletic Performance / Enhancement High Dose
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High Dose ALA
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Immunity + Vitality High Dose
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Mitochondrial Support / Oxidative Stress
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NAD+
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Specific Condition IV
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Hyperemesis Gravidarum
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Migraine Recovery
|
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MTHFR Hyperhomocysteinemia
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Tide Recovery
|
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IV Push
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Antioxidant Booster
|
High Dose Glutathione
|
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High Dose N-Acetylcysteine
|
High Dose Taurine
|
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Standard Additives
|
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Acetylcysteine
|
Alpha Lipoic Acid
|
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Amino Blend
|
Arginine
|
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Ascorbic Acid (Vitamin C)
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B Complex
|
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B5 (Dexpanthenol)
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B6 (Pyridoxine)
|
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B7 (Biotin)
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B12 (Cobalamin)
|
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Glutathione
|
L-Carnitine
|
|
L-Lysine
|
L-Taurine
|
|
NAD+
|
Tri-Amino
|
|
Tri-Immune
|
Zinc
|
|
|
|
|
Pharmaceutical Additive Education
|
|
|
Calcium Chloride
|
Dexamethasone
|
|
Diphenhydramine (Benadryl)
|
Famotidine (Pepcid)
|
|
Ketorolac (Toradol)
|
Magnesium Chloride
|
|
Metoclopramide (Reglan)
|
Ondansetron (Zofran)
|
|
Promethazine (Phenergan)
|
|
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Provider
|
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Administered by
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MA / Assistant (Charted by)
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Compounded by
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