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ICU Monitoring - Updated 4-24

This document contains fields for collecting a patient's name, medical history, vital signs, lab results, notes, radiology results, medications, and follow-up plan over multiple days. Key information includes fields for patient name, medical problems, vital signs, lab results, notes, radiology reports, current medications, and planned follow-up.

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Anonymous NyZLF2LKT
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20 views

ICU Monitoring - Updated 4-24

This document contains fields for collecting a patient's name, medical history, vital signs, lab results, notes, radiology results, medications, and follow-up plan over multiple days. Key information includes fields for patient name, medical problems, vital signs, lab results, notes, radiology reports, current medications, and planned follow-up.

Uploaded by

Anonymous NyZLF2LKT
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
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Name:  ID  Asad  Medina-Garcia

All:  Renal  Neuro


 Surgery  Other Consults: ____________________________
PMH:

Date Final Site Organisms / Susceptibilities Date Final Site Organisms / Susceptibilites

Tm/Tc
BP
MAP
HR
WBC / LA / / / / / / / / /
Hgb/Hct
Plt
Gran/Band
Na / / / / / / / / /
K / / / / / / / / /
Cl / / / / / / / / /
CO2 / / / / / / / / /
BUN / / / / / / / / /
SCr / / / / / / / / /
Glucose / / / / / / / / /
Ca2+ / / / / / / / / /
Phos / / / / / / / / /
Mag / / / / / / / / /
Corr/ion Ca2+ / / / / / / / / /
T.Bili/D.Bili
INR/PT
Respiratory
-Peridex
- FIO2
CPOT
CAM ICU / Tx
Blood Sugars

-Lantus / / / / / / / /
-SS#/units / / / / / / / / /
DVT? E / H / SCD / F E / H / SCD / F E / H / SCD / F E / H / SCD / F E / H / SCD / F E / H / SCD / F E / H / SCD / F E / H / SCD / F E / H / SCD / F
Reason if N/A
GI prophy? Y / N / NA Y / N / NA Y / N / NA Y / N / NA Y / N / NA Y / N / NA Y / N / NA Y / N / NA Y / N / NA
- indication
Nutrition
- route / rate
Steroids
Phenytoin
SZ ppx / tx

Notes
Date Type Radiology Results Date Type Radiology Results

CC: HPI:

PMH: OP Meds:
1. 1.
2. 2.
3. 3.
4. 4.
5. 5.
6. 6.
7. 7.
8. 8.
9. 9.
10. 10.

Date Plan/Follow-Up
1.
2.
3.
1.
2.
3.
1.
2.
3.
1.
2.
3.
1.
2.
3.
1.
2.
3.
1.
2.
3.

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