This log is also available as text (239cc.txt) and as a (binary) annotation file (239cc.log).
Generated: Thursday, 23-Apr-2009 00:36:15 EDT
(All dates below are surrogates.)
id: Temperature C t0: [20:00:00 19/11/2018] el: 0 cg: -1 cu: CCU st: D/C'd id: HOB Measurement t0: [20:00:00 19/11/2018] el: 0 cg: -1 cu: CCU st: D/C'd
id: Less Restrict Meas. t0: [20:00:00 19/11/2018] el: 0 cg: RN cu: CCU v1: Orientation st: NotStopd id: Pain Present t0: [20:00:00 19/11/2018] el: 0 cg: RN cu: CCU v1: No st: NotStopd id: Range of Motion t0: [20:00:00 19/11/2018] el: 0 cg: RN cu: CCU v1: Done st: NotStopd id: Pain Assess Method t0: [20:00:00 19/11/2018] el: 0 cg: RN cu: CCU v1: Non-verbal cues st: NotStopd id: Circulation/SkinInt t0: [20:00:00 19/11/2018] el: 0 cg: RN cu: CCU v1: Circulation Adeq st: NotStopd id: Dorsal PedPulse R/L t0: [20:00:00 19/11/2018] el: 0 cg: RN cu: CCU v1: Not Applicable v2: Doppler st: NotStopd id: GI#1 Intub Site t0: [20:00:00 19/11/2018] el: 0 cg: RN cu: CCU v1: Salem Sump v2: Oral st: NotStopd id: Education Topic #1 t0: [20:00:00 19/11/2018] el: 0 cg: RN cu: CCU v1: Plan of Care st: NotStopd id: Eye Opening t0: [20:00:00 19/11/2018] el: 0 cg: RN cu: CCU v1: 3 To speech st: NotStopd id: Follows Commands t0: [20:00:00 19/11/2018] el: 0 cg: RN cu: CCU v1: Inconsistently st: NotStopd id: GCS Total t0: [20:00:00 19/11/2018] el: 0 cg: RN cu: CCU v1: 10 n1: 10 u1: points st: NotStopd id: GI Intub #1/Site t0: [20:00:00 19/11/2018] el: 0 cg: RN cu: CCU v1: Salem Sump v2: Oral st: NotStopd id: HOB t0: [20:00:00 19/11/2018] el: 0 cg: RN cu: CCU v1: 45 degrees st: NotStopd id: INV Line#3 Type/Site t0: [20:00:00 19/11/2018] el: 0 cg: RN cu: CCU v1: A-Line v2: Left Radial st: NotStopd id: INV Line#3 Zero/Cal t0: [20:00:00 19/11/2018] el: 0 cg: RN cu: CCU v1: Yes st: NotStopd id: INV Line#3InsertDate t0: [20:00:00 19/11/2018] el: 0 cg: RN cu: CCU v1: 9 n1: 9 v2: 24 n2: 24 st: NotStopd id: INV Line#3SiteAppear t0: [20:00:00 19/11/2018] el: 0 cg: RN cu: CCU v1: WNL st: NotStopd id: INV#3 WaveformAppear t0: [20:00:00 19/11/2018] el: 0 cg: RN cu: CCU v1: Sharp st: NotStopd id: IV #1 Insert Date t0: [20:00:00 19/11/2018] el: 0 cg: RN cu: CCU v1: 9 n1: 9 v2: 22 n2: 22 st: NotStopd id: IV #1 Site/Size t0: [20:00:00 19/11/2018] el: 0 cg: RN cu: CCU v1: Right Antecub v2: 18 gauge st: NotStopd id: IV #2 Insert Date t0: [20:00:00 19/11/2018] el: 0 cg: RN cu: CCU v1: 9 n1: 9 v2: 25 n2: 25 st: NotStopd id: IV #2 Site/Size t0: [20:00:00 19/11/2018] el: 0 cg: RN cu: CCU v1: Right Wrist v2: 20 gauge st: NotStopd id: Activity t0: [20:00:00 19/11/2018] el: 0 cg: RN cu: CCU v1: Bedrest st: NotStopd id: IV Site Appear #1 t0: [20:00:00 19/11/2018] el: 0 cg: RN cu: CCU v1: WNL st: NotStopd id: IV Site Appear #2 t0: [20:00:00 19/11/2018] el: 0 cg: RN cu: CCU v1: WNL st: NotStopd id: ImpSkin Character #1 t0: [20:00:00 19/11/2018] el: 0 cg: RN cu: CCU v1: Abrasion st: NotStopd id: ImpSkin Treatment #1 t0: [20:00:00 19/11/2018] el: 0 cg: RN cu: CCU v1: Dry Sterile Dsg st: NotStopd id: Impaired Skin Site#1 t0: [20:00:00 19/11/2018] el: 0 cg: RN cu: CCU v1: Abdomen st: NotStopd id: Level of Conscious t0: [20:00:00 19/11/2018] el: 0 cg: RN cu: CCU v1: Arouse to Voice st: NotStopd id: Angio Appearance #1 t0: [20:00:00 19/11/2018] el: 0 cg: RN cu: CCU v1: Clean and Dry v2: Ecchymotic st: NotStopd id: Angio Appearance #2 t0: [20:00:00 19/11/2018] el: 0 cg: RN cu: CCU v1: Clean and Dry v2: Clean and Dry st: NotStopd id: Motor Response t0: [20:00:00 19/11/2018] el: 0 cg: RN cu: CCU v1: 6 Obeys Commands st: NotStopd id: Angio Dressing #1 t0: [20:00:00 19/11/2018] el: 0 cg: RN cu: CCU v1: Transparent st: NotStopd id: Angio Dressing #2 t0: [20:00:00 19/11/2018] el: 0 cg: RN cu: CCU v1: Dry Sterile Dsg st: NotStopd id: Oral Care t0: [20:00:00 19/11/2018] el: 0 cg: RN cu: CCU v1: Done st: NotStopd id: Orientation t0: [20:00:00 19/11/2018] el: 0 cg: RN cu: CCU v1: Unable to Assess st: NotStopd id: Angio Site #1 t0: [20:00:00 19/11/2018] el: 0 cg: RN cu: CCU v1: R Femoral st: NotStopd id: Angio Site #2 t0: [20:00:00 19/11/2018] el: 0 cg: RN cu: CCU v1: L Femoral st: NotStopd id: PT Splint Loc/Stat#1 t0: [20:00:00 19/11/2018] el: 0 cg: RN cu: CCU v1: Left Leg v2: On st: NotStopd id: Pain Location t0: [20:00:00 19/11/2018] el: 0 cg: RN cu: CCU v1: Not Indicated st: NotStopd id: Pain Type t0: [20:00:00 19/11/2018] el: 0 cg: RN cu: CCU v1: None st: NotStopd id: Position t0: [20:00:00 19/11/2018] el: 0 cg: RN cu: CCU v1: Left Side st: NotStopd id: Position Change t0: [20:00:00 19/11/2018] el: 0 cg: RN cu: CCU v1: Done st: NotStopd id: PostTib. Pulses R/L t0: [20:00:00 19/11/2018] el: 0 cg: RN cu: CCU v1: Not Applicable v2: Not Applicable st: NotStopd id: Assistance Device t0: [20:00:00 19/11/2018] el: 0 cg: RN cu: CCU v1: 2 Person Assist st: NotStopd id: INV#3 Dsg Change t0: [20:00:00 19/11/2018] el: 0 cg: RN cu: CCU v1: 9 n1: 9 v2: 24 n2: 24 st: NotStopd id: Pupil Response R/L t0: [20:00:00 19/11/2018] el: 0 cg: RN cu: CCU v1: Brisk v2: Brisk st: NotStopd id: Pupil Size R/L t0: [20:00:00 19/11/2018] el: 0 cg: RN cu: CCU v1: 3 mm v2: 3 mm st: NotStopd id: Reason For Restraint t0: [20:00:00 19/11/2018] el: 0 cg: RN cu: CCU v1: Ext/TXInterfere st: NotStopd id: Removed x 5 Mins t0: [20:00:00 19/11/2018] el: 0 cg: RN cu: CCU v1: Done st: NotStopd id: Respiratory Pattern t0: [20:00:00 19/11/2018] el: 0 cg: RN cu: CCU v1: Regular st: NotStopd id: Restraint Location t0: [20:00:00 19/11/2018] el: 0 cg: RN cu: CCU v1: Both Arms st: NotStopd id: Restraint Type t0: [20:00:00 19/11/2018] el: 0 cg: RN cu: CCU v1: Soft Limb st: NotStopd id: Restraints Evaluated t0: [20:00:00 19/11/2018] el: 0 cg: RN cu: CCU v1: RestraintReapply st: NotStopd id: Side Rails t0: [20:00:00 19/11/2018] el: 0 cg: RN cu: CCU v1: All rails up st: NotStopd id: Skin Care t0: [20:00:00 19/11/2018] el: 0 cg: RN cu: CCU v1: Done st: NotStopd id: Skin Integrity t0: [20:00:00 19/11/2018] el: 0 cg: RN cu: CCU v1: Impaired st: NotStopd id: Spontaneous Movement t0: [20:00:00 19/11/2018] el: 0 cg: RN cu: CCU v1: Purposeful st: NotStopd id: Support Systems t0: [20:00:00 19/11/2018] el: 0 cg: RN cu: CCU v1: Children st: NotStopd id: INV#3 Cap Change t0: [20:00:00 19/11/2018] el: 0 cg: RN cu: CCU v1: 9 n1: 9 v2: 24 n2: 24 st: NotStopd id: INV#3 Tubing Change t0: [20:00:00 19/11/2018] el: 0 cg: RN cu: CCU v1: 9 n1: 9 v2: 24 n2: 24 st: NotStopd id: Temp. Site t0: [20:00:00 19/11/2018] el: 0 cg: RN cu: CCU v1: Oral st: NotStopd id: Temperature C (calc) t0: [20:00:00 19/11/2018] el: 0 cg: RN cu: CCU v1: 37.0556 n1: 37.0556 u1: Deg. C st: NotStopd id: Temperature F t0: [20:00:00 19/11/2018] el: 0 cg: RN cu: CCU v1: 98.7 n1: 98.7 u1: Deg. F st: NotStopd id: Therapeutic Bed t0: [20:00:00 19/11/2018] el: 0 cg: RN cu: CCU v1: AtmosAir Mattres st: NotStopd id: Turn t0: [20:00:00 19/11/2018] el: 0 cg: RN cu: CCU v1: Left Side st: NotStopd id: Urine Source t0: [20:00:00 19/11/2018] el: 0 cg: RN cu: CCU v1: Indwelling Cath st: NotStopd id: Verbal Response t0: [20:00:00 19/11/2018] el: 0 cg: RN cu: CCU v1: 1.0 ET/Trach st: NotStopd id: Back Care t0: [20:00:00 19/11/2018] el: 0 cg: RN cu: CCU v1: Done st: NotStopd id: Behavior t0: [20:00:00 19/11/2018] el: 0 cg: RN cu: CCU v1: Sleeping st: NotStopd id: Braden Activity t0: [20:00:00 19/11/2018] el: 0 cg: RN cu: CCU v1: Bedfast st: NotStopd id: Braden Frict/Shear t0: [20:00:00 19/11/2018] el: 0 cg: RN cu: CCU v1: Potential Prob st: NotStopd id: Braden Mobility t0: [20:00:00 19/11/2018] el: 0 cg: RN cu: CCU v1: Comp. Immobile st: NotStopd id: Braden Moisture t0: [20:00:00 19/11/2018] el: 0 cg: RN cu: CCU v1: Occ. Moist st: NotStopd id: Braden Nutrition t0: [20:00:00 19/11/2018] el: 0 cg: RN cu: CCU v1: Very Poor st: NotStopd id: Braden Score t0: [20:00:00 19/11/2018] el: 0 cg: RN cu: CCU v1: 9 n1: 9 u1: number st: NotStopd id: Braden SensoryPercep t0: [20:00:00 19/11/2018] el: 0 cg: RN cu: CCU v1: Comp. Limited st: NotStopd
id: Gastric Meds t0: [20:00:00 19/11/2018] el: 1 ai: 155 cg: RN cu: CCU vo: 30 vu: ml id: GT Flush t0: [20:00:00 19/11/2018] el: 1 ai: 338 cg: RN cu: CCU vo: 30 vu: ml id: Urine Out Foley t0: [20:00:00 19/11/2018] el: 1 cg: RN cu: CCU vo: 55 vu: ml
id: Stool Color/Consist t0: [20:00:00 19/11/2018] el: 0 cg: RN cu: CCU v1: Brown v2: Loose st: NotStopd
id: Stool Out Stool t0: [20:00:00 19/11/2018] el: 1 cg: RN cu: CCU vu: ml es: Medium
id: Stool Out Total t0: [23:00:00 19/11/2018] el: 2 cg: RN cu: CCU cv: 0 ac: 24 ap: carryForward re: 0
id: Service Type t0: [21:00:00 19/11/2018] el: 0 cg: RN cu: CCU v1: CCU st: NotStopd id: Code Status t0: [21:00:00 19/11/2018] el: 0 cg: RN cu: CCU v1: Full Code st: NotStopd id: Risk for Falls t0: [21:00:00 19/11/2018] el: 0 cg: RN cu: CCU v1: Yes st: NotStopd id: Ectopy Frequency t0: [21:00:00 19/11/2018] el: 0 cg: RN cu: CCU v1: None st: NotStopd id: Ectopy Type t0: [21:00:00 19/11/2018] el: 0 cg: RN cu: CCU v1: None st: NotStopd id: Heart Rate t0: [21:00:00 19/11/2018] el: 0 cg: RN cu: CCU v1: 72 n1: 72 u1: BPM st: NotStopd id: Heart Rhythm t0: [21:00:00 19/11/2018] el: 0 cg: RN cu: CCU v1: Atrial Fib st: NotStopd id: Arterial BP t0: [21:00:00 19/11/2018] el: 0 cg: RN cu: CCU v1: 88 n1: 88 u1: mmHg v2: 38 n2: 38 u2: mmHg st: NotStopd id: Arterial BP Mean t0: [21:00:00 19/11/2018] el: 0 cg: RN cu: CCU v1: 54 n1: 54 u1: mmHg st: NotStopd id: Precautions t0: [21:00:00 19/11/2018] el: 0 cg: RN cu: CCU v1: Contact st: NotStopd id: ABP Alarm (Lo/Hi) t0: [21:00:00 19/11/2018] el: 0 cg: RN cu: CCU v1: 90 n1: 90 u1: mmHg v2: 160 n2: 160 u2: mmHg st: NotStopd id: HR Alarm (Lo/Hi) t0: [21:00:00 19/11/2018] el: 0 cg: RN cu: CCU v1: 50 n1: 50 u1: BPM v2: 145 n2: 145 u2: BPM st: NotStopd id: Resp Alarm (Lo/Hi) t0: [21:00:00 19/11/2018] el: 0 cg: RN cu: CCU v1: 8 n1: 8 u1: BPM v2: 35 n2: 35 u2: BPM st: NotStopd id: SpO2 Alarm (Lo/Hi) t0: [21:00:00 19/11/2018] el: 0 cg: RN cu: CCU v1: 90 n1: 90 u1: % v2: 100 n2: 100 u2: % st: NotStopd id: Respiratory Rate t0: [21:00:00 19/11/2018] el: 0 cg: RN cu: CCU v1: 30 n1: 30 u1: BPM st: NotStopd id: calprevflg t0: [21:00:00 19/11/2018] el: 0 cg: RN cu: CCU v1: 1 n1: 1 u1: kg st: NotStopd
id: D5W 250.0ml + 25000Uhr Heparin t0: [21:00:00 19/11/2018] el: 1 ai: 117 cg: RN cu: CCU vo: 9 vu: ml id: Promote w/fiber t0: [21:00:00 19/11/2018] el: 1 ai: 1109 cg: RN cu: CCU vo: 20 vu: ml id: .9% Normal Saline 50.0ml + 50mghr Midazolam t0: [21:00:00 19/11/2018] el: 1 ai: 189 cg: RN cu: CCU vo: 0 vu: ml
id: Midazolam t0: [21:00:00 19/11/2018] el: 1 cg: RN cu: CCU vo: 0 do: 0 du: mghr so: .9% Normal Saline sv: 50 su: ml rt: IV Drip id: Heparin t0: [21:00:00 19/11/2018] el: 1 cg: RN cu: CCU vo: 0 do: 900 du: Uhr so: D5W sv: 250 su: ml rt: IV Drip
id: Service Type t0: [22:00:00 19/11/2018] el: 0 cg: RN cu: CCU v1: CCU st: NotStopd id: Code Status t0: [22:00:00 19/11/2018] el: 0 cg: RN cu: CCU v1: Full Code st: NotStopd id: Riker-SAS Scale t0: [22:00:00 19/11/2018] el: 0 cg: RN cu: CCU v1: Calm/Cooperative st: NotStopd id: Risk for Falls t0: [22:00:00 19/11/2018] el: 0 cg: RN cu: CCU v1: Yes st: NotStopd id: Ectopy Frequency t0: [22:00:00 19/11/2018] el: 0 cg: RN cu: CCU v1: None st: NotStopd id: Ectopy Type t0: [22:00:00 19/11/2018] el: 0 cg: RN cu: CCU v1: None st: NotStopd id: Alarms t0: [22:00:00 19/11/2018] el: 0 cg: RN cu: CCU v1: ON st: NotStopd id: Parameters Checked t0: [22:00:00 19/11/2018] el: 0 cg: RN cu: CCU v1: Yes st: NotStopd id: Heart Rate t0: [22:00:00 19/11/2018] el: 0 cg: RN cu: CCU v1: 76 n1: 76 u1: BPM st: NotStopd id: Heart Rhythm t0: [22:00:00 19/11/2018] el: 0 cg: RN cu: CCU v1: Atrial Fib st: NotStopd id: Arterial BP t0: [22:00:00 19/11/2018] el: 0 cg: RN cu: CCU v1: 98 n1: 98 u1: mmHg v2: 40 n2: 40 u2: mmHg st: NotStopd id: Arterial BP Mean t0: [22:00:00 19/11/2018] el: 0 cg: RN cu: CCU v1: 58 n1: 58 u1: mmHg st: NotStopd id: Precautions t0: [22:00:00 19/11/2018] el: 0 cg: RN cu: CCU v1: Contact st: NotStopd id: ABP Alarm (Lo/Hi) t0: [22:00:00 19/11/2018] el: 0 cg: RN cu: CCU v1: 90 n1: 90 u1: mmHg v2: 160 n2: 160 u2: mmHg st: NotStopd id: HR Alarm (Lo/Hi) t0: [22:00:00 19/11/2018] el: 0 cg: RN cu: CCU v1: 50 n1: 50 u1: BPM v2: 145 n2: 145 u2: BPM st: NotStopd id: Resp Alarm (Lo/Hi) t0: [22:00:00 19/11/2018] el: 0 cg: RN cu: CCU v1: 8 n1: 8 u1: BPM v2: 35 n2: 35 u2: BPM st: NotStopd id: SpO2 Alarm (Lo/Hi) t0: [22:00:00 19/11/2018] el: 0 cg: RN cu: CCU v1: 90 n1: 90 u1: % v2: 100 n2: 100 u2: % st: NotStopd id: Respiratory Rate t0: [22:00:00 19/11/2018] el: 0 cg: RN cu: CCU v1: 33 n1: 33 u1: BPM st: NotStopd id: Restraint Location t0: [21:00:00 19/11/2018] el: 0 cg: RN cu: CCU v1: None st: NotStopd id: Restraint Location t0: [22:00:00 19/11/2018] el: 0 cg: RN cu: CCU v1: None st: NotStopd id: SpO2 t0: [22:00:00 19/11/2018] el: 0 cg: RN cu: CCU v1: 99 n1: 99 u1: % st: NotStopd id: calprevflg t0: [22:00:00 19/11/2018] el: 0 cg: RN cu: CCU v1: 1 n1: 1 u1: kg st: NotStopd id: Fingerstick Glucose t0: [22:00:00 19/11/2018] el: 0 cg: RN cu: CCU v1: 175 n1: 175 rs: Manual st: NotStopd
id: Midazolam t0: [22:00:00 19/11/2018] el: 1 cg: RN cu: CCU vo: 0 do: 0 du: mghr so: .9% Normal Saline sv: 50 su: ml rt: IV Drip id: Heparin t0: [22:00:00 19/11/2018] el: 1 cg: RN cu: CCU vo: 0 do: 900 du: Uhr so: D5W sv: 250 su: ml rt: IV Drip
id: .9% Normal Saline 50.0ml + 50mghr Midazolam t0: [00:00:00 20/11/2018] el: 1 ai: 189 cg: -1 cu: CCU vo: 0 st: D/C'd
pi: 4072691 hi: 10161 t0: [01:00:00 20/11/2018] tf: [13:00:00 21/11/2018] mn: Insulin pt: Unit Dose st: Discontinued rt: SC fr: ASDIR ss: Y di: Ongoing xv: 36 xu: Hours pi: 4072692 hi: 10161 t0: [22:00:00 20/11/2018] tf: [13:00:00 21/11/2018] mn: Insulin pt: Unit Dose st: Discontinued rt: SC fr: HS ds: 22 dn: 1 di: Ongoing xv: 36 xu: Hours
id: Service Type t0: [00:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: CCU st: NotStopd id: Service Type t0: [23:00:00 19/11/2018] el: 0 cg: RN cu: CCU v1: CCU st: NotStopd id: Code Status t0: [00:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Full Code st: NotStopd id: Code Status t0: [23:00:00 19/11/2018] el: 0 cg: RN cu: CCU v1: Full Code st: NotStopd id: Riker-SAS Scale t0: [00:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Calm/Cooperative st: NotStopd id: Risk for Falls t0: [00:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Yes st: NotStopd id: Risk for Falls t0: [23:00:00 19/11/2018] el: 0 cg: RN cu: CCU v1: Yes st: NotStopd id: Ectopy Frequency t0: [00:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: None st: NotStopd id: Ectopy Frequency t0: [23:00:00 19/11/2018] el: 0 cg: RN cu: CCU v1: None st: NotStopd id: Ectopy Type t0: [00:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: None st: NotStopd id: Ectopy Type t0: [23:00:00 19/11/2018] el: 0 cg: RN cu: CCU v1: None st: NotStopd id: Alarms t0: [00:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: ON st: NotStopd id: Parameters Checked t0: [00:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Yes st: NotStopd id: Heart Rate t0: [00:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 75 n1: 75 u1: BPM st: NotStopd id: Heart Rate t0: [23:00:00 19/11/2018] el: 0 cg: RN cu: CCU v1: 74 n1: 74 u1: BPM st: NotStopd id: Heart Rhythm t0: [00:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Atrial Fib st: NotStopd id: Heart Rhythm t0: [23:00:00 19/11/2018] el: 0 cg: RN cu: CCU v1: Atrial Fib st: NotStopd id: Arterial BP t0: [00:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 88 n1: 88 u1: mmHg v2: 37 n2: 37 u2: mmHg st: NotStopd id: Arterial BP t0: [23:00:00 19/11/2018] el: 0 cg: RN cu: CCU v1: 98 n1: 98 u1: mmHg v2: 40 n2: 40 u2: mmHg st: NotStopd id: Arterial BP Mean t0: [00:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 52 n1: 52 u1: mmHg st: NotStopd id: Arterial BP Mean t0: [23:00:00 19/11/2018] el: 0 cg: RN cu: CCU v1: 58 n1: 58 u1: mmHg st: NotStopd id: Precautions t0: [00:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Contact st: NotStopd id: Precautions t0: [23:00:00 19/11/2018] el: 0 cg: RN cu: CCU v1: Contact st: NotStopd id: ABP Alarm (Lo/Hi) t0: [00:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 90 n1: 90 u1: mmHg v2: 160 n2: 160 u2: mmHg st: NotStopd id: ABP Alarm (Lo/Hi) t0: [23:00:00 19/11/2018] el: 0 cg: RN cu: CCU v1: 90 n1: 90 u1: mmHg v2: 160 n2: 160 u2: mmHg st: NotStopd id: HR Alarm (Lo/Hi) t0: [00:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 50 n1: 50 u1: BPM v2: 145 n2: 145 u2: BPM st: NotStopd id: HR Alarm (Lo/Hi) t0: [23:00:00 19/11/2018] el: 0 cg: RN cu: CCU v1: 50 n1: 50 u1: BPM v2: 145 n2: 145 u2: BPM st: NotStopd id: Resp Alarm (Lo/Hi) t0: [00:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 8 n1: 8 u1: BPM v2: 35 n2: 35 u2: BPM st: NotStopd id: Resp Alarm (Lo/Hi) t0: [23:00:00 19/11/2018] el: 0 cg: RN cu: CCU v1: 8 n1: 8 u1: BPM v2: 35 n2: 35 u2: BPM st: NotStopd id: SpO2 Alarm (Lo/Hi) t0: [00:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 90 n1: 90 u1: % v2: 100 n2: 100 u2: % st: NotStopd id: SpO2 Alarm (Lo/Hi) t0: [23:00:00 19/11/2018] el: 0 cg: RN cu: CCU v1: 90 n1: 90 u1: % v2: 100 n2: 100 u2: % st: NotStopd id: Respiratory Rate t0: [00:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 36 n1: 36 u1: BPM st: NotStopd id: Respiratory Rate t0: [23:00:00 19/11/2018] el: 0 cg: RN cu: CCU v1: 31 n1: 31 u1: BPM st: NotStopd id: SpO2 t0: [00:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 100 n1: 100 u1: % st: NotStopd id: SpO2 t0: [23:00:00 19/11/2018] el: 0 cg: RN cu: CCU v1: 100 n1: 100 u1: % st: NotStopd id: calprevflg t0: [00:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 1 n1: 1 u1: kg st: NotStopd id: calprevflg t0: [23:00:00 19/11/2018] el: 0 cg: RN cu: CCU v1: 1 n1: 1 u1: kg st: NotStopd
