should also include hospital meds) PMH: Home and Hospital Classification: Expected Meds: Outcome: 1. 1. 2. 2. 3. 3. 4. 4. 5. 5. 6. 6. 7. 7. Nutrition Diet (TPN/Lipds, Enteral, Rate or Frequency Benefits: Oral) Nutritional Assessment (What are the nutritional needs for your patient based on his/her health status and diagnoses; this may differ from the actual ordered diet)? Lab Results: (Complete for day before/most recent and then day of clinical) What lab results are RELEVANT that must be recognized as clinically significant to the nurse? Complete Count Norms Mm/dd/yy Mm/dd/yy High/Low/WNL? (CBC:) WBC Hgb Platelets Neutrophil % Band forms What lab results are RELEVANT that must be recognized as clinically significant to the nurse? RELEVANT Lab(s): Clinical Significance: TREND: Improve/Worsening/Stable: Metabolic Norms Mm/dd/yy Mm/dd/yy High/Low/WNL? Panel (BMP:) Sodium Potassium Chloride CO2 (Bicarb)
should also include hospital meds) PMH: Home and Hospital Meds: Classification: Expected Outcome: 1. 2. 3. 4. 5. 6. 7. 1. 2. 3. 4. 5. 6. 7. Nutrition Diet (TPN/Lipds, Enteral, Oral) Rate or Frequency Benefits: Nutritional Assessment (What are the nutritional needs for your patient based on his/her health status and diagnoses; this may differ from the actual ordered diet)? Lab Results: (Complete for day before/most recent and then day of clinical) What lab results are RELEVANT that must be recognized as clinically significant to the nurse? Complete Count (CBC:) Norms Mm/dd/yy Mm/dd/yy High/Low/WNL? WBC Hgb Platelets Neutrophil % Band forms What lab results are RELEVANT that must be recognized as clinically significant to the nurse? RELEVANT Lab(s): Clinical Significance: TREND: Improve/Worsening/Stable: Metabolic Panel (BMP:) Norms Mm/dd/yy Mm/dd/yy High/Low/WNL? Sodium Potassium Chloride CO2 (Bicarb)
nur4405-spr18.docx