Download Adult patient kardex

Buffalo General Hospital
DeGraff Memorial Hospital
Millard Fillmore Gates Circle Hospital
Millard Fillmore Suburban Hospital
Millard Fillmore Surgery Center
Women & Children’s Hospital of Buffalo
Others: ADULT PATIENT KARDEX 1 of 2
Patient ID Area
DO NOT USE THESE UNSAFE ABBREVIATIONS
“U” and “IU” should be unit, “Ug” should be mcg, “QD” should be daily, “QOD” should be every other day, “BIW” should be two times a
week, “TIW” should be three times a week, “AU,” “AS,” “AD,” “OS,” and “OD” should be written out in full. Correct Use of Leading and Trailing
Zeros - Always Leading Never Trailing .1 should be 0.1 and 1.0 should be 1
ADMISSION DATE: AGE: Code Status [ check]
DIAGNOSIS: ADVANCE DIRECTIVES:
Special Considerations
Full
DNR
Date:
PREVIOUS MEDICAL/SURGICAL HISTORY: Patient goal to be achieved: ALLERGIES: Language Barrier: Current Invasive Procedures/ Operation:
VACCINES (Date Given):
Pneumoccocal:
Other:
Influenza:
Diet: Feed
Assist
Fluid Restriction: Order
Date
Recurring Lab
ÌKHÇÂ=È4Â1ÂOFÂ2&Î
KH00294 Rev. 09/18/07
Renew
Date
Order
Date
Consults/Tests/Procedures
Date
Completed
ADULT PATIENT KARDEX 2 of 2
Patient ID Area
STANDING ORDERS (indicate date of order)
Vital Signs: Neuro Checks: Intermittent Infusion Device: Oxygen: Incentive Spirometry: Pulse Ox: Cough & Deep Breathe: Telemetry: Bedrest: Bathroom Privileges: Chair: Up ad lib: Assistive Device: Sequential Compression Device: Anti-Embolism Stockings: Foot Pumps: Weight (indicate units): Indwelling Catheter: PT/OT: Intake & Output: Treatments: ADDITIONAL PHYSICIAN STANDING ORDERS
Date
Ordered
(indications must be included for all medications)
ÌKHÇÂ=È4Â2ÂOFÂ2/Î
KH00294 Rev. 09/18/07
Date
Discontinued