id: D5W 250.0ml + 25000Uhr Heparin t0: [22:00:00 19/11/2018] el: 1 ai: 117 cg: RN cu: CCU vo: 9 vu: ml id: D5W 250.0ml + 25000Uhr Heparin t0: [23:00:00 19/11/2018] el: 1 ai: 117 cg: RN cu: CCU vo: 9 vu: ml id: Urine Out Foley t0: [00:00:00 20/11/2018] el: 1 cg: RN cu: CCU vo: 90 vu: ml id: Urine Out Foley t0: [22:00:00 19/11/2018] el: 1 cg: RN cu: CCU vo: 90 vu: ml id: .9% Normal Saline 50.0ml + 50mghr Midazolam t0: [22:00:00 19/11/2018] el: 1 ai: 189 cg: RN cu: CCU vo: 0 vu: ml id: .9% Normal Saline 50.0ml + 50mghr Midazolam t0: [23:00:00 19/11/2018] el: 1 ai: 189 cg: RN cu: CCU vo: 0 vu: ml
id: Midazolam t0: [00:00:00 20/11/2018] el: 1 cg: RN cu: CCU vo: 0 do: 0 du: mghr so: .9% Normal Saline sv: 50 su: ml rt: IV Drip id: Midazolam t0: [23:00:00 19/11/2018] el: 1 cg: RN cu: CCU vo: 0 do: 0 du: mghr so: .9% Normal Saline sv: 50 su: ml rt: IV Drip id: Heparin t0: [00:00:00 20/11/2018] el: 1 cg: RN cu: CCU vo: 0 do: 900 du: Uhr so: D5W sv: 250 su: ml rt: IV Drip id: Heparin t0: [23:00:00 19/11/2018] el: 1 cg: RN cu: CCU vo: 0 do: 900 du: Uhr so: D5W sv: 250 su: ml rt: IV Drip
id: Total Hourly Output t0: [23:00:00 19/11/2018] el: 2 cg: RN cu: CCU cv: 0 ac: 1 ap: none re: 0 id: Urine Out Total t0: [23:00:00 19/11/2018] el: 2 cg: RN cu: CCU cv: 1805 ac: 24 ap: none re: 0 id: Urine Out Total t0: [23:00:00 20/11/2018] el: 2 cg: RN cu: CCU cv: 2073 ac: 24 ap: none re: 0 id: 24h Total Out t0: [23:00:00 19/11/2018] el: 2 cg: RN cu: CCU cv: 1805 ac: 24 ap: carryForward re: 0
id: ETT Mark/Location t0: [00:00:00 20/11/2018] el: 0 cg: RRT cu: CCU v1: 22cm v2: Lip st: NotStopd id: FiO2 Set t0: [00:00:00 20/11/2018] el: 0 cg: RRT cu: CCU v1: 0.4 n1: 0.4 u1: torr st: NotStopd id: High Insp. Pressure t0: [00:00:00 20/11/2018] el: 0 cg: RRT cu: CCU v1: 45 n1: 45 u1: cmH2O st: NotStopd id: High Resp. Rate t0: [00:00:00 20/11/2018] el: 0 cg: RRT cu: CCU v1: 30 n1: 30 u1: BPM st: NotStopd id: Airway Size t0: [00:00:00 20/11/2018] el: 0 cg: RRT cu: CCU v1: 7.0 mm st: NotStopd id: Airway Type t0: [00:00:00 20/11/2018] el: 0 cg: RRT cu: CCU v1: Endotracheal st: NotStopd id: Inspired Gas Temp t0: [00:00:00 20/11/2018] el: 0 cg: RRT cu: CCU v1: 37 n1: 37 u1: Deg. C st: NotStopd id: Intubation Date t0: [00:00:00 20/11/2018] el: 0 cg: RRT cu: CCU v1: 6 n1: 6 v2: 22 n2: 22 st: NotStopd id: Low Exhaled Min Vol t0: [00:00:00 20/11/2018] el: 0 cg: RRT cu: CCU v1: 2.5 n1: 2.5 st: NotStopd id: MDI #1 (Puff/Drug) t0: [00:00:00 20/11/2018] el: 0 cg: RRT cu: CCU v1: 6 n1: 6 v2: Combivent st: NotStopd id: Mean Airway Pressure t0: [00:00:00 20/11/2018] el: 0 cg: RRT cu: CCU v1: 6 n1: 6 u1: cmH2O st: NotStopd id: Minute Volume(Obser) t0: [00:00:00 20/11/2018] el: 0 cg: RRT cu: CCU v1: 5.6 n1: 5.6 u1: L/min st: NotStopd id: PEEP Set t0: [00:00:00 20/11/2018] el: 0 cg: RRT cu: CCU v1: 5 n1: 5 u1: cmH2O st: NotStopd id: Apnea Time Interval t0: [00:00:00 20/11/2018] el: 0 cg: RRT cu: CCU v1: 20 n1: 20 st: NotStopd id: Pressure Support t0: [00:00:00 20/11/2018] el: 0 cg: RRT cu: CCU v1: 5 n1: 5 u1: . st: NotStopd id: Resp Rate (Spont) t0: [00:00:00 20/11/2018] el: 0 cg: RRT cu: CCU v1: 2 n1: 2 u1: BPM st: NotStopd id: Resp Rate (Total) t0: [00:00:00 20/11/2018] el: 0 cg: RRT cu: CCU v1: 8 n1: 8 u1: BPM st: NotStopd id: Respiratory Rate Set t0: [00:00:00 20/11/2018] el: 0 cg: RRT cu: CCU v1: 6 n1: 6 u1: BPM st: NotStopd id: Ve High t0: [00:00:00 20/11/2018] el: 0 cg: RRT cu: CCU v1: 14 n1: 14 st: NotStopd id: Sensitivity-Vent t0: [00:00:00 20/11/2018] el: 0 cg: RRT cu: CCU v1: 2 n1: 2 u1: cmH2O st: NotStopd id: Tidal Volume (Set) t0: [00:00:00 20/11/2018] el: 0 cg: RRT cu: CCU v1: 520 n1: 520 u1: ml/B st: NotStopd id: Tidal Volume (Spont) t0: [00:00:00 20/11/2018] el: 0 cg: RRT cu: CCU v1: 700 n1: 700 u1: ml/B st: NotStopd id: Ventilator Mode t0: [00:00:00 20/11/2018] el: 0 cg: RRT cu: CCU v1: Other/Remarks st: NotStopd id: Ventilator Type t0: [00:00:00 20/11/2018] el: 0 cg: RRT cu: CCU v1: Drager st: NotStopd id: Waveform-Vent t0: [00:00:00 20/11/2018] el: 0 cg: RRT cu: CCU v1: RAMP st: NotStopd
id: Art.pH t0: [00:54:00 20/11/2018] el: 0 cg: 1663 cu: CCU v1: 7.42 n1: 7.42 rs: Final st: NotStopd id: Temp. Site t0: [00:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Oral st: NotStopd id: Temperature C (calc) t0: [00:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 37.2222 n1: 37.2222 u1: Deg. C st: NotStopd id: Temperature F t0: [00:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 99 n1: 99 u1: Deg. F st: NotStopd id: Arterial Base Excess t0: [00:54:00 20/11/2018] el: 0 cg: 1663 cu: CCU v1: 3 n1: 3 rs: Final st: NotStopd id: Arterial CO2(Calc) t0: [00:54:00 20/11/2018] el: 0 cg: 1663 cu: CCU v1: 29 n1: 29 rs: Final st: NotStopd id: Arterial PaCO2 t0: [00:54:00 20/11/2018] el: 0 cg: 1663 cu: CCU v1: 43 n1: 43 u1: mmHg rs: Final st: NotStopd id: Arterial PaO2 t0: [00:54:00 20/11/2018] el: 0 cg: 1663 cu: CCU v1: 151 n1: 151 u1: mmHg rs: Final st: NotStopd id: Arterial pH t0: [00:54:00 20/11/2018] el: 0 cg: 1663 cu: CCU v1: 7.42 n1: 7.42 rs: Final st: NotStopd
id: D5W 250.0ml + 25000Uhr Heparin t0: [00:00:00 20/11/2018] el: 1 ai: 117 cg: RN cu: CCU vo: 9 vu: ml nb: 1 id: Stool Out Stool t0: [00:00:00 20/11/2018] el: 1 cg: RN cu: CCU vu: ml es: Small
id: Stool Out Total t0: [23:00:00 20/11/2018] el: 2 cg: RN cu: CCU cv: 0 ac: 24 ap: carryForward re: 0 id: Total Hourly Output t0: [23:00:00 20/11/2018] el: 2 cg: RN cu: CCU cv: 0 ac: 1 ap: none re: 0 id: 24h Total Out t0: [23:00:00 20/11/2018] el: 2 cg: RN cu: CCU cv: 2073 ac: 24 ap: carryForward re: 0
id: Service Type t0: [01:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: CCU st: NotStopd id: Service Type t0: [02:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: CCU st: NotStopd id: Service Type t0: [03:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: CCU st: NotStopd id: Code Status t0: [01:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Full Code st: NotStopd id: Code Status t0: [02:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Full Code st: NotStopd id: Code Status t0: [03:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Full Code st: NotStopd id: Risk for Falls t0: [01:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Yes st: NotStopd id: Risk for Falls t0: [02:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Yes st: NotStopd id: Risk for Falls t0: [03:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Yes st: NotStopd id: Ectopy Frequency t0: [01:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: None st: NotStopd id: Ectopy Frequency t0: [02:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: None st: NotStopd id: Ectopy Frequency t0: [03:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: None st: NotStopd id: Ectopy Type t0: [01:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: None st: NotStopd id: Ectopy Type t0: [02:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: None st: NotStopd id: Ectopy Type t0: [03:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: None st: NotStopd id: Heart Rate t0: [01:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 84 n1: 84 u1: BPM st: NotStopd id: Heart Rate t0: [02:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 82 n1: 82 u1: BPM st: NotStopd id: Heart Rate t0: [03:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 79 n1: 79 u1: BPM st: NotStopd id: Heart Rhythm t0: [01:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Atrial Fib st: NotStopd id: Heart Rhythm t0: [02:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Atrial Fib st: NotStopd id: Heart Rhythm t0: [03:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Atrial Fib st: NotStopd id: Arterial BP t0: [01:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 111 n1: 111 u1: mmHg v2: 48 n2: 48 u2: mmHg st: NotStopd id: Arterial BP t0: [02:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 103 n1: 103 u1: mmHg v2: 46 n2: 46 u2: mmHg st: NotStopd id: Arterial BP t0: [03:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 113 n1: 113 u1: mmHg v2: 48 n2: 48 u2: mmHg st: NotStopd id: Arterial BP Mean t0: [01:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 68 n1: 68 u1: mmHg st: NotStopd id: Arterial BP Mean t0: [02:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 64 n1: 64 u1: mmHg st: NotStopd id: Arterial BP Mean t0: [03:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 69 n1: 69 u1: mmHg st: NotStopd id: Precautions t0: [01:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Contact st: NotStopd id: Precautions t0: [02:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Contact st: NotStopd id: Precautions t0: [03:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Contact st: NotStopd id: ABP Alarm (Lo/Hi) t0: [01:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 90 n1: 90 u1: mmHg v2: 160 n2: 160 u2: mmHg st: NotStopd id: ABP Alarm (Lo/Hi) t0: [02:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 90 n1: 90 u1: mmHg v2: 160 n2: 160 u2: mmHg st: NotStopd id: ABP Alarm (Lo/Hi) t0: [03:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 90 n1: 90 u1: mmHg v2: 160 n2: 160 u2: mmHg st: NotStopd id: HR Alarm (Lo/Hi) t0: [01:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 50 n1: 50 u1: BPM v2: 145 n2: 145 u2: BPM st: NotStopd id: HR Alarm (Lo/Hi) t0: [02:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 50 n1: 50 u1: BPM v2: 145 n2: 145 u2: BPM st: NotStopd id: HR Alarm (Lo/Hi) t0: [03:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 50 n1: 50 u1: BPM v2: 145 n2: 145 u2: BPM st: NotStopd id: Resp Alarm (Lo/Hi) t0: [01:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 8 n1: 8 u1: BPM v2: 35 n2: 35 u2: BPM st: NotStopd id: Resp Alarm (Lo/Hi) t0: [02:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 8 n1: 8 u1: BPM v2: 35 n2: 35 u2: BPM st: NotStopd id: Resp Alarm (Lo/Hi) t0: [03:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 8 n1: 8 u1: BPM v2: 35 n2: 35 u2: BPM st: NotStopd id: SpO2 Alarm (Lo/Hi) t0: [01:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 90 n1: 90 u1: % v2: 100 n2: 100 u2: % st: NotStopd id: SpO2 Alarm (Lo/Hi) t0: [02:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 90 n1: 90 u1: % v2: 100 n2: 100 u2: % st: NotStopd id: SpO2 Alarm (Lo/Hi) t0: [03:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 90 n1: 90 u1: % v2: 100 n2: 100 u2: % st: NotStopd id: Respiratory Rate t0: [01:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 36 n1: 36 u1: BPM st: NotStopd id: Respiratory Rate t0: [02:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 35 n1: 35 u1: BPM st: NotStopd id: Respiratory Rate t0: [03:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 39 n1: 39 u1: BPM st: NotStopd id: SpO2 t0: [01:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 97 n1: 97 u1: % st: NotStopd id: SpO2 t0: [02:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 97 n1: 97 u1: % st: NotStopd id: SpO2 t0: [03:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 98 n1: 98 u1: % st: NotStopd id: calprevflg t0: [01:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 1 n1: 1 u1: kg st: NotStopd id: calprevflg t0: [02:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 1 n1: 1 u1: kg st: NotStopd id: calprevflg t0: [03:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 1 n1: 1 u1: kg st: NotStopd
id: D5W 250.0ml + 25000Uhr Heparin t0: [01:00:00 20/11/2018] el: 1 ai: 117 cg: RN cu: CCU vo: 9 vu: ml id: D5W 250.0ml + 25000Uhr Heparin t0: [02:00:00 20/11/2018] el: 1 ai: 117 cg: RN cu: CCU vo: 9 vu: ml id: D5W 250.0ml + 25000Uhr Heparin t0: [03:00:00 20/11/2018] el: 1 ai: 117 cg: RN cu: CCU vo: 9 vu: ml id: Gastric Meds t0: [00:00:00 20/11/2018] el: 1 ai: 155 cg: RN cu: CCU vo: 30 vu: ml id: Promote w/fiber t0: [00:00:00 20/11/2018] el: 1 ai: 1109 cg: RN cu: CCU vo: 30 vu: ml st: Stopped id: Promote w/fiber t0: [22:00:00 19/11/2018] el: 1 ai: 1109 cg: RN cu: CCU vo: 30 vu: ml id: Promote w/fiber t0: [23:00:00 19/11/2018] el: 1 ai: 1109 cg: RN cu: CCU vo: 30 vu: ml
id: Heparin t0: [01:00:00 20/11/2018] el: 1 cg: RN cu: CCU vo: 0 do: 900 du: Uhr so: D5W sv: 250 su: ml rt: IV Drip id: Heparin t0: [02:00:00 20/11/2018] el: 1 cg: RN cu: CCU vo: 0 do: 900 du: Uhr so: D5W sv: 250 su: ml rt: IV Drip id: Heparin t0: [03:00:00 20/11/2018] el: 1 cg: RN cu: CCU vo: 0 do: 900 du: Uhr so: D5W sv: 250 su: ml rt: IV Drip
id: IV Infusion In Total t0: [23:00:00 20/11/2018] el: 2 cg: RN cu: CCU pv: 19 cv: 1486 ac: 24 ap: none re: 0 id: 24h Total In t0: [23:00:00 20/11/2018] el: 2 cg: RN cu: CCU pv: 19 cv: 1576 ac: 24 ap: none re: 0 id: PO/Gastric In Total t0: [23:00:00 20/11/2018] el: 2 cg: RN cu: CCU cv: 60 ac: 24 ap: none re: 0 id: Tube Feeds In Total t0: [23:00:00 19/11/2018] el: 2 cg: RN cu: CCU pv: 30 cv: 90 ac: 24 ap: none re: 0 id: Tube Feeds In Total t0: [23:00:00 20/11/2018] el: 2 cg: RN cu: CCU cv: 30 ac: 24 ap: none re: 0 id: 24h Net Body Balance t0: [23:00:00 19/11/2018] el: 2 cg: RN cu: CCU pv: 39 cv: -220 ac: 24 ap: carryForward re: 0 id: 24h Net Body Balance t0: [23:00:00 20/11/2018] el: 2 cg: RN cu: CCU pv: 19 cv: -497 ac: 24 ap: carryForward re: 0 id: LOS Net Body Balance t0: [23:00:00 19/11/2018] el: 2 cg: RN cu: CCU pv: 39 cv: 2371.75 ac: multiple days ap: carryForward re: 0 id: LOS Net Body Balance t0: [23:00:00 20/11/2018] el: 2 cg: RN cu: CCU pv: 19 cv: 1874.75 ac: multiple days ap: carryForward re: 0 id: Net Hourly Balance t0: [23:00:00 19/11/2018] el: 2 cg: RN cu: CCU pv: 39 cv: 39 ac: 1 ap: none re: 0 id: Net Hourly Balance t0: [23:00:00 20/11/2018] el: 2 cg: RN cu: CCU pv: 19 cv: 19 ac: 1 ap: none re: 0
id: Service Type t0: [04:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: CCU st: NotStopd id: Code Status t0: [04:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Full Code st: NotStopd id: Riker-SAS Scale t0: [04:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Calm/Cooperative st: NotStopd id: Risk for Falls t0: [04:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Yes st: NotStopd id: Ectopy Frequency t0: [04:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: None st: NotStopd id: Ectopy Type t0: [04:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: None st: NotStopd id: Alarms t0: [04:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: ON st: NotStopd id: Parameters Checked t0: [04:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Yes st: NotStopd id: Heart Rate t0: [04:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 85 n1: 85 u1: BPM st: NotStopd id: Heart Rhythm t0: [04:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Atrial Fib st: NotStopd id: Arterial BP t0: [04:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 116 n1: 116 u1: mmHg v2: 50 n2: 50 u2: mmHg st: NotStopd id: Arterial BP Mean t0: [04:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 71 n1: 71 u1: mmHg st: NotStopd id: Precautions t0: [04:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Contact st: NotStopd id: ABP Alarm (Lo/Hi) t0: [04:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 90 n1: 90 u1: mmHg v2: 160 n2: 160 u2: mmHg st: NotStopd id: HR Alarm (Lo/Hi) t0: [04:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 50 n1: 50 u1: BPM v2: 145 n2: 145 u2: BPM st: NotStopd id: Resp Alarm (Lo/Hi) t0: [04:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 8 n1: 8 u1: BPM v2: 35 n2: 35 u2: BPM st: NotStopd id: SpO2 Alarm (Lo/Hi) t0: [04:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 90 n1: 90 u1: % v2: 100 n2: 100 u2: % st: NotStopd id: Respiratory Rate t0: [04:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 26 n1: 26 u1: BPM st: NotStopd id: SpO2 t0: [04:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 97 n1: 97 u1: % st: NotStopd id: calprevflg t0: [04:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 1 n1: 1 u1: kg st: NotStopd
id: D5W 250.0ml + 25000Uhr Heparin t0: [04:00:00 20/11/2018] el: 1 ai: 117 cg: RN cu: CCU vo: 9 vu: ml
id: Heparin t0: [04:00:00 20/11/2018] el: 1 cg: RN cu: CCU vo: 0 do: 900 du: Uhr so: D5W sv: 250 su: ml rt: IV Drip
id: Art.pH t0: [04:34:00 20/11/2018] el: 0 cg: 1663 cu: CCU v1: 7.42 n1: 7.42 rs: Final st: NotStopd id: Arterial Base Excess t0: [04:34:00 20/11/2018] el: 0 cg: 1663 cu: CCU v1: 4 n1: 4 rs: Final st: NotStopd id: Arterial CO2(Calc) t0: [04:34:00 20/11/2018] el: 0 cg: 1663 cu: CCU v1: 31 n1: 31 rs: Final st: NotStopd id: Arterial PaCO2 t0: [04:34:00 20/11/2018] el: 0 cg: 1663 cu: CCU v1: 46 n1: 46 u1: mmHg rs: Final st: NotStopd id: Arterial PaO2 t0: [04:34:00 20/11/2018] el: 0 cg: 1663 cu: CCU v1: 106 n1: 106 u1: mmHg rs: Final st: NotStopd id: Arterial pH t0: [04:34:00 20/11/2018] el: 0 cg: 1663 cu: CCU v1: 7.42 n1: 7.42 rs: Final st: NotStopd
id: WBC (4-11,000) t0: [04:24:00 20/11/2018] el: 0 cg: 1663 cu: CCU v1: 6.6 n1: 6.6 rs: Final st: NotStopd id: WBC t0: [04:24:00 20/11/2018] el: 0 cg: 1663 cu: CCU v1: 6.6 n1: 6.6 rs: Final st: NotStopd id: Hematocrit t0: [04:24:00 20/11/2018] el: 0 cg: 1663 cu: CCU v1: 28.5 n1: 28.5 u1: % rs: Final st: NotStopd id: Hemoglobin t0: [04:24:00 20/11/2018] el: 0 cg: 1663 cu: CCU v1: 9.8 n1: 9.8 u1: gm/dl rs: Final st: NotStopd id: Platelets t0: [04:24:00 20/11/2018] el: 0 cg: 1663 cu: CCU v1: 133 n1: 133 rs: Final st: NotStopd id: RBC t0: [04:24:00 20/11/2018] el: 0 cg: 1663 cu: CCU v1: 3.5 n1: 3.5 u1: /mic l rs: Final st: NotStopd id: WBC (4-11,000) t0: [04:24:00 20/11/2018] el: 0 cg: 1663 cu: CCU v1: 6.6 n1: 6.6 rs: Final st: NotStopd
io: .9% Normal Saline 1000.0ml el: 1 cg: RN cu: CCU ra: 10 ru: ml/hr
id: Cath Lab Intake t0: [05:00:00 20/11/2018] el: 1 ai: 190 cg: -1 cu: CCU vo: 0 st: D/C'd id: Gastric Emesis t0: [05:00:00 20/11/2018] el: 1 cg: -1 cu: CCU vo: 0 st: D/C'd
id: PT t0: [04:24:00 20/11/2018] el: 0 cg: 1663 cu: CCU v1: 16.8 n1: 16.8 rs: Final st: NotStopd id: INR t0: [04:24:00 20/11/2018] el: 0 cg: 1663 cu: CCU v1: 1.6 n1: 1.6 rs: Final st: NotStopd id: PTT t0: [04:24:00 20/11/2018] el: 0 cg: 1663 cu: CCU v1: 66.7 n1: 66.7 rs: Final st: NotStopd id: INR (2-4 ref. range) t0: [04:24:00 20/11/2018] el: 0 cg: 1663 cu: CCU v1: 1.6 n1: 1.6 rs: Final st: NotStopd id: PT(11-13.5) t0: [04:24:00 20/11/2018] el: 0 cg: 1663 cu: CCU v1: 16.8 n1: 16.8 rs: Final st: NotStopd id: PTT(22-35) t0: [04:24:00 20/11/2018] el: 0 cg: 1663 cu: CCU v1: 66.7 n1: 66.7 rs: Final st: NotStopd
id: Service Type t0: [05:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: CCU st: NotStopd id: Code Status t0: [05:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Full Code st: NotStopd id: Risk for Falls t0: [05:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Yes st: NotStopd id: Ectopy Frequency t0: [05:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: None st: NotStopd id: Ectopy Type t0: [05:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: None st: NotStopd id: Heart Rate t0: [05:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 84 n1: 84 u1: BPM st: NotStopd id: Heart Rhythm t0: [05:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Atrial Fib st: NotStopd id: Arterial BP t0: [05:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 105 n1: 105 u1: mmHg v2: 41 n2: 41 u2: mmHg st: NotStopd id: Arterial BP Mean t0: [05:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 61 n1: 61 u1: mmHg st: NotStopd id: Precautions t0: [05:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Contact st: NotStopd id: ABP Alarm (Lo/Hi) t0: [05:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 90 n1: 90 u1: mmHg v2: 160 n2: 160 u2: mmHg st: NotStopd id: HR Alarm (Lo/Hi) t0: [05:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 50 n1: 50 u1: BPM v2: 145 n2: 145 u2: BPM st: NotStopd id: Resp Alarm (Lo/Hi) t0: [05:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 8 n1: 8 u1: BPM v2: 35 n2: 35 u2: BPM st: NotStopd id: SpO2 Alarm (Lo/Hi) t0: [05:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 90 n1: 90 u1: % v2: 100 n2: 100 u2: % st: NotStopd id: Respiratory Rate t0: [05:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 30 n1: 30 u1: BPM st: NotStopd id: SpO2 t0: [05:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 97 n1: 97 u1: % st: NotStopd id: Temp. Site t0: [05:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Oral st: NotStopd id: Temperature C (calc) t0: [05:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 37.7778 n1: 37.7778 u1: Deg. C st: NotStopd id: Temperature F t0: [05:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 100 n1: 100 u1: Deg. F st: NotStopd id: calprevflg t0: [05:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 1 n1: 1 u1: kg st: NotStopd
id: D5W 250.0ml + 25000Uhr Heparin t0: [05:00:00 20/11/2018] el: 1 ai: 117 cg: RN cu: CCU vo: 9 vu: ml id: Urine Out Foley t0: [02:00:00 20/11/2018] el: 1 cg: RN cu: CCU vo: 60 vu: ml id: Urine Out Foley t0: [04:00:00 20/11/2018] el: 1 cg: RN cu: CCU vo: 100 vu: ml
id: Heparin t0: [05:00:00 20/11/2018] el: 1 cg: RN cu: CCU vo: 0 do: 900 du: Uhr so: D5W sv: 250 su: ml rt: IV Drip
id: RSBI (<100) t0: [05:00:00 20/11/2018] el: 0 cg: RRT cu: CCU v1: 21.8182 n1: 21.8182 u1: units st: NotStopd id: ETT Mark/Location t0: [05:00:00 20/11/2018] el: 0 cg: RRT cu: CCU v1: 22cm v2: Lip st: NotStopd id: FiO2 Set t0: [05:00:00 20/11/2018] el: 0 cg: RRT cu: CCU v1: 0.4 n1: 0.4 u1: torr st: NotStopd id: High Insp. Pressure t0: [05:00:00 20/11/2018] el: 0 cg: RRT cu: CCU v1: 40 n1: 40 u1: cmH2O st: NotStopd id: High Resp. Rate t0: [05:00:00 20/11/2018] el: 0 cg: RRT cu: CCU v1: 30 n1: 30 u1: BPM st: NotStopd id: Airway Size t0: [05:00:00 20/11/2018] el: 0 cg: RRT cu: CCU v1: 7.0 mm st: NotStopd id: Airway Type t0: [05:00:00 20/11/2018] el: 0 cg: RRT cu: CCU v1: Endotracheal st: NotStopd id: Inspired Gas Temp t0: [05:00:00 20/11/2018] el: 0 cg: RRT cu: CCU v1: 37 n1: 37 u1: Deg. C st: NotStopd id: Intubation Date t0: [05:00:00 20/11/2018] el: 0 cg: RRT cu: CCU v1: 6 n1: 6 v2: 22 n2: 22 st: NotStopd id: Low Exhaled Min Vol t0: [05:00:00 20/11/2018] el: 0 cg: RRT cu: CCU v1: 3 n1: 3 st: NotStopd id: MDI #1 (Puff/Drug) t0: [05:00:00 20/11/2018] el: 0 cg: RRT cu: CCU v1: 6 n1: 6 v2: Combivent st: NotStopd id: Minute Volume(Obser) t0: [05:00:00 20/11/2018] el: 0 cg: RRT cu: CCU v1: 6 n1: 6 u1: L/min st: NotStopd id: PEEP Set t0: [05:00:00 20/11/2018] el: 0 cg: RRT cu: CCU v1: 0 n1: 0 u1: cmH2O st: NotStopd id: Apnea Time Interval t0: [05:00:00 20/11/2018] el: 0 cg: RRT cu: CCU v1: 20 n1: 20 st: NotStopd id: Pressure Support t0: [05:00:00 20/11/2018] el: 0 cg: RRT cu: CCU v1: 5 n1: 5 u1: . st: NotStopd id: RSBI (<200) t0: [05:00:00 20/11/2018] el: 0 cg: RRT cu: CCU v1: 21.8182 n1: 21.8182 u1: units st: NotStopd id: Resp Rate (Total) t0: [05:00:00 20/11/2018] el: 0 cg: RRT cu: CCU v1: 12 n1: 12 u1: BPM st: NotStopd id: Ve High t0: [05:00:00 20/11/2018] el: 0 cg: RRT cu: CCU v1: 14 n1: 14 st: NotStopd id: Sensitivity-Vent t0: [05:00:00 20/11/2018] el: 0 cg: RRT cu: CCU v1: 2 n1: 2 u1: cmH2O st: NotStopd id: Spon RR (Mech.) t0: [05:00:00 20/11/2018] el: 0 cg: RRT cu: CCU v1: 12 n1: 12 u1: BPM st: NotStopd id: Spon. Vt (L) (Mech.) t0: [05:00:00 20/11/2018] el: 0 cg: RRT cu: CCU v1: 0.55 n1: 0.55 u1: L st: NotStopd id: Sputum Color/Consist t0: [05:00:00 20/11/2018] el: 0 cg: RRT cu: CCU v1: Blood Tinged v2: Thick st: NotStopd id: Sputum Source/Amt t0: [05:00:00 20/11/2018] el: 0 cg: RRT cu: CCU v1: Suctioned v2: Small st: NotStopd id: Tidal Volume (Spont) t0: [05:00:00 20/11/2018] el: 0 cg: RRT cu: CCU v1: 550 n1: 550 u1: ml/B st: NotStopd id: Ventilator Mode t0: [05:00:00 20/11/2018] el: 0 cg: RRT cu: CCU v1: CPAP+PS st: NotStopd id: Ventilator Type t0: [05:00:00 20/11/2018] el: 0 cg: RRT cu: CCU v1: Drager st: NotStopd
id: BUN t0: [04:24:00 20/11/2018] el: 0 cg: 1663 cu: CCU v1: 17 n1: 17 rs: Final st: NotStopd id: Calcium t0: [04:24:00 20/11/2018] el: 0 cg: 1663 cu: CCU v1: 8.6 n1: 8.6 u1: mg/dl rs: Final st: NotStopd id: Chloride t0: [04:24:00 20/11/2018] el: 0 cg: 1663 cu: CCU v1: 112 n1: 112 rs: Final st: NotStopd id: Creatinine t0: [04:24:00 20/11/2018] el: 0 cg: 1663 cu: CCU v1: 0.9 n1: 0.9 rs: Final st: NotStopd id: Glucose t0: [04:24:00 20/11/2018] el: 0 cg: 1663 cu: CCU v1: 170 n1: 170 rs: Final st: NotStopd id: Magnesium t0: [04:24:00 20/11/2018] el: 0 cg: 1663 cu: CCU v1: 2.5 n1: 2.5 rs: Final st: NotStopd id: Phosphorous t0: [04:24:00 20/11/2018] el: 0 cg: 1663 cu: CCU v1: 2.8 n1: 2.8 u1: mEq/L rs: Final st: NotStopd id: Potassium t0: [04:24:00 20/11/2018] el: 0 cg: 1663 cu: CCU v1: 4.1 n1: 4.1 rs: Final st: NotStopd id: Sodium t0: [04:24:00 20/11/2018] el: 0 cg: 1663 cu: CCU v1: 147 n1: 147 rs: Final st: NotStopd id: BUN (6-20) t0: [04:24:00 20/11/2018] el: 0 cg: 1663 cu: CCU v1: 17 n1: 17 rs: Final st: NotStopd id: Calcium (8.4-10.2) t0: [04:24:00 20/11/2018] el: 0 cg: 1663 cu: CCU v1: 8.6 n1: 8.6 u1: mg/dl rs: Final st: NotStopd id: Carbon Dioxide t0: [04:24:00 20/11/2018] el: 0 cg: 1663 cu: CCU v1: 27 n1: 27 rs: Final st: NotStopd id: Chloride (100-112) t0: [04:24:00 20/11/2018] el: 0 cg: 1663 cu: CCU v1: 112 n1: 112 rs: Final st: NotStopd id: Creatinine (0-1.3) t0: [04:24:00 20/11/2018] el: 0 cg: 1663 cu: CCU v1: 0.9 n1: 0.9 rs: Final st: NotStopd id: Glucose (70-105) t0: [04:24:00 20/11/2018] el: 0 cg: 1663 cu: CCU v1: 170 n1: 170 rs: Final st: NotStopd id: Magnesium (1.6-2.6) t0: [04:24:00 20/11/2018] el: 0 cg: 1663 cu: CCU v1: 2.5 n1: 2.5 rs: Final st: NotStopd id: Phosphorous(2.7-4.5) t0: [04:24:00 20/11/2018] el: 0 cg: 1663 cu: CCU v1: 2.8 n1: 2.8 u1: mEq/L rs: Final st: NotStopd id: Potassium (3.5-5.3) t0: [04:24:00 20/11/2018] el: 0 cg: 1663 cu: CCU v1: 4.1 n1: 4.1 rs: Final st: NotStopd id: Sodium (135-148) t0: [04:24:00 20/11/2018] el: 0 cg: 1663 cu: CCU v1: 147 n1: 147 rs: Final st: NotStopd
id: Pain Present t0: [00:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Yes st: NotStopd id: Pain Present t0: [01:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: No st: NotStopd id: Pain Present t0: [04:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Yes st: NotStopd id: Pain Present t0: [05:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: No st: NotStopd id: Pain Present t0: [21:00:00 19/11/2018] el: 0 cg: RN cu: CCU v1: Yes st: NotStopd id: Pain Present t0: [22:00:00 19/11/2018] el: 0 cg: RN cu: CCU v1: No st: NotStopd id: Pain Assess Method t0: [00:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Grimace Scale st: NotStopd id: Pain Assess Method t0: [04:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Grimace Scale st: NotStopd id: GI Prophylaxis t0: [00:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Proton/Pump/Inhi st: NotStopd id: GI Prophylaxis t0: [04:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Proton/Pump/Inhi st: NotStopd id: GI Prophylaxis t0: [20:00:00 19/11/2018] el: 0 cg: RN cu: CCU v1: Proton/Pump/Inhi st: NotStopd id: Diet Type t0: [00:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: NPO st: NotStopd id: Diet Type t0: [04:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: NPO st: NotStopd id: Diet Type t0: [19:00:00 19/11/2018] el: 0 cg: RN cu: CCU v1: Tube Feeding st: NotStopd id: Diet Type t0: [20:00:00 19/11/2018] el: 0 cg: RN cu: CCU v1: Tube Feeding st: NotStopd id: Diet Type t0: [23:00:00 19/11/2018] el: 0 cg: RN cu: CCU v1: Tube Feeding st: NotStopd id: Dorsal PedPulse R/L t0: [00:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Not Applicable v2: Doppler st: NotStopd id: Dorsal PedPulse R/L t0: [04:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Not Applicable v2: Doppler st: NotStopd id: GI#1 Intub Site t0: [00:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Salem Sump v2: Oral st: NotStopd id: GI#1 Intub Site t0: [04:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Salem Sump v2: Oral st: NotStopd id: Education Topic #1 t0: [00:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Plan of Care st: NotStopd id: Education Topic #1 t0: [04:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Plan of Care st: NotStopd id: Eye Opening t0: [00:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 3 To speech st: NotStopd id: Eye Opening t0: [04:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 3 To speech st: NotStopd id: Follows Commands t0: [00:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Inconsistently st: NotStopd id: Follows Commands t0: [04:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Inconsistently st: NotStopd id: GCS Total t0: [00:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 9 n1: 9 u1: points st: NotStopd id: GCS Total t0: [04:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 9 n1: 9 u1: points st: NotStopd id: GI Intub #1/Site t0: [00:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Salem Sump v2: Oral st: NotStopd id: GI Intub #1/Site t0: [04:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Salem Sump v2: Oral st: NotStopd id: GI#1 Tube PlaceCheck t0: [20:00:00 19/11/2018] el: 0 cg: RN cu: CCU v1: Done st: NotStopd id: GI#1 Tube Stat/Drain t0: [00:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Clamped st: NotStopd id: GI#1 Tube Stat/Drain t0: [04:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Clamped st: NotStopd id: GI#1 Tube Stat/Drain t0: [20:00:00 19/11/2018] el: 0 cg: RN cu: CCU v1: Feeding st: NotStopd id: HOB t0: [00:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 30 degrees st: NotStopd id: HOB t0: [04:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 30 degrees st: NotStopd id: INV Line#3 Type/Site t0: [00:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: A-Line v2: Left Radial st: NotStopd id: INV Line#3 Type/Site t0: [04:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: A-Line v2: Left Radial st: NotStopd id: INV Line#3 Zero/Cal t0: [00:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: No st: NotStopd id: INV Line#3 Zero/Cal t0: [04:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: No st: NotStopd id: INV Line#3InsertDate t0: [00:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 9 n1: 9 v2: 24 n2: 24 st: NotStopd id: INV Line#3InsertDate t0: [04:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 9 n1: 9 v2: 24 n2: 24 st: NotStopd id: INV Line#3SiteAppear t0: [00:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: WNL st: NotStopd id: INV Line#3SiteAppear t0: [04:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: WNL st: NotStopd id: Abdominal Assessment t0: [00:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Obese st: NotStopd id: Abdominal Assessment t0: [04:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Obese st: NotStopd id: Abdominal Assessment t0: [20:00:00 19/11/2018] el: 0 cg: RN cu: CCU v1: Obese st: NotStopd id: INV#3 WaveformAppear t0: [00:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Sharp st: NotStopd id: INV#3 WaveformAppear t0: [04:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Sharp st: NotStopd id: IV #1 Insert Date t0: [00:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 9 n1: 9 v2: 22 n2: 22 st: NotStopd id: IV #1 Insert Date t0: [04:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 9 n1: 9 v2: 22 n2: 22 st: NotStopd id: IV #1 Site/Size t0: [00:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Right Antecub v2: 18 gauge st: NotStopd id: IV #1 Site/Size t0: [04:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Right Antecub v2: 18 gauge st: NotStopd id: IV #2 Insert Date t0: [00:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 9 n1: 9 v2: 25 n2: 25 st: NotStopd id: IV #2 Insert Date t0: [04:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 9 n1: 9 v2: 25 n2: 25 st: NotStopd id: IV #2 Site/Size t0: [00:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Right Wrist v2: 20 gauge st: NotStopd id: IV #2 Site/Size t0: [04:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Right Wrist v2: 20 gauge st: NotStopd id: Activity t0: [00:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Bedrest st: NotStopd id: Activity t0: [04:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Bedrest st: NotStopd id: IV Site Appear #1 t0: [00:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: WNL st: NotStopd id: IV Site Appear #1 t0: [04:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: WNL st: NotStopd id: IV Site Appear #2 t0: [00:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: WNL st: NotStopd id: IV Site Appear #2 t0: [04:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: WNL st: NotStopd id: Activity Tolerance t0: [00:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Poor st: NotStopd id: Activity Tolerance t0: [04:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Fair st: NotStopd id: Activity Tolerance t0: [20:00:00 19/11/2018] el: 0 cg: RN cu: CCU v1: Poor st: NotStopd id: ImpSkin Character #1 t0: [00:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Abrasion st: NotStopd id: ImpSkin Character #1 t0: [04:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Abrasion st: NotStopd id: ImpSkin Treatment #1 t0: [00:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Dry Sterile Dsg st: NotStopd id: ImpSkin Treatment #1 t0: [04:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Dry Sterile Dsg st: NotStopd id: Impaired Skin Site#1 t0: [00:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Abdomen st: NotStopd id: Impaired Skin Site#1 t0: [04:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Abdomen st: NotStopd id: LLE Temp/Color t0: [00:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Warm v2: Dusky st: NotStopd id: LLE Temp/Color t0: [04:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Warm v2: Dusky st: NotStopd id: LLE Temp/Color t0: [20:00:00 19/11/2018] el: 0 cg: RN cu: CCU v1: Warm v2: Dusky st: NotStopd id: LLL Lung Sounds t0: [00:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Diminished st: NotStopd id: LLL Lung Sounds t0: [04:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Diminished st: NotStopd id: LLL Lung Sounds t0: [20:00:00 19/11/2018] el: 0 cg: RN cu: CCU v1: Diminished st: NotStopd id: LUL Lung Sounds t0: [00:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Clear st: NotStopd id: LUL Lung Sounds t0: [04:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Clear st: NotStopd id: LUL Lung Sounds t0: [20:00:00 19/11/2018] el: 0 cg: RN cu: CCU v1: Clear st: NotStopd id: Level of Conscious t0: [00:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Arouse to Voice st: NotStopd id: Level of Conscious t0: [04:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Arouse to Voice st: NotStopd id: Angio Appearance #1 t0: [00:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Ecchymotic v2: Clean and Dry st: NotStopd id: Angio Appearance #1 t0: [04:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Ecchymotic v2: Clean and Dry st: NotStopd id: Angio Appearance #2 t0: [00:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Clean and Dry v2: Clean and Dry st: NotStopd id: Angio Appearance #2 t0: [04:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Clean and Dry v2: Clean and Dry st: NotStopd id: Motor Response t0: [00:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 5 Localizes Pain st: NotStopd id: Motor Response t0: [04:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 5 Localizes Pain st: NotStopd id: Angio Dressing #1 t0: [00:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Transparent st: NotStopd id: Angio Dressing #1 t0: [04:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Transparent st: NotStopd id: Angio Dressing #2 t0: [00:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Dry Sterile Dsg st: NotStopd id: Angio Dressing #2 t0: [04:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Dry Sterile Dsg st: NotStopd id: Oral Care t0: [00:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Done st: NotStopd id: Oral Care t0: [04:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Done st: NotStopd id: Oral Cavity t0: [00:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Teeth/Tissue WNL st: NotStopd id: Oral Cavity t0: [04:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Teeth/Tissue WNL st: NotStopd id: Oral Cavity t0: [20:00:00 19/11/2018] el: 0 cg: RN cu: CCU v1: Teeth/Tissue WNL st: NotStopd id: Orientation t0: [00:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Unable to Assess st: NotStopd id: Orientation t0: [04:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Unable to Assess st: NotStopd id: Angio Site #1 t0: [00:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: R Femoral st: NotStopd id: Angio Site #1 t0: [04:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: R Femoral st: NotStopd id: Angio Site #2 t0: [00:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: L Femoral st: NotStopd id: Angio Site #2 t0: [04:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: L Femoral st: NotStopd id: PT Splint Loc/Stat#1 t0: [00:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Left Leg v2: On st: NotStopd id: PT Splint Loc/Stat#1 t0: [04:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Left Leg v2: On st: NotStopd id: Pain Cause t0: [00:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Movement/Turning st: NotStopd id: Pain Cause t0: [04:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Movement/Turning st: NotStopd id: Pain Cause t0: [21:00:00 19/11/2018] el: 0 cg: RN cu: CCU v1: Movement/Turning st: NotStopd id: Pain Location t0: [00:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Left Leg st: NotStopd id: Pain Location t0: [04:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Left Leg st: NotStopd id: Pain Location t0: [21:00:00 19/11/2018] el: 0 cg: RN cu: CCU v1: Not Indicated st: NotStopd id: Pain Management t0: [00:00:00 20/11/2018] el: 1 cg: RN cu: CCU v1: Repositioned st: NotStopd id: Pain Management t0: [04:00:00 20/11/2018] el: 1 cg: RN cu: CCU v1: Repositioned st: NotStopd id: Pain Type t0: [00:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Other/Remarks st: NotStopd id: Position t0: [00:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Right Side st: NotStopd id: Position t0: [04:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Left Side st: NotStopd id: PostTib. Pulses R/L t0: [00:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Not Applicable v2: Not Applicable st: NotStopd id: PostTib. Pulses R/L t0: [04:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Not Applicable v2: Not Applicable st: NotStopd id: Assistance Device t0: [00:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 2 Person Assist st: NotStopd id: Assistance Device t0: [04:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 2 Person Assist st: NotStopd id: INV#3 Dsg Change t0: [00:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 9 n1: 9 v2: 24 n2: 24 st: NotStopd id: INV#3 Dsg Change t0: [04:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 9 n1: 9 v2: 24 n2: 24 st: NotStopd id: Pupil Response R/L t0: [00:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Brisk v2: Brisk st: NotStopd id: Pupil Response R/L t0: [04:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Brisk v2: Brisk st: NotStopd id: Pupil Size R/L t0: [00:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 2 mm v2: 2 mm st: NotStopd id: Pupil Size R/L t0: [04:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 3 mm v2: 3 mm st: NotStopd id: RLL Lung Sounds t0: [00:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Diminished st: NotStopd id: RLL Lung Sounds t0: [04:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Diminished st: NotStopd id: RLL Lung Sounds t0: [20:00:00 19/11/2018] el: 0 cg: RN cu: CCU v1: Diminished st: NotStopd id: RUL Lung Sounds t0: [00:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Clear st: NotStopd id: RUL Lung Sounds t0: [04:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Clear st: NotStopd id: RUL Lung Sounds t0: [20:00:00 19/11/2018] el: 0 cg: RN cu: CCU v1: Clear st: NotStopd id: Respiratory Pattern t0: [00:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Regular st: NotStopd id: Respiratory Pattern t0: [04:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Regular st: NotStopd id: Restraint Location t0: [00:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: None st: NotStopd id: Restraint Location t0: [04:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: None st: NotStopd id: Side Rails t0: [00:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: All rails up st: NotStopd id: Side Rails t0: [04:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: All rails up st: NotStopd id: Skin Care t0: [00:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Done st: NotStopd id: Skin Care t0: [04:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Done st: NotStopd id: Skin Integrity t0: [00:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Impaired st: NotStopd id: Skin Integrity t0: [04:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Impaired st: NotStopd id: Spontaneous Movement t0: [00:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Nonpurposeful st: NotStopd id: Spontaneous Movement t0: [04:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Nonpurposeful st: NotStopd id: Support Systems t0: [00:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Children st: NotStopd id: Support Systems t0: [04:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Children st: NotStopd id: INV#3 Cap Change t0: [00:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 9 n1: 9 v2: 24 n2: 24 st: NotStopd id: INV#3 Cap Change t0: [04:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 9 n1: 9 v2: 24 n2: 24 st: NotStopd id: INV#3 Tubing Change t0: [00:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 9 n1: 9 v2: 24 n2: 24 st: NotStopd id: INV#3 Tubing Change t0: [04:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 9 n1: 9 v2: 24 n2: 24 st: NotStopd id: Therapeutic Bed t0: [00:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: AtmosAir Mattres st: NotStopd id: Therapeutic Bed t0: [04:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: AtmosAir Mattres st: NotStopd id: Turn t0: [00:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Side to Side st: NotStopd id: Turn t0: [04:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Side to Side st: NotStopd id: Urine Color/Appear t0: [00:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Yellow v2: Sediment st: NotStopd id: Urine Color/Appear t0: [04:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Yellow v2: Clear st: NotStopd id: Urine Color/Appear t0: [20:00:00 19/11/2018] el: 0 cg: RN cu: CCU v1: Yellow v2: Sediment st: NotStopd id: Urine Source t0: [00:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Indwelling Cath st: NotStopd id: Urine Source t0: [04:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Indwelling Cath st: NotStopd id: Verbal Response t0: [00:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 1.0 ET/Trach st: NotStopd id: Verbal Response t0: [04:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 1.0 ET/Trach st: NotStopd id: Back Care t0: [00:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Done st: NotStopd id: Behavior t0: [00:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Withdrawn st: NotStopd id: Behavior t0: [01:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Sleeping st: NotStopd id: Behavior t0: [04:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Uncomfortable st: NotStopd id: Behavior t0: [05:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Sleeping st: NotStopd id: Bowel Sounds t0: [00:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Present st: NotStopd id: Bowel Sounds t0: [04:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Present st: NotStopd id: Bowel Sounds t0: [20:00:00 19/11/2018] el: 0 cg: RN cu: CCU v1: Present st: NotStopd id: Braden Activity t0: [00:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Bedfast st: NotStopd id: Braden Activity t0: [04:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Bedfast st: NotStopd id: Braden Frict/Shear t0: [00:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Potential Prob st: NotStopd id: Braden Frict/Shear t0: [04:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Problem st: NotStopd id: Braden Mobility t0: [00:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Comp. Immobile st: NotStopd id: Braden Mobility t0: [04:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Comp. Immobile st: NotStopd id: Braden Moisture t0: [00:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Occ. Moist st: NotStopd id: Braden Moisture t0: [04:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Occ. Moist st: NotStopd id: Braden Nutrition t0: [00:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Very Poor st: NotStopd id: Braden Nutrition t0: [04:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Very Poor st: NotStopd id: Braden Score t0: [00:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 9 n1: 9 u1: number st: NotStopd id: Braden Score t0: [04:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 8 n1: 8 u1: number st: NotStopd id: Braden SensoryPercep t0: [00:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Comp. Limited st: NotStopd id: Braden SensoryPercep t0: [04:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Comp. Limited st: NotStopd
id: D5W 100.0ml t0: [00:00:00 20/11/2018] el: 1 ai: 105 cg: RN cu: CCU vo: 40 vu: ml id: D5W 100.0ml t0: [04:00:00 20/11/2018] el: 1 ai: 105 cg: RN cu: CCU vo: 100 vu: ml id: D5W 100.0ml t0: [20:00:00 19/11/2018] el: 1 ai: 105 cg: RN cu: CCU vo: 100 vu: ml id: .9% Normal Saline 1000.0ml t0: [01:00:00 20/11/2018] el: 1 ai: 107 cg: RN cu: CCU vo: 0 vu: ml nb: 1 id: .9% Normal Saline 1000.0ml t0: [02:00:00 20/11/2018] el: 1 ai: 107 cg: RN cu: CCU vo: 20 vu: ml id: .9% Normal Saline 1000.0ml t0: [03:00:00 20/11/2018] el: 1 ai: 107 cg: RN cu: CCU vo: 10 vu: ml id: .9% Normal Saline 1000.0ml t0: [04:00:00 20/11/2018] el: 1 ai: 107 cg: RN cu: CCU vo: 10 vu: ml id: .9% Normal Saline 1000.0ml t0: [05:00:00 20/11/2018] el: 1 ai: 107 cg: RN cu: CCU vo: 10 vu: ml id: .9% Normal Saline 1000.0ml t0: [06:00:00 20/11/2018] el: 1 ai: 107 cg: RN cu: CCU vo: 10 vu: ml id: D5W 250.0ml + 25000Uhr Heparin t0: [06:00:00 20/11/2018] el: 1 ai: 117 cg: RN cu: CCU vo: 9 vu: ml
id: Service Type t0: [06:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: CCU st: NotStopd id: Code Status t0: [06:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Full Code st: NotStopd id: Risk for Falls t0: [06:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Yes st: NotStopd id: Ectopy Frequency t0: [06:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: None st: NotStopd id: Ectopy Type t0: [06:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: None st: NotStopd id: Heart Rate t0: [06:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 91 n1: 91 u1: BPM st: NotStopd id: Heart Rhythm t0: [06:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Atrial Fib st: NotStopd id: Arterial BP t0: [06:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 116 n1: 116 u1: mmHg v2: 46 n2: 46 u2: mmHg st: NotStopd id: Arterial BP Mean t0: [06:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 70 n1: 70 u1: mmHg st: NotStopd id: Precautions t0: [06:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Contact st: NotStopd id: ABP Alarm (Lo/Hi) t0: [06:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 90 n1: 90 u1: mmHg v2: 160 n2: 160 u2: mmHg st: NotStopd id: HR Alarm (Lo/Hi) t0: [06:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 50 n1: 50 u1: BPM v2: 145 n2: 145 u2: BPM st: NotStopd id: Resp Alarm (Lo/Hi) t0: [06:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 8 n1: 8 u1: BPM v2: 35 n2: 35 u2: BPM st: NotStopd id: SpO2 Alarm (Lo/Hi) t0: [06:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 90 n1: 90 u1: % v2: 100 n2: 100 u2: % st: NotStopd id: Respiratory Rate t0: [06:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 16 n1: 16 u1: BPM st: NotStopd id: SpO2 t0: [06:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 96 n1: 96 u1: % st: NotStopd id: calprevflg t0: [06:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 1 n1: 1 u1: kg st: NotStopd
id: Urine Out Foley t0: [06:00:00 20/11/2018] el: 1 cg: RN cu: CCU vo: 55 vu: ml
id: Heparin t0: [06:00:00 20/11/2018] el: 1 cg: RN cu: CCU vo: 0 do: 900 du: Uhr so: D5W sv: 250 su: ml rt: IV Drip
id: Art.pH t0: [06:42:00 20/11/2018] el: 0 cg: 1663 cu: CCU v1: 7.44 n1: 7.44 rs: Final st: NotStopd id: Arterial Base Excess t0: [06:42:00 20/11/2018] el: 0 cg: 1663 cu: CCU v1: 7 n1: 7 rs: Final st: NotStopd id: Arterial CO2(Calc) t0: [06:42:00 20/11/2018] el: 0 cg: 1663 cu: CCU v1: 34 n1: 34 rs: Final st: NotStopd id: Arterial PaCO2 t0: [06:42:00 20/11/2018] el: 0 cg: 1663 cu: CCU v1: 48 n1: 48 u1: mmHg rs: Final st: NotStopd id: Arterial PaO2 t0: [06:42:00 20/11/2018] el: 0 cg: 1663 cu: CCU v1: 111 n1: 111 u1: mmHg rs: Final st: NotStopd id: Arterial pH t0: [06:42:00 20/11/2018] el: 0 cg: 1663 cu: CCU v1: 7.44 n1: 7.44 rs: Final st: NotStopd
id: ETT Mark/Location t0: [08:00:00 20/11/2018] el: 0 cg: RRT cu: CCU v1: 22cm v2: Lip st: NotStopd id: FiO2 Set t0: [08:00:00 20/11/2018] el: 0 cg: RRT cu: CCU v1: 0.4 n1: 0.4 u1: torr st: NotStopd id: High Insp. Pressure t0: [08:00:00 20/11/2018] el: 0 cg: RRT cu: CCU v1: 40 n1: 40 u1: cmH2O st: NotStopd id: High Resp. Rate t0: [08:00:00 20/11/2018] el: 0 cg: RRT cu: CCU v1: 30 n1: 30 u1: BPM st: NotStopd id: Airway Size t0: [08:00:00 20/11/2018] el: 0 cg: RRT cu: CCU v1: 7.0 mm st: NotStopd id: Airway Type t0: [08:00:00 20/11/2018] el: 0 cg: RRT cu: CCU v1: Endotracheal st: NotStopd id: Inspired Gas Temp t0: [08:00:00 20/11/2018] el: 0 cg: RRT cu: CCU v1: 37 n1: 37 u1: Deg. C st: NotStopd id: Intubation Date t0: [08:00:00 20/11/2018] el: 0 cg: RRT cu: CCU v1: 6 n1: 6 v2: 22 n2: 22 st: NotStopd id: Low Exhaled Min Vol t0: [08:00:00 20/11/2018] el: 0 cg: RRT cu: CCU v1: 3 n1: 3 st: NotStopd id: MDI #1 (Puff/Drug) t0: [08:00:00 20/11/2018] el: 0 cg: RRT cu: CCU v1: 6 n1: 6 v2: Combivent st: NotStopd id: Minute Volume(Obser) t0: [08:00:00 20/11/2018] el: 0 cg: RRT cu: CCU v1: 8.5 n1: 8.5 u1: L/min st: NotStopd id: PEEP Set t0: [08:00:00 20/11/2018] el: 0 cg: RRT cu: CCU v1: 0 n1: 0 u1: cmH2O st: NotStopd id: Apnea Time Interval t0: [08:00:00 20/11/2018] el: 0 cg: RRT cu: CCU v1: 20 n1: 20 st: NotStopd id: Pressure Support t0: [08:00:00 20/11/2018] el: 0 cg: RRT cu: CCU v1: 5 n1: 5 u1: . st: NotStopd id: Resp Rate (Total) t0: [08:00:00 20/11/2018] el: 0 cg: RRT cu: CCU v1: 18 n1: 18 u1: BPM st: NotStopd id: Ve High t0: [08:00:00 20/11/2018] el: 0 cg: RRT cu: CCU v1: 14 n1: 14 st: NotStopd id: Sensitivity-Vent t0: [08:00:00 20/11/2018] el: 0 cg: RRT cu: CCU v1: 2 n1: 2 u1: cmH2O st: NotStopd id: SpO2 t0: [08:00:00 20/11/2018] el: 0 cg: RRT cu: CCU v1: 98 n1: 98 u1: % st: NotStopd id: Tidal Volume (Spont) t0: [08:00:00 20/11/2018] el: 0 cg: RRT cu: CCU v1: 485 n1: 485 u1: ml/B st: NotStopd id: Ventilator Mode t0: [08:00:00 20/11/2018] el: 0 cg: RRT cu: CCU v1: Pressure Support st: NotStopd id: Ventilator Type t0: [08:00:00 20/11/2018] el: 0 cg: RRT cu: CCU v1: Drager st: NotStopd
id: Less Restrict Meas. t0: [08:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Orientation st: NotStopd id: Pain Level t0: [08:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 6-Mod to Severe st: NotStopd id: Pain Level/Response t0: [08:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 3-Mild to Mod st: NotStopd id: Pain Present t0: [08:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Yes st: NotStopd id: Range of Motion t0: [08:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Done st: NotStopd id: Pain Assess Method t0: [08:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Grimace Scale st: NotStopd id: PainLevel Acceptable t0: [08:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Yes st: NotStopd id: Service Type t0: [07:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: CCU st: NotStopd id: Service Type t0: [08:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: CCU st: NotStopd id: Service Type t0: [09:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: CCU st: NotStopd id: Circulation/SkinInt t0: [08:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Circulation Adeq st: NotStopd id: Code Status t0: [07:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Full Code st: NotStopd id: Code Status t0: [08:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Full Code st: NotStopd id: Code Status t0: [09:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Full Code st: NotStopd id: Riker-SAS Scale t0: [08:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Calm/Cooperative st: NotStopd id: Daily Wake Up t0: [08:00:00 20/11/2018] el: 1 cg: RN cu: CCU v1: No/Not Sedated st: NotStopd id: GI Prophylaxis t0: [08:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Proton/Pump/Inhi st: NotStopd id: Risk for Falls t0: [07:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Yes st: NotStopd id: Risk for Falls t0: [08:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Yes st: NotStopd id: Risk for Falls t0: [09:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Yes st: NotStopd id: Diet Type t0: [08:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: NPO st: NotStopd id: Ectopy Frequency t0: [07:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: None st: NotStopd id: Ectopy Frequency t0: [08:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: None st: NotStopd id: Ectopy Frequency t0: [09:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: None st: NotStopd id: Ectopy Type t0: [07:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: None st: NotStopd id: Ectopy Type t0: [08:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: None st: NotStopd id: Ectopy Type t0: [09:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: None st: NotStopd id: Alarms t0: [09:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: ON st: NotStopd id: Parameters Checked t0: [09:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Yes st: NotStopd id: Education Barrier t0: [08:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Altered LOC st: NotStopd id: Education Handout t0: [08:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Not Given st: NotStopd id: Education Learner t0: [08:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Patient st: NotStopd id: Education Method t0: [08:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Explanation st: NotStopd id: GI#1 Intub Site t0: [08:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Salem Sump v2: Oral st: NotStopd id: Education Readiness t0: [08:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Yes st: NotStopd id: Education Response t0: [08:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Reinforced st: NotStopd id: Education Topic #1 t0: [08:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Plan of Care st: NotStopd id: Eye Care t0: [08:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Done st: NotStopd id: Eye Opening t0: [08:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 3 To speech st: NotStopd id: Follows Commands t0: [08:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Consistently st: NotStopd id: GCS Total t0: [08:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 10 n1: 10 u1: points st: NotStopd id: GI Intub #1/Site t0: [08:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Salem Sump v2: Oral st: NotStopd id: GI#1 Tube Stat/Drain t0: [08:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Clamped st: NotStopd id: HOB t0: [08:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 30 degrees st: NotStopd id: Heart Rate t0: [07:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 84 n1: 84 u1: BPM st: NotStopd id: Heart Rate t0: [08:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 80 n1: 80 u1: BPM st: NotStopd id: Heart Rate t0: [09:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 69 n1: 69 u1: BPM st: NotStopd id: Heart Rhythm t0: [07:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Atrial Fib st: NotStopd id: Heart Rhythm t0: [08:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Atrial Fib st: NotStopd id: Heart Rhythm t0: [09:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Atrial Fib st: NotStopd id: INV Line#3 Type/Site t0: [08:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: A-Line v2: Left Radial st: NotStopd id: INV Line#3InsertDate t0: [08:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 9 n1: 9 v2: 24 n2: 24 st: NotStopd id: INV Line#3SiteAppear t0: [08:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: WNL st: NotStopd id: Abdominal Assessment t0: [08:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Obese st: NotStopd id: INV#3 WaveformAppear t0: [08:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Sharp st: NotStopd id: IV #1 Insert Date t0: [08:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 9 n1: 9 v2: 22 n2: 22 st: NotStopd id: IV #1 Site/Size t0: [08:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Right Antecub v2: 18 gauge st: NotStopd id: IV #2 Insert Date t0: [08:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 9 n1: 9 v2: 25 n2: 25 st: NotStopd id: IV #2 Site/Size t0: [08:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Right Wrist v2: 20 gauge st: NotStopd id: Activity t0: [08:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Bedrest st: NotStopd id: IV Site Appear #1 t0: [08:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: WNL st: NotStopd id: IV Site Appear #2 t0: [08:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: WNL st: NotStopd id: Activity Tolerance t0: [08:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Tolerated Well st: NotStopd id: Imp Skin Cleanse #1 t0: [08:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Normal Saline st: NotStopd id: ImpSkin Character #1 t0: [08:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Abrasion st: NotStopd id: ImpSkin Drain/Amt#1 t0: [08:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Serosanguinous v2: Scant st: NotStopd id: ImpSkin Treatment #1 t0: [08:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Dry Sterile Dsg st: NotStopd id: ImpSkin Wound Base#1 t0: [08:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Pink st: NotStopd id: Impaired Skin Site#1 t0: [08:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Abdomen st: NotStopd id: LLL Lung Sounds t0: [08:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Coarse st: NotStopd id: LUL Lung Sounds t0: [08:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Clear st: NotStopd id: Level of Conscious t0: [08:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Arouse to Voice st: NotStopd id: Angio Appearance #1 t0: [08:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Clean and Dry v2: Clean and Dry st: NotStopd id: Angio Appearance #2 t0: [08:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Clean and Dry v2: Clean and Dry st: NotStopd id: Motor Response t0: [08:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 6 Obeys Commands st: NotStopd id: Angio Dressing #1 t0: [08:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Dry Sterile Dsg st: NotStopd id: Angio Dressing #2 t0: [08:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Dry Sterile Dsg st: NotStopd id: Oral Care t0: [08:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Done st: NotStopd id: Oral Cavity t0: [08:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Teeth/Tissue WNL st: NotStopd id: Orientation t0: [08:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Oriented x 1 st: NotStopd id: Angio Site #1 t0: [08:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: R Femoral st: NotStopd id: Angio Site #2 t0: [08:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: L Femoral st: NotStopd id: PT Splint Loc/Stat#1 t0: [08:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Left Leg v2: On st: NotStopd id: Arterial BP t0: [07:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 88 n1: 88 u1: mmHg v2: 38 n2: 38 u2: mmHg st: NotStopd id: Arterial BP t0: [08:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 119 n1: 119 u1: mmHg v2: 48 n2: 48 u2: mmHg st: NotStopd id: Arterial BP t0: [09:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 106 n1: 106 u1: mmHg v2: 44 n2: 44 u2: mmHg st: NotStopd id: Pain Cause t0: [08:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Activity st: NotStopd id: Pain Level (Rest) t0: [08:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 6-Mod to Severe st: NotStopd id: Pain Location t0: [08:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Left Leg st: NotStopd id: Pain Management t0: [08:00:00 20/11/2018] el: 1 cg: RN cu: CCU v1: PO Med v2: Repositioned st: NotStopd id: Pain Type t0: [08:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Sharp st: NotStopd id: Arterial BP Mean t0: [07:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 55 n1: 55 u1: mmHg st: NotStopd id: Arterial BP Mean t0: [08:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 71 n1: 71 u1: mmHg st: NotStopd id: Arterial BP Mean t0: [09:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 63 n1: 63 u1: mmHg st: NotStopd id: Position t0: [08:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Right Side st: NotStopd id: Position Change t0: [08:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Done st: NotStopd id: Assistance Device t0: [08:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 2 Person Assist st: NotStopd id: Precautions t0: [07:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Contact st: NotStopd id: Precautions t0: [08:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Contact st: NotStopd id: Precautions t0: [09:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Contact st: NotStopd id: INV#3 Dsg Change t0: [08:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 9 n1: 9 v2: 24 n2: 24 st: NotStopd id: ABP Alarm (Lo/Hi) t0: [07:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 90 n1: 90 u1: mmHg v2: 160 n2: 160 u2: mmHg st: NotStopd id: ABP Alarm (Lo/Hi) t0: [08:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 90 n1: 90 u1: mmHg v2: 160 n2: 160 u2: mmHg st: NotStopd id: ABP Alarm (Lo/Hi) t0: [09:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 85 n1: 85 u1: mmHg v2: 145 n2: 145 u2: mmHg st: NotStopd id: HR Alarm (Lo/Hi) t0: [07:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 50 n1: 50 u1: BPM v2: 145 n2: 145 u2: BPM st: NotStopd id: HR Alarm (Lo/Hi) t0: [08:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 50 n1: 50 u1: BPM v2: 145 n2: 145 u2: BPM st: NotStopd id: HR Alarm (Lo/Hi) t0: [09:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 60 n1: 60 u1: BPM v2: 125 n2: 125 u2: BPM st: NotStopd id: Resp Alarm (Lo/Hi) t0: [07:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 8 n1: 8 u1: BPM v2: 35 n2: 35 u2: BPM st: NotStopd id: Resp Alarm (Lo/Hi) t0: [08:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 8 n1: 8 u1: BPM v2: 35 n2: 35 u2: BPM st: NotStopd id: Resp Alarm (Lo/Hi) t0: [09:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 8 n1: 8 u1: BPM v2: 40 n2: 40 u2: BPM st: NotStopd id: SpO2 Alarm (Lo/Hi) t0: [07:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 90 n1: 90 u1: % v2: 100 n2: 100 u2: % st: NotStopd id: SpO2 Alarm (Lo/Hi) t0: [08:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 90 n1: 90 u1: % v2: 100 n2: 100 u2: % st: NotStopd id: SpO2 Alarm (Lo/Hi) t0: [09:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 90 n1: 90 u1: % v2: 100 n2: 100 u2: % st: NotStopd id: RLL Lung Sounds t0: [08:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Coarse st: NotStopd id: RUL Lung Sounds t0: [08:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Clear st: NotStopd id: Reason For Restraint t0: [08:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Ext/TXInterfere st: NotStopd id: Removed x 5 Mins t0: [08:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Done st: NotStopd id: Respiratory Pattern t0: [08:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Regular st: NotStopd id: Respiratory Rate t0: [07:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 40 n1: 40 u1: BPM st: NotStopd id: Respiratory Rate t0: [08:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 25 n1: 25 u1: BPM st: NotStopd id: Respiratory Rate t0: [09:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 39 n1: 39 u1: BPM st: NotStopd id: Restraint Location t0: [08:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Both Arms st: NotStopd id: Restraint Type t0: [08:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Soft Limb st: NotStopd id: Restraints Evaluated t0: [08:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Behavior Conts st: NotStopd id: Side Rails t0: [08:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: All rails up st: NotStopd id: Skin Care t0: [08:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Done st: NotStopd id: Skin Integrity t0: [08:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Impaired st: NotStopd id: SpO2 t0: [07:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 97 n1: 97 u1: % st: NotStopd id: SpO2 t0: [09:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 98 n1: 98 u1: % st: NotStopd id: Spontaneous Movement t0: [08:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Nonpurposeful st: NotStopd id: Sputum Color/Consist t0: [08:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Bloody v2: Thick st: NotStopd id: Sputum Source/Amt t0: [08:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Suctioned v2: Moderate st: NotStopd id: Support Systems t0: [08:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Children st: NotStopd id: INV#3 Cap Change t0: [08:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 9 n1: 9 v2: 24 n2: 24 st: NotStopd id: INV#3 Tubing Change t0: [08:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 9 n1: 9 v2: 24 n2: 24 st: NotStopd id: Temp. Site t0: [08:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Oral st: NotStopd id: Temperature C (calc) t0: [08:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 37.5556 n1: 37.5556 u1: Deg. C st: NotStopd id: Temperature F t0: [08:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 99.6 n1: 99.6 u1: Deg. F st: NotStopd id: Therapeutic Bed t0: [08:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: AtmosAir Mattres st: NotStopd id: Turn t0: [08:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Side to Side st: NotStopd id: Urine Color/Appear t0: [08:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Yellow v2: Clear st: NotStopd id: Urine Source t0: [08:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Indwelling Cath st: NotStopd id: Verbal Response t0: [08:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 1.0 ET/Trach st: NotStopd id: Back Care t0: [08:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Done st: NotStopd id: calprevflg t0: [07:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 1 n1: 1 u1: kg st: NotStopd id: calprevflg t0: [08:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 1 n1: 1 u1: kg st: NotStopd id: calprevflg t0: [09:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 1 n1: 1 u1: kg st: NotStopd id: Bowel Sounds t0: [08:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Present st: NotStopd id: Braden Activity t0: [08:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Bedfast st: NotStopd id: Braden Frict/Shear t0: [08:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Potential Prob st: NotStopd id: Braden Mobility t0: [08:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Very Limited st: NotStopd id: Braden Moisture t0: [08:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Occ. Moist st: NotStopd id: Braden Nutrition t0: [08:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Prob. Inadequate st: NotStopd id: Braden Score t0: [08:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 12 n1: 12 u1: number st: NotStopd id: Braden SensoryPercep t0: [08:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Very Limited st: NotStopd
id: D5W 100.0ml t0: [08:00:00 20/11/2018] el: 1 ai: 105 cg: RN cu: CCU vo: 200 vu: ml id: .9% Normal Saline 1000.0ml t0: [08:00:00 20/11/2018] el: 1 ai: 107 cg: RN cu: CCU vo: 20 vu: ml id: D5W 250.0ml + 25000Uhr Heparin t0: [08:00:00 20/11/2018] el: 1 ai: 117 cg: RN cu: CCU vo: 18 vu: ml id: Urine Out Foley t0: [08:00:00 20/11/2018] el: 1 cg: RN cu: CCU vo: 80 vu: ml
id: Heparin t0: [07:00:00 20/11/2018] el: 1 cg: RN cu: CCU vo: 0 do: 900 du: Uhr so: D5W sv: 250 su: ml rt: IV Drip id: Heparin t0: [08:00:00 20/11/2018] el: 1 cg: RN cu: CCU vo: 0 do: 900 du: Uhr so: D5W sv: 250 su: ml rt: IV Drip id: Heparin t0: [09:00:00 20/11/2018] el: 1 cg: RN cu: CCU vo: 0 do: 900 du: Uhr so: D5W sv: 250 su: ml rt: IV Drip
pi: 4073348 hi: 10161 t0: [10:00:00 20/11/2018] tf: [18:00:00 20/11/2018] pt: IV Large Volume st: Expired rt: IV fr: ASDIR iv: 1000 ml D5W Continuous at 75 ml/hr for 600 ml ir: 75 it: C ss: N dt: 8 di: Hours xu: Enter on Label
id: Service Type t0: [10:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: CCU st: NotStopd id: Code Status t0: [10:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Full Code st: NotStopd id: Risk for Falls t0: [10:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Yes st: NotStopd id: Ectopy Frequency t0: [10:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: None st: NotStopd id: Ectopy Type t0: [10:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: None st: NotStopd id: Heart Rate t0: [10:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 70 n1: 70 u1: BPM st: NotStopd id: Heart Rhythm t0: [10:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Atrial Fib st: NotStopd id: Arterial BP t0: [10:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 108 n1: 108 u1: mmHg v2: 44 n2: 44 u2: mmHg st: NotStopd id: Arterial BP Mean t0: [10:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 63 n1: 63 u1: mmHg st: NotStopd id: Precautions t0: [10:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Contact st: NotStopd id: ABP Alarm (Lo/Hi) t0: [10:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 85 n1: 85 u1: mmHg v2: 145 n2: 145 u2: mmHg st: NotStopd id: HR Alarm (Lo/Hi) t0: [10:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 60 n1: 60 u1: BPM v2: 125 n2: 125 u2: BPM st: NotStopd id: Resp Alarm (Lo/Hi) t0: [10:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 8 n1: 8 u1: BPM v2: 40 n2: 40 u2: BPM st: NotStopd id: SpO2 Alarm (Lo/Hi) t0: [10:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 90 n1: 90 u1: % v2: 100 n2: 100 u2: % st: NotStopd id: Respiratory Rate t0: [10:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 26 n1: 26 u1: BPM st: NotStopd id: SpO2 t0: [10:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 99 n1: 99 u1: % st: NotStopd id: calprevflg t0: [10:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 1 n1: 1 u1: kg st: NotStopd
id: D5W 250.0ml + 25000Uhr Heparin t0: [10:00:00 20/11/2018] el: 1 ai: 117 cg: RN cu: CCU vo: 18 vu: ml id: Urine Out Foley t0: [10:00:00 20/11/2018] el: 1 cg: RN cu: CCU vo: 30 vu: ml
id: Heparin t0: [10:00:00 20/11/2018] el: 1 cg: RN cu: CCU vo: 0 do: 900 du: Uhr so: D5W sv: 250 su: ml rt: IV Drip
io: D5W el: 1 cg: RN cu: CCU ra: 75 ru: ml/hr
id: .9% Normal Saline 1000.0ml t0: [10:00:00 20/11/2018] el: 1 ai: 107 cg: -1 cu: CCU vo: 0 st: D/C'd
id: Education Topic #1 t0: [10:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Plan of Care st: NotStopd id: Impaired Skin Site#1 t0: [10:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Abdomen st: NotStopd id: Restraint Location t0: [10:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: None st: NotStopd id: Side Rails t0: [10:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: All rails up st: NotStopd id: Support Systems t0: [10:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Children st: NotStopd
id: D5W t0: [10:00:00 20/11/2018] el: 1 ai: 168 cg: RN cu: CCU vo: 0 vu: ml nb: 1
id: Service Type t0: [11:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: CCU st: NotStopd id: Code Status t0: [11:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Full Code st: NotStopd id: Risk for Falls t0: [11:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Yes st: NotStopd id: Ectopy Frequency t0: [11:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: None st: NotStopd id: Ectopy Type t0: [11:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: None st: NotStopd id: Heart Rate t0: [11:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 72 n1: 72 u1: BPM st: NotStopd id: Heart Rhythm t0: [11:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Atrial Fib st: NotStopd id: Arterial BP t0: [11:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 118 n1: 118 u1: mmHg v2: 47 n2: 47 u2: mmHg st: NotStopd id: Arterial BP Mean t0: [11:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 69 n1: 69 u1: mmHg st: NotStopd id: Precautions t0: [11:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Contact st: NotStopd id: ABP Alarm (Lo/Hi) t0: [11:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 85 n1: 85 u1: mmHg v2: 145 n2: 145 u2: mmHg st: NotStopd id: HR Alarm (Lo/Hi) t0: [11:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 60 n1: 60 u1: BPM v2: 125 n2: 125 u2: BPM st: NotStopd id: Resp Alarm (Lo/Hi) t0: [11:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 8 n1: 8 u1: BPM v2: 40 n2: 40 u2: BPM st: NotStopd id: SpO2 Alarm (Lo/Hi) t0: [11:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 90 n1: 90 u1: % v2: 100 n2: 100 u2: % st: NotStopd id: Respiratory Rate t0: [11:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 17 n1: 17 u1: BPM st: NotStopd id: SpO2 t0: [11:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 97 n1: 97 u1: % st: NotStopd id: calprevflg t0: [11:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 1 n1: 1 u1: kg st: NotStopd
id: D5W 250.0ml + 25000Uhr Heparin t0: [11:00:00 20/11/2018] el: 1 ai: 117 cg: RN cu: CCU vo: 9 vu: ml id: D5W t0: [11:00:00 20/11/2018] el: 1 ai: 168 cg: RN cu: CCU vo: 75 vu: ml id: Urine Out Foley t0: [11:00:00 20/11/2018] el: 1 cg: RN cu: CCU vo: 360 vu: ml
id: Heparin t0: [11:00:00 20/11/2018] el: 1 cg: RN cu: CCU vo: 0 do: 900 du: Uhr so: D5W sv: 250 su: ml rt: IV Drip
id: Follows Commands t0: [11:00:00 20/11/2018] el: 0 cg: -1 cu: CCU st: D/C'd id: Pupil Response R/L t0: [11:00:00 20/11/2018] el: 0 cg: -1 cu: CCU st: D/C'd id: Pupil Size R/L t0: [11:00:00 20/11/2018] el: 0 cg: -1 cu: CCU st: D/C'd id: Spontaneous Movement t0: [11:00:00 20/11/2018] el: 0 cg: -1 cu: CCU st: D/C'd
id: Pain Level t0: [12:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 6-Mod to Severe st: NotStopd id: Pain Level/Response t0: [12:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 5-Moderate st: NotStopd id: Pain Present t0: [12:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Yes st: NotStopd id: Pain Assess Method t0: [12:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Pt Verbalized st: NotStopd id: PainLevel Acceptable t0: [12:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Yes st: NotStopd id: Service Type t0: [12:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: CCU st: NotStopd id: Code Status t0: [12:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Full Code st: NotStopd id: Riker-SAS Scale t0: [12:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Calm/Cooperative st: NotStopd id: Daily Wake Up t0: [12:00:00 20/11/2018] el: 1 cg: RN cu: CCU v1: No/Not Sedated st: NotStopd id: GI Prophylaxis t0: [12:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Proton/Pump/Inhi st: NotStopd id: Risk for Falls t0: [12:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Yes st: NotStopd id: Glucose t0: [12:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 190 n1: 190 rs: Manual st: NotStopd id: Diet Type t0: [12:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: NPO st: NotStopd id: ETT Mark/Location t0: [12:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 22cm v2: Lip st: NotStopd id: Ectopy Frequency t0: [12:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: None st: NotStopd id: Ectopy Type t0: [12:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: None st: NotStopd id: Alarms t0: [12:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: ON st: NotStopd id: Parameters Checked t0: [12:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Yes st: NotStopd id: GI#1 Intub Site t0: [12:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Salem Sump v2: Oral st: NotStopd id: Education Topic #1 t0: [12:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Plan of Care st: NotStopd id: Eye Opening t0: [12:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 4 Spontaneously st: NotStopd id: GCS Total t0: [12:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 15 n1: 15 u1: points st: NotStopd id: GI Intub #1/Site t0: [12:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Salem Sump v2: Oral st: NotStopd id: GI#1 Tube Stat/Drain t0: [12:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Clamped st: NotStopd id: HOB t0: [12:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 30 degrees st: NotStopd id: Heart Rate t0: [12:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 73 n1: 73 u1: BPM st: NotStopd id: Heart Rhythm t0: [12:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Atrial Fib st: NotStopd id: Abdominal Assessment t0: [12:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Obese st: NotStopd id: Activity t0: [12:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Bedrest st: NotStopd id: Activity Tolerance t0: [12:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Tolerated Well st: NotStopd id: Impaired Skin Site#1 t0: [12:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Abdomen st: NotStopd id: Airway Size t0: [12:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 7.0 mm st: NotStopd id: Airway Type t0: [12:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Endotracheal st: NotStopd id: Intubation Date t0: [12:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 6 n1: 6 v2: 22 n2: 22 st: NotStopd id: LUL Lung Sounds t0: [12:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Clear st: NotStopd id: Level of Conscious t0: [12:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Lethargic st: NotStopd id: Angio Appearance #1 t0: [12:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Clean and Dry v2: Clean and Dry st: NotStopd id: Angio Appearance #2 t0: [12:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Clean and Dry v2: Clean and Dry st: NotStopd id: Motor Response t0: [12:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 6 Obeys Commands st: NotStopd id: Angio Dressing #1 t0: [12:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Dry Sterile Dsg st: NotStopd id: Angio Dressing #2 t0: [12:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Dry Sterile Dsg st: NotStopd id: Oral Cavity t0: [12:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Teeth/Tissue WNL st: NotStopd id: Orientation t0: [12:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Oriented x 3 st: NotStopd id: Angio Site #1 t0: [12:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: R Femoral st: NotStopd id: Angio Site #2 t0: [12:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: L Femoral st: NotStopd id: PT Splint Loc/Stat#1 t0: [12:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Left Leg v2: On st: NotStopd id: Arterial BP t0: [12:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 131 n1: 131 u1: mmHg v2: 55 n2: 55 u2: mmHg st: NotStopd id: Pain Cause t0: [12:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: At Rest st: NotStopd id: Pain Level (Rest) t0: [12:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 6-Mod to Severe st: NotStopd id: Pain Location t0: [12:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Left Leg st: NotStopd id: Pain Management t0: [12:00:00 20/11/2018] el: 1 cg: RN cu: CCU v1: PO Med v2: Repositioned st: NotStopd id: Pain Type t0: [12:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Aching st: NotStopd id: Arterial BP Mean t0: [12:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 81 n1: 81 u1: mmHg st: NotStopd id: Position t0: [12:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Left Side st: NotStopd id: Assistance Device t0: [12:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 2 Person Assist st: NotStopd id: Precautions t0: [12:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Contact st: NotStopd id: ABP Alarm (Lo/Hi) t0: [12:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 85 n1: 85 u1: mmHg v2: 145 n2: 145 u2: mmHg st: NotStopd id: HR Alarm (Lo/Hi) t0: [12:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 60 n1: 60 u1: BPM v2: 125 n2: 125 u2: BPM st: NotStopd id: Resp Alarm (Lo/Hi) t0: [12:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 8 n1: 8 u1: BPM v2: 40 n2: 40 u2: BPM st: NotStopd id: SpO2 Alarm (Lo/Hi) t0: [12:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 90 n1: 90 u1: % v2: 100 n2: 100 u2: % st: NotStopd id: RUL Lung Sounds t0: [12:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Clear st: NotStopd id: Respiratory Pattern t0: [12:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Regular st: NotStopd id: Respiratory Rate t0: [12:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 39 n1: 39 u1: BPM st: NotStopd id: Restraint Location t0: [12:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: None st: NotStopd id: Side Rails t0: [12:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: All rails up st: NotStopd id: Skin Care t0: [12:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Done st: NotStopd id: SpO2 t0: [12:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 99 n1: 99 u1: % st: NotStopd id: Support Systems t0: [12:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Children st: NotStopd id: Temp. Site t0: [12:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Rectal st: NotStopd id: Temperature C (calc) t0: [12:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 37.6667 n1: 37.6667 u1: Deg. C st: NotStopd id: Temperature F t0: [12:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 99.8 n1: 99.8 u1: Deg. F st: NotStopd id: Therapeutic Bed t0: [12:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: AtmosAir Mattres st: NotStopd id: Turn t0: [12:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Side to Side st: NotStopd id: Urine Color/Appear t0: [12:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Yellow v2: Clear st: NotStopd id: Urine Source t0: [12:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Indwelling Cath st: NotStopd id: Ventilator Type t0: [12:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Drager st: NotStopd id: Verbal Response t0: [12:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 5 Oriented st: NotStopd id: Back Care t0: [12:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Done st: NotStopd id: calprevflg t0: [12:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 1 n1: 1 u1: kg st: NotStopd id: Bowel Sounds t0: [12:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Present st: NotStopd id: Glucose (70-105) t0: [12:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 190 n1: 190 rs: Manual st: NotStopd
id: D5W 250.0ml + 25000Uhr Heparin t0: [12:00:00 20/11/2018] el: 1 ai: 117 cg: RN cu: CCU vo: 9 vu: ml id: D5W t0: [12:00:00 20/11/2018] el: 1 ai: 168 cg: RN cu: CCU vo: 75 vu: ml id: Urine Out Foley t0: [12:00:00 20/11/2018] el: 1 cg: RN cu: CCU vo: 450 vu: ml
id: Heparin t0: [12:00:00 20/11/2018] el: 1 cg: RN cu: CCU vo: 0 do: 900 du: Uhr so: D5W sv: 250 su: ml rt: IV Drip
id: Dorsal PedPulse R/L t0: [12:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Not Applicable v2: Doppler st: NotStopd id: LLE Temp/Color t0: [12:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Warm v2: Pink st: NotStopd id: PostTib. Pulses R/L t0: [12:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Not Applicable v2: Doppler st: NotStopd
id: Service Type t0: [13:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: CCU st: NotStopd id: Code Status t0: [13:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Full Code st: NotStopd id: Risk for Falls t0: [13:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Yes st: NotStopd id: Ectopy Frequency t0: [13:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: None st: NotStopd id: Ectopy Type t0: [13:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: None st: NotStopd id: Heart Rate t0: [13:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 69 n1: 69 u1: BPM st: NotStopd id: Heart Rhythm t0: [13:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Atrial Fib st: NotStopd id: Arterial BP t0: [13:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 103 n1: 103 u1: mmHg v2: 46 n2: 46 u2: mmHg st: NotStopd id: Arterial BP Mean t0: [13:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 64 n1: 64 u1: mmHg st: NotStopd id: Precautions t0: [13:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Contact st: NotStopd id: ABP Alarm (Lo/Hi) t0: [13:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 85 n1: 85 u1: mmHg v2: 145 n2: 145 u2: mmHg st: NotStopd id: HR Alarm (Lo/Hi) t0: [13:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 60 n1: 60 u1: BPM v2: 125 n2: 125 u2: BPM st: NotStopd id: Resp Alarm (Lo/Hi) t0: [13:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 8 n1: 8 u1: BPM v2: 40 n2: 40 u2: BPM st: NotStopd id: SpO2 Alarm (Lo/Hi) t0: [13:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 90 n1: 90 u1: % v2: 100 n2: 100 u2: % st: NotStopd id: Respiratory Rate t0: [13:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 27 n1: 27 u1: BPM st: NotStopd id: SpO2 t0: [13:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 100 n1: 100 u1: % st: NotStopd id: calprevflg t0: [13:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 1 n1: 1 u1: kg st: NotStopd
id: D5W 250.0ml + 25000Uhr Heparin t0: [14:00:00 20/11/2018] el: 1 ai: 117 cg: RN cu: CCU vo: 18 vu: ml id: D5W t0: [14:00:00 20/11/2018] el: 1 ai: 168 cg: RN cu: CCU vo: 150 vu: ml id: Urine Out Foley t0: [14:00:00 20/11/2018] el: 1 cg: RN cu: CCU vo: 450 vu: ml
id: Heparin t0: [13:00:00 20/11/2018] el: 1 cg: RN cu: CCU vo: 0 do: 900 du: Uhr so: D5W sv: 250 su: ml rt: IV Drip
id: Art.pH t0: [15:54:00 20/11/2018] el: 0 cg: 1663 cu: CCU v1: 7.44 n1: 7.44 rs: Final st: NotStopd id: Arterial Base Excess t0: [15:54:00 20/11/2018] el: 0 cg: 1663 cu: CCU v1: 4 n1: 4 rs: Final st: NotStopd id: Arterial CO2(Calc) t0: [15:54:00 20/11/2018] el: 0 cg: 1663 cu: CCU v1: 31 n1: 31 rs: Final st: NotStopd id: Arterial PaCO2 t0: [15:54:00 20/11/2018] el: 0 cg: 1663 cu: CCU v1: 44 n1: 44 u1: mmHg rs: Final st: NotStopd id: Arterial PaO2 t0: [15:54:00 20/11/2018] el: 0 cg: 1663 cu: CCU v1: 101 n1: 101 u1: mmHg rs: Final st: NotStopd id: Arterial pH t0: [15:54:00 20/11/2018] el: 0 cg: 1663 cu: CCU v1: 7.44 n1: 7.44 rs: Final st: NotStopd
id: GI#1 Tube PlaceCheck t0: [16:00:00 20/11/2018] el: 0 cg: -1 cu: CCU st: D/C'd id: GI#1 Tube Stat/Drain t0: [16:00:00 20/11/2018] el: 0 cg: -1 cu: CCU st: D/C'd
id: Service Type t0: [16:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: CCU st: NotStopd id: Code Status t0: [16:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Full Code st: NotStopd id: Risk for Falls t0: [16:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Yes st: NotStopd id: Ectopy Frequency t0: [16:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: None st: NotStopd id: Ectopy Type t0: [16:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: None st: NotStopd id: Heart Rate t0: [16:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 69 n1: 69 u1: BPM st: NotStopd id: Heart Rhythm t0: [16:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Atrial Fib st: NotStopd id: Arterial BP t0: [16:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 139 n1: 139 u1: mmHg v2: 57 n2: 57 u2: mmHg st: NotStopd id: Arterial BP Mean t0: [16:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 82 n1: 82 u1: mmHg st: NotStopd id: Precautions t0: [16:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Contact st: NotStopd id: ABP Alarm (Lo/Hi) t0: [16:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 85 n1: 85 u1: mmHg v2: 145 n2: 145 u2: mmHg st: NotStopd id: HR Alarm (Lo/Hi) t0: [16:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 60 n1: 60 u1: BPM v2: 125 n2: 125 u2: BPM st: NotStopd id: Resp Alarm (Lo/Hi) t0: [16:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 8 n1: 8 u1: BPM v2: 40 n2: 40 u2: BPM st: NotStopd id: SpO2 Alarm (Lo/Hi) t0: [16:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 90 n1: 90 u1: % v2: 100 n2: 100 u2: % st: NotStopd id: Respiratory Rate t0: [16:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 46 n1: 46 u1: BPM st: NotStopd id: SpO2 t0: [16:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 100 n1: 100 u1: % st: NotStopd id: calprevflg t0: [16:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 1 n1: 1 u1: kg st: NotStopd
id: D5W 250.0ml + 25000Uhr Heparin t0: [16:00:00 20/11/2018] el: 1 ai: 117 cg: RN cu: CCU vo: 18 vu: ml id: D5W t0: [16:00:00 20/11/2018] el: 1 ai: 168 cg: RN cu: CCU vo: 150 vu: ml id: Urine Out Foley t0: [16:00:00 20/11/2018] el: 1 cg: RN cu: CCU vo: 200 vu: ml
id: Heparin t0: [16:00:00 20/11/2018] el: 1 cg: RN cu: CCU vo: 0 do: 900 du: Uhr so: D5W sv: 250 su: ml rt: IV Drip
id: Pain Level t0: [16:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 6-Mod to Severe st: NotStopd id: Pain Level/Response t0: [16:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 3-Mild to Mod st: NotStopd id: Pain Present t0: [16:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Yes st: NotStopd id: Pain Assess Method t0: [16:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Pt Verbalized st: NotStopd id: PainLevel Acceptable t0: [16:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Yes st: NotStopd id: Service Type t0: [14:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: CCU st: NotStopd id: Service Type t0: [15:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: CCU st: NotStopd id: Code Status t0: [14:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Full Code st: NotStopd id: Code Status t0: [15:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Full Code st: NotStopd id: Riker-SAS Scale t0: [16:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Calm/Cooperative st: NotStopd id: Daily Wake Up t0: [16:00:00 20/11/2018] el: 1 cg: RN cu: CCU v1: No/Not Sedated st: NotStopd id: GI Prophylaxis t0: [16:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Proton/Pump/Inhi st: NotStopd id: Risk for Falls t0: [14:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Yes st: NotStopd id: Risk for Falls t0: [15:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Yes st: NotStopd id: Diet Type t0: [16:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: NPO st: NotStopd id: Ectopy Frequency t0: [14:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: None st: NotStopd id: Ectopy Frequency t0: [15:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: None st: NotStopd id: Ectopy Type t0: [14:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: None st: NotStopd id: Ectopy Type t0: [15:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: None st: NotStopd id: Alarms t0: [16:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: ON st: NotStopd id: Parameters Checked t0: [16:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Yes st: NotStopd id: GI#1 Intub Site t0: [16:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Salem Sump v2: Oral st: NotStopd id: Education Topic #1 t0: [16:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Plan of Care st: NotStopd id: Eye Opening t0: [16:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 4 Spontaneously st: NotStopd id: FiO2 Set t0: [16:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 0.4 n1: 0.4 u1: torr st: NotStopd id: GCS Total t0: [16:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 15 n1: 15 u1: points st: NotStopd id: GI Intub #1/Site t0: [16:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Salem Sump v2: Oral st: NotStopd id: Heart Rate t0: [14:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 65 n1: 65 u1: BPM st: NotStopd id: Heart Rate t0: [15:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 68 n1: 68 u1: BPM st: NotStopd id: Heart Rhythm t0: [14:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Atrial Fib st: NotStopd id: Heart Rhythm t0: [15:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Atrial Fib st: NotStopd id: Abdominal Assessment t0: [16:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Obese st: NotStopd id: Impaired Skin Site#1 t0: [16:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Abdomen st: NotStopd id: LLL Lung Sounds t0: [12:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Diminished st: NotStopd id: LLL Lung Sounds t0: [16:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Diminished st: NotStopd id: LUL Lung Sounds t0: [16:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Clear st: NotStopd id: Level of Conscious t0: [16:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Lethargic st: NotStopd id: Motor Response t0: [16:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 6 Obeys Commands st: NotStopd id: O2 Delivery Device t0: [16:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Aerosol-Cool st: NotStopd id: Oral Cavity t0: [16:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Teeth/Tissue WNL st: NotStopd id: Orientation t0: [16:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Oriented x 3 st: NotStopd id: Angio Site #1 t0: [16:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: R Femoral st: NotStopd id: Angio Site #2 t0: [16:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: L Femoral st: NotStopd id: Arterial BP t0: [14:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 99 n1: 99 u1: mmHg v2: 45 n2: 45 u2: mmHg st: NotStopd id: Arterial BP t0: [15:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 119 n1: 119 u1: mmHg v2: 50 n2: 50 u2: mmHg st: NotStopd id: Pain Cause t0: [16:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Activity st: NotStopd id: Pain Level (Rest) t0: [16:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 6-Mod to Severe st: NotStopd id: Pain Location t0: [16:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Left Leg st: NotStopd id: Pain Management t0: [16:00:00 20/11/2018] el: 1 cg: RN cu: CCU v1: PO Med st: NotStopd id: Pain Type t0: [16:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Aching st: NotStopd id: Arterial BP Mean t0: [14:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 62 n1: 62 u1: mmHg st: NotStopd id: Arterial BP Mean t0: [15:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 72 n1: 72 u1: mmHg st: NotStopd id: Precautions t0: [14:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Contact st: NotStopd id: Precautions t0: [15:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Contact st: NotStopd id: ABP Alarm (Lo/Hi) t0: [14:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 85 n1: 85 u1: mmHg v2: 145 n2: 145 u2: mmHg st: NotStopd id: ABP Alarm (Lo/Hi) t0: [15:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 85 n1: 85 u1: mmHg v2: 145 n2: 145 u2: mmHg st: NotStopd id: HR Alarm (Lo/Hi) t0: [14:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 60 n1: 60 u1: BPM v2: 125 n2: 125 u2: BPM st: NotStopd id: HR Alarm (Lo/Hi) t0: [15:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 60 n1: 60 u1: BPM v2: 125 n2: 125 u2: BPM st: NotStopd id: Resp Alarm (Lo/Hi) t0: [14:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 8 n1: 8 u1: BPM v2: 40 n2: 40 u2: BPM st: NotStopd id: Resp Alarm (Lo/Hi) t0: [15:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 8 n1: 8 u1: BPM v2: 40 n2: 40 u2: BPM st: NotStopd id: SpO2 Alarm (Lo/Hi) t0: [14:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 90 n1: 90 u1: % v2: 100 n2: 100 u2: % st: NotStopd id: SpO2 Alarm (Lo/Hi) t0: [15:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 90 n1: 90 u1: % v2: 100 n2: 100 u2: % st: NotStopd id: RLL Lung Sounds t0: [12:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Diminished st: NotStopd id: RLL Lung Sounds t0: [16:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Diminished st: NotStopd id: RUL Lung Sounds t0: [16:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Clear st: NotStopd id: Respiratory Pattern t0: [16:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Regular st: NotStopd id: Respiratory Rate t0: [14:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 32 n1: 32 u1: BPM st: NotStopd id: Respiratory Rate t0: [15:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 34 n1: 34 u1: BPM st: NotStopd id: Restraint Location t0: [16:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: None st: NotStopd id: Side Rails t0: [16:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: All rails up st: NotStopd id: SpO2 t0: [14:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 100 n1: 100 u1: % st: NotStopd id: SpO2 t0: [15:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 100 n1: 100 u1: % st: NotStopd id: Support Systems t0: [16:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Children st: NotStopd id: Temp. Site t0: [16:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Rectal st: NotStopd id: Temperature C (calc) t0: [16:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 37.6667 n1: 37.6667 u1: Deg. C st: NotStopd id: Temperature F t0: [16:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 99.8 n1: 99.8 u1: Deg. F st: NotStopd id: Urine Source t0: [16:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Indwelling Cath st: NotStopd id: Verbal Response t0: [16:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 5 Oriented st: NotStopd id: calprevflg t0: [14:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 1 n1: 1 u1: kg st: NotStopd id: calprevflg t0: [15:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 1 n1: 1 u1: kg st: NotStopd id: Bowel Sounds t0: [16:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Present st: NotStopd
id: D5W 100.0ml t0: [12:00:00 20/11/2018] el: 1 ai: 105 cg: RN cu: CCU vo: 100 vu: ml
id: Heparin t0: [14:00:00 20/11/2018] el: 1 cg: RN cu: CCU vo: 0 do: 900 du: Uhr so: D5W sv: 250 su: ml rt: IV Drip id: Heparin t0: [15:00:00 20/11/2018] el: 1 cg: RN cu: CCU vo: 0 do: 900 du: Uhr so: D5W sv: 250 su: ml rt: IV Drip
pi: 4075094 hi: 10161 t0: [18:00:00 20/11/2018] tf: [17:00:00 21/11/2018] mn: Morphine Sulfate pt: Unit Dose st: Expired rt: IV fr: ONCE ds: 18 dn: 1 dt: 1 di: Doses xv: 36 xu: Hours
id: Service Type t0: [17:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: CCU st: NotStopd id: Code Status t0: [17:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Full Code st: NotStopd id: Risk for Falls t0: [17:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Yes st: NotStopd id: Ectopy Frequency t0: [17:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: None st: NotStopd id: Ectopy Type t0: [17:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: None st: NotStopd id: Heart Rate t0: [17:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 71 n1: 71 u1: BPM st: NotStopd id: Heart Rhythm t0: [17:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Atrial Fib st: NotStopd id: Arterial BP t0: [17:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 140 n1: 140 u1: mmHg v2: 50 n2: 50 u2: mmHg st: NotStopd id: Arterial BP Mean t0: [17:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 79 n1: 79 u1: mmHg st: NotStopd id: Precautions t0: [17:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Contact st: NotStopd id: ABP Alarm (Lo/Hi) t0: [17:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 85 n1: 85 u1: mmHg v2: 145 n2: 145 u2: mmHg st: NotStopd id: HR Alarm (Lo/Hi) t0: [17:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 60 n1: 60 u1: BPM v2: 125 n2: 125 u2: BPM st: NotStopd id: Resp Alarm (Lo/Hi) t0: [17:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 8 n1: 8 u1: BPM v2: 40 n2: 40 u2: BPM st: NotStopd id: SpO2 Alarm (Lo/Hi) t0: [17:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 90 n1: 90 u1: % v2: 100 n2: 100 u2: % st: NotStopd id: Respiratory Rate t0: [17:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 16 n1: 16 u1: BPM st: NotStopd id: SpO2 t0: [17:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 100 n1: 100 u1: % st: NotStopd id: calprevflg t0: [17:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 1 n1: 1 u1: kg st: NotStopd
id: D5W 250.0ml + 25000Uhr Heparin t0: [17:00:00 20/11/2018] el: 1 ai: 117 cg: RN cu: CCU vo: 9 vu: ml id: D5W t0: [17:00:00 20/11/2018] el: 1 ai: 168 cg: RN cu: CCU vo: 75 vu: ml id: Urine Out Foley t0: [17:00:00 20/11/2018] el: 1 cg: RN cu: CCU vo: 50 vu: ml
id: Heparin t0: [17:00:00 20/11/2018] el: 1 cg: RN cu: CCU vo: 0 do: 900 du: Uhr so: D5W sv: 250 su: ml rt: IV Drip
id: Glucose t0: [17:00:00 20/11/2018] el: 0 cg: CoWker cu: CCU v1: 244 n1: 244 rs: Manual st: NotStopd id: Glucose (70-105) t0: [17:00:00 20/11/2018] el: 0 cg: CoWker cu: CCU v1: 244 n1: 244 rs: Manual st: NotStopd
id: BUN t0: [15:31:00 20/11/2018] el: 0 cg: 1663 cu: CCU v1: 13 n1: 13 rs: Final st: NotStopd id: Calcium t0: [15:31:00 20/11/2018] el: 0 cg: 1663 cu: CCU v1: 8.4 n1: 8.4 u1: mg/dl rs: Final st: NotStopd id: Chloride t0: [15:31:00 20/11/2018] el: 0 cg: 1663 cu: CCU v1: 108 n1: 108 rs: Final st: NotStopd id: Creatinine t0: [15:31:00 20/11/2018] el: 0 cg: 1663 cu: CCU v1: 2.1 n1: 2.1 rs: Final st: NotStopd id: Glucose t0: [15:31:00 20/11/2018] el: 0 cg: 1663 cu: CCU v1: 217 n1: 217 rs: Final st: NotStopd id: Magnesium t0: [15:31:00 20/11/2018] el: 0 cg: 1663 cu: CCU v1: 2.5 n1: 2.5 rs: Final st: NotStopd id: Phosphorous t0: [15:31:00 20/11/2018] el: 0 cg: 1663 cu: CCU v1: 2.5 n1: 2.5 u1: mEq/L rs: Final st: NotStopd id: Potassium t0: [15:31:00 20/11/2018] el: 0 cg: 1663 cu: CCU v1: 4.1 n1: 4.1 rs: Final st: NotStopd id: Sodium t0: [15:31:00 20/11/2018] el: 0 cg: 1663 cu: CCU v1: 147 n1: 147 rs: Final st: NotStopd id: BUN (6-20) t0: [15:31:00 20/11/2018] el: 0 cg: 1663 cu: CCU v1: 13 n1: 13 rs: Final st: NotStopd id: Calcium (8.4-10.2) t0: [15:31:00 20/11/2018] el: 0 cg: 1663 cu: CCU v1: 8.4 n1: 8.4 u1: mg/dl rs: Final st: NotStopd id: Carbon Dioxide t0: [15:31:00 20/11/2018] el: 0 cg: 1663 cu: CCU v1: 30 n1: 30 rs: Final st: NotStopd id: Chloride (100-112) t0: [15:31:00 20/11/2018] el: 0 cg: 1663 cu: CCU v1: 108 n1: 108 rs: Final st: NotStopd id: Creatinine (0-1.3) t0: [15:31:00 20/11/2018] el: 0 cg: 1663 cu: CCU v1: 2.1 n1: 2.1 rs: Final st: NotStopd id: Glucose (70-105) t0: [15:31:00 20/11/2018] el: 0 cg: 1663 cu: CCU v1: 217 n1: 217 rs: Final st: NotStopd id: Magnesium (1.6-2.6) t0: [15:31:00 20/11/2018] el: 0 cg: 1663 cu: CCU v1: 2.5 n1: 2.5 rs: Final st: NotStopd id: Phosphorous(2.7-4.5) t0: [15:31:00 20/11/2018] el: 0 cg: 1663 cu: CCU v1: 2.5 n1: 2.5 u1: mEq/L rs: Final st: NotStopd id: Potassium (3.5-5.3) t0: [15:31:00 20/11/2018] el: 0 cg: 1663 cu: CCU v1: 4.1 n1: 4.1 rs: Final st: NotStopd id: Sodium (135-148) t0: [15:31:00 20/11/2018] el: 0 cg: 1663 cu: CCU v1: 147 n1: 147 rs: Final st: NotStopd
id: Service Type t0: [18:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: CCU st: NotStopd id: Code Status t0: [18:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Full Code st: NotStopd id: Risk for Falls t0: [18:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Yes st: NotStopd id: Ectopy Frequency t0: [18:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: None st: NotStopd id: Ectopy Type t0: [18:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: None st: NotStopd id: Heart Rate t0: [18:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 86 n1: 86 u1: BPM st: NotStopd id: Heart Rhythm t0: [18:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Atrial Fib st: NotStopd id: Arterial BP t0: [18:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 131 n1: 131 u1: mmHg v2: 50 n2: 50 u2: mmHg st: NotStopd id: Arterial BP Mean t0: [18:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 78 n1: 78 u1: mmHg st: NotStopd id: Precautions t0: [18:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Contact st: NotStopd id: ABP Alarm (Lo/Hi) t0: [18:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 85 n1: 85 u1: mmHg v2: 145 n2: 145 u2: mmHg st: NotStopd id: HR Alarm (Lo/Hi) t0: [18:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 60 n1: 60 u1: BPM v2: 125 n2: 125 u2: BPM st: NotStopd id: Resp Alarm (Lo/Hi) t0: [18:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 8 n1: 8 u1: BPM v2: 40 n2: 40 u2: BPM st: NotStopd id: SpO2 Alarm (Lo/Hi) t0: [18:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 90 n1: 90 u1: % v2: 100 n2: 100 u2: % st: NotStopd id: Respiratory Rate t0: [18:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 18 n1: 18 u1: BPM st: NotStopd id: SpO2 t0: [18:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 96 n1: 96 u1: % st: NotStopd id: calprevflg t0: [18:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 1 n1: 1 u1: kg st: NotStopd
id: D5W 250.0ml + 25000Uhr Heparin t0: [18:00:00 20/11/2018] el: 1 ai: 117 cg: RN cu: CCU vo: 9 vu: ml id: D5W t0: [18:00:00 20/11/2018] el: 1 ai: 168 cg: RN cu: CCU vo: 75 vu: ml id: Stool Out Stool t0: [11:00:00 20/11/2018] el: 1 cg: RN cu: CCU vu: ml es: Medium id: Stool Out Stool t0: [16:00:00 20/11/2018] el: 1 cg: RN cu: CCU vu: ml es: Medium id: Urine Out Foley t0: [18:00:00 20/11/2018] el: 1 cg: RN cu: CCU vo: 30 vu: ml
id: Heparin t0: [18:00:00 20/11/2018] el: 1 cg: RN cu: CCU vo: 0 do: 900 du: Uhr so: D5W sv: 250 su: ml rt: IV Drip
id: Service Type t0: [19:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: CCU st: NotStopd id: Code Status t0: [19:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Full Code st: NotStopd id: Risk for Falls t0: [19:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Yes st: NotStopd id: Ectopy Frequency t0: [19:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: None st: NotStopd id: Ectopy Type t0: [19:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: None st: NotStopd id: Heart Rate t0: [19:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 72 n1: 72 u1: BPM st: NotStopd id: Heart Rhythm t0: [19:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Atrial Fib st: NotStopd id: Arterial BP t0: [19:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 109 n1: 109 u1: mmHg v2: 44 n2: 44 u2: mmHg st: NotStopd id: Arterial BP Mean t0: [19:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 64 n1: 64 u1: mmHg st: NotStopd id: Precautions t0: [19:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Contact st: NotStopd id: ABP Alarm (Lo/Hi) t0: [19:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 85 n1: 85 u1: mmHg v2: 145 n2: 145 u2: mmHg st: NotStopd id: HR Alarm (Lo/Hi) t0: [19:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 60 n1: 60 u1: BPM v2: 125 n2: 125 u2: BPM st: NotStopd id: Resp Alarm (Lo/Hi) t0: [19:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 8 n1: 8 u1: BPM v2: 40 n2: 40 u2: BPM st: NotStopd id: SpO2 Alarm (Lo/Hi) t0: [19:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 90 n1: 90 u1: % v2: 100 n2: 100 u2: % st: NotStopd id: Respiratory Rate t0: [19:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 15 n1: 15 u1: BPM st: NotStopd id: SpO2 t0: [19:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 97 n1: 97 u1: % st: NotStopd id: calprevflg t0: [19:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 1 n1: 1 u1: kg st: NotStopd
id: Heparin t0: [19:00:00 20/11/2018] el: 1 cg: RN cu: CCU vo: 0 do: 900 du: Uhr so: D5W sv: 250 su: ml rt: IV Drip
pi: 4075623 hi: 10161 t0: [10:00:00 20/11/2018] tf: [22:00:00 26/11/2018] mn: Lansoprazole pt: Unit Dose st: Discontinued via patient discharge rt: PO fr: DAILY ds: 10 dn: 1 di: Ongoing xv: 36 xu: Hours
id: Service Type t0: [20:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: CCU st: NotStopd id: Code Status t0: [20:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Full Code st: NotStopd id: Riker-SAS Scale t0: [20:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Calm/Cooperative st: NotStopd id: Daily Wake Up t0: [20:00:00 20/11/2018] el: 1 cg: RN cu: CCU v1: No/Not Sedated st: NotStopd id: Risk for Falls t0: [20:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Yes st: NotStopd id: ETT Mark/Location t0: [20:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 22cm v2: Lip st: NotStopd id: Extubation Date t0: [20:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 6 n1: 6 v2: 26 n2: 26 st: NotStopd id: FiO2 Set t0: [20:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 0.4 n1: 0.4 u1: torr st: NotStopd id: Airway Size t0: [20:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 7.0 mm st: NotStopd id: Airway Type t0: [20:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Endotracheal st: NotStopd id: Intubation Date t0: [20:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 6 n1: 6 v2: 22 n2: 22 st: NotStopd id: O2 Delivery Device t0: [20:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Aerosol-Cool st: NotStopd id: Angio Site #1 t0: [20:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: R Femoral st: NotStopd id: Angio Site #2 t0: [20:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: L Femoral st: NotStopd id: Precautions t0: [20:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Contact st: NotStopd id: ABP Alarm (Lo/Hi) t0: [20:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 85 n1: 85 u1: mmHg v2: 145 n2: 145 u2: mmHg st: NotStopd id: HR Alarm (Lo/Hi) t0: [20:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 60 n1: 60 u1: BPM v2: 125 n2: 125 u2: BPM st: NotStopd id: Resp Alarm (Lo/Hi) t0: [20:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 8 n1: 8 u1: BPM v2: 40 n2: 40 u2: BPM st: NotStopd id: SpO2 Alarm (Lo/Hi) t0: [20:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 90 n1: 90 u1: % v2: 100 n2: 100 u2: % st: NotStopd id: Respiratory Pattern t0: [20:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Regular st: NotStopd id: Urine Source t0: [20:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Indwelling Cath st: NotStopd
id: D5W 250.0ml + 25000Uhr Heparin t0: [19:00:00 20/11/2018] el: 1 ai: 117 cg: RN cu: CCU vo: 9 vu: ml id: D5W 250.0ml + 25000Uhr Heparin t0: [20:00:00 20/11/2018] el: 1 ai: 117 cg: RN cu: CCU vo: 9 vu: ml
id: Heparin t0: [20:00:00 20/11/2018] el: 1 cg: RN cu: CCU vo: 0 do: 900 du: Uhr so: D5W sv: 250 su: ml rt: IV Drip
id: IV #1 Reason DC'D t0: [21:00:00 20/11/2018] el: 0 cg: -1 cu: CCU st: D/C'd id: IV #1 D/C Date t0: [21:00:00 20/11/2018] el: 0 cg: -1 cu: CCU st: D/C'd id: IV #1 Insert Date t0: [21:00:00 20/11/2018] el: 0 cg: -1 cu: CCU st: D/C'd id: IV #1 Site/Size t0: [21:00:00 20/11/2018] el: 0 cg: -1 cu: CCU st: D/C'd id: IV Site Appear #1 t0: [21:00:00 20/11/2018] el: 0 cg: -1 cu: CCU st: D/C'd
pi: 4075907 hi: 10161 t0: [22:00:00 20/11/2018] tf: [09:00:00 21/11/2018] mn: Morphine Sulfate pt: Unit Dose st: Inactive (Due to a change order) rt: IV fr: Q6H:PRN di: Ongoing xv: 36 xu: Hours
id: Service Type t0: [21:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: CCU st: NotStopd id: Code Status t0: [21:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Full Code st: NotStopd id: GI Prophylaxis t0: [20:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Proton/Pump/Inhi st: NotStopd id: IV #1 Reason DC'D t0: [20:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Routine Change st: NotStopd id: Risk for Falls t0: [21:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Yes st: NotStopd id: Diet Type t0: [20:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Soft Solid st: NotStopd id: Dorsal PedPulse R/L t0: [20:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Not Applicable v2: Doppler st: NotStopd id: Ectopy Frequency t0: [20:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: None st: NotStopd id: Ectopy Frequency t0: [21:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: None st: NotStopd id: Ectopy Type t0: [20:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: None st: NotStopd id: Ectopy Type t0: [21:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: None st: NotStopd id: Alarms t0: [20:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: ON st: NotStopd id: Parameters Checked t0: [20:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Yes st: NotStopd id: Education Topic #1 t0: [20:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Plan of Care st: NotStopd id: Eye Care t0: [20:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Done st: NotStopd id: Eye Opening t0: [20:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 4 Spontaneously st: NotStopd id: GCS Total t0: [20:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 15 n1: 15 u1: points st: NotStopd id: HOB t0: [20:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 45 degrees st: NotStopd id: Heart Rate t0: [20:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 68 n1: 68 u1: BPM st: NotStopd id: Heart Rate t0: [21:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 79 n1: 79 u1: BPM st: NotStopd id: Heart Rhythm t0: [20:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Atrial Fib st: NotStopd id: Heart Rhythm t0: [21:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Atrial Fib st: NotStopd id: INV Line#3 Type/Site t0: [20:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: A-Line v2: Left Radial st: NotStopd id: INV Line#3 Zero/Cal t0: [20:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Yes st: NotStopd id: INV Line#3InsertDate t0: [20:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 9 n1: 9 v2: 24 n2: 24 st: NotStopd id: INV Line#3SiteAppear t0: [20:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: WNL st: NotStopd id: Abdominal Assessment t0: [20:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Obese st: NotStopd id: INV#3 WaveformAppear t0: [20:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Sharp st: NotStopd id: IV #1 D/C Date t0: [20:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 9 n1: 9 v2: 26 n2: 26 st: NotStopd id: IV #1 Insert Date t0: [20:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 9 n1: 9 v2: 22 n2: 22 st: NotStopd id: IV #1 Site/Size t0: [20:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Right Antecub v2: 18 gauge st: NotStopd id: IV #2 Insert Date t0: [20:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 9 n1: 9 v2: 25 n2: 25 st: NotStopd id: IV #2 Site/Size t0: [20:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Right Wrist v2: 20 gauge st: NotStopd id: Activity t0: [20:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Bedrest st: NotStopd id: IV Site Appear #1 t0: [20:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: WNL st: NotStopd id: IV Site Appear #2 t0: [20:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: WNL st: NotStopd id: Activity Tolerance t0: [20:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Tolerated Well st: NotStopd id: ImpSkin Character #1 t0: [20:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Abrasion st: NotStopd id: ImpSkin Treatment #1 t0: [20:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Dry Sterile Dsg st: NotStopd id: Impaired Skin Site#1 t0: [20:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Abdomen st: NotStopd id: LLE Temp/Color t0: [20:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Warm v2: Dusky st: NotStopd id: LLL Lung Sounds t0: [20:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Diminished st: NotStopd id: LUE Temp/Color t0: [20:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Warm v2: Dusky st: NotStopd id: LUL Lung Sounds t0: [20:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Clear st: NotStopd id: Level of Conscious t0: [20:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Arouse to Voice st: NotStopd id: Angio Appearance #1 t0: [20:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Clean and Dry v2: Clean and Dry st: NotStopd id: Angio Appearance #2 t0: [20:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Ecchymotic v2: Clean and Dry st: NotStopd id: Motor Response t0: [20:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 6 Obeys Commands st: NotStopd id: Angio Dressing #1 t0: [20:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Transparent st: NotStopd id: Angio Dressing #2 t0: [20:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Dry Sterile Dsg st: NotStopd id: Oral Care t0: [20:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Done st: NotStopd id: Oral Cavity t0: [20:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Teeth/Tissue WNL st: NotStopd id: Orientation t0: [20:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Oriented x 3 st: NotStopd id: PT Splint Loc/Stat#1 t0: [20:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Left Leg v2: On st: NotStopd id: Arterial BP t0: [20:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 111 n1: 111 u1: mmHg v2: 44 n2: 44 u2: mmHg st: NotStopd id: Arterial BP t0: [21:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 132 n1: 132 u1: mmHg v2: 51 n2: 51 u2: mmHg st: NotStopd id: Arterial BP Mean t0: [20:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 65 n1: 65 u1: mmHg st: NotStopd id: Arterial BP Mean t0: [21:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 77 n1: 77 u1: mmHg st: NotStopd id: Position t0: [20:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Supine st: NotStopd id: PostTib. Pulses R/L t0: [20:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Not Applicable v2: Doppler st: NotStopd id: Assistance Device t0: [20:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 2 Person Assist st: NotStopd id: Precautions t0: [21:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Contact st: NotStopd id: INV#3 Dsg Change t0: [20:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 9 n1: 9 v2: 24 n2: 24 st: NotStopd id: ABP Alarm (Lo/Hi) t0: [21:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 85 n1: 85 u1: mmHg v2: 145 n2: 145 u2: mmHg st: NotStopd id: HR Alarm (Lo/Hi) t0: [21:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 60 n1: 60 u1: BPM v2: 125 n2: 125 u2: BPM st: NotStopd id: Resp Alarm (Lo/Hi) t0: [21:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 8 n1: 8 u1: BPM v2: 40 n2: 40 u2: BPM st: NotStopd id: SpO2 Alarm (Lo/Hi) t0: [21:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 90 n1: 90 u1: % v2: 100 n2: 100 u2: % st: NotStopd id: RLL Lung Sounds t0: [20:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Diminished st: NotStopd id: RUL Lung Sounds t0: [20:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Clear st: NotStopd id: Respiratory Rate t0: [20:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 21 n1: 21 u1: BPM st: NotStopd id: Respiratory Rate t0: [21:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 43 n1: 43 u1: BPM st: NotStopd id: Restraint Location t0: [20:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: None st: NotStopd id: Side Rails t0: [20:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: All rails up st: NotStopd id: Skin Care t0: [20:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Done st: NotStopd id: Skin Integrity t0: [20:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Impaired st: NotStopd id: SpO2 t0: [20:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 98 n1: 98 u1: % st: NotStopd id: SpO2 t0: [21:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 100 n1: 100 u1: % st: NotStopd id: Support Systems t0: [20:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Children st: NotStopd id: INV#3 Cap Change t0: [20:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 9 n1: 9 v2: 24 n2: 24 st: NotStopd id: INV#3 Tubing Change t0: [20:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 9 n1: 9 v2: 24 n2: 24 st: NotStopd id: Therapeutic Bed t0: [20:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: AtmosAir Mattres st: NotStopd id: Turn t0: [20:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Left Side st: NotStopd id: Urine Color/Appear t0: [20:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Yellow v2: Clear st: NotStopd id: Verbal Response t0: [20:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 5 Oriented st: NotStopd id: Back Care t0: [20:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Done st: NotStopd id: calprevflg t0: [20:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 1 n1: 1 u1: kg st: NotStopd id: calprevflg t0: [21:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 1 n1: 1 u1: kg st: NotStopd id: Behavior t0: [20:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Appropriate st: NotStopd id: Bowel Sounds t0: [20:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Present st: NotStopd id: Braden Activity t0: [20:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Bedfast st: NotStopd id: Braden Frict/Shear t0: [20:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Potential Prob st: NotStopd id: Braden Mobility t0: [20:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Comp. Immobile st: NotStopd id: Braden Moisture t0: [20:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Occ. Moist st: NotStopd id: Braden Nutrition t0: [20:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Very Poor st: NotStopd id: Braden Score t0: [20:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 9 n1: 9 u1: number st: NotStopd id: Braden SensoryPercep t0: [20:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Comp. Limited st: NotStopd
id: D5W 250.0ml + 25000Uhr Heparin t0: [21:00:00 20/11/2018] el: 1 ai: 117 cg: RN cu: CCU vo: 9 vu: ml id: Urine Out Foley t0: [20:00:00 20/11/2018] el: 1 cg: RN cu: CCU vo: 85 vu: ml
id: Heparin t0: [21:00:00 20/11/2018] el: 1 cg: RN cu: CCU vo: 0 do: 900 du: Uhr so: D5W sv: 250 su: ml rt: IV Drip
id: Glucose t0: [22:00:00 20/11/2018] el: 0 cg: CoWker cu: CCU v1: 175 n1: 175 rs: Manual st: NotStopd id: Glucose (70-105) t0: [22:00:00 20/11/2018] el: 0 cg: CoWker cu: CCU v1: 175 n1: 175 rs: Manual st: NotStopd
id: Service Type t0: [22:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: CCU st: NotStopd id: Code Status t0: [22:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Full Code st: NotStopd id: Risk for Falls t0: [22:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Yes st: NotStopd id: Ectopy Frequency t0: [22:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: None st: NotStopd id: Ectopy Type t0: [22:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: None st: NotStopd id: Alarms t0: [22:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: ON st: NotStopd id: Parameters Checked t0: [22:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Yes st: NotStopd id: Heart Rate t0: [22:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 68 n1: 68 u1: BPM st: NotStopd id: Heart Rhythm t0: [22:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Atrial Fib st: NotStopd id: Arterial BP t0: [22:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 122 n1: 122 u1: mmHg v2: 48 n2: 48 u2: mmHg st: NotStopd id: Arterial BP Mean t0: [22:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 72 n1: 72 u1: mmHg st: NotStopd id: Precautions t0: [22:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Contact st: NotStopd id: ABP Alarm (Lo/Hi) t0: [22:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 85 n1: 85 u1: mmHg v2: 145 n2: 145 u2: mmHg st: NotStopd id: HR Alarm (Lo/Hi) t0: [22:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 60 n1: 60 u1: BPM v2: 125 n2: 125 u2: BPM st: NotStopd id: Resp Alarm (Lo/Hi) t0: [22:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 8 n1: 8 u1: BPM v2: 40 n2: 40 u2: BPM st: NotStopd id: SpO2 Alarm (Lo/Hi) t0: [22:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 90 n1: 90 u1: % v2: 100 n2: 100 u2: % st: NotStopd id: Respiratory Rate t0: [22:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 30 n1: 30 u1: BPM st: NotStopd id: SpO2 t0: [22:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 100 n1: 100 u1: % st: NotStopd id: Temp. Site t0: [22:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Oral st: NotStopd id: Temperature C (calc) t0: [22:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 36.8333 n1: 36.8333 u1: Deg. C st: NotStopd id: Temperature F t0: [22:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 98.3 n1: 98.3 u1: Deg. F st: NotStopd id: calprevflg t0: [22:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 1 n1: 1 u1: kg st: NotStopd
id: D5W 100.0ml t0: [20:00:00 20/11/2018] el: 1 ai: 105 cg: RN cu: CCU vo: 100 vu: ml id: D5W 250.0ml + 25000Uhr Heparin t0: [22:00:00 20/11/2018] el: 1 ai: 117 cg: RN cu: CCU vo: 9 vu: ml id: D5W t0: [19:00:00 20/11/2018] el: 1 ai: 168 cg: RN cu: CCU vu: ml id: D5W t0: [20:00:00 20/11/2018] el: 1 ai: 168 cg: RN cu: CCU vo: 0 vu: ml nb: 1 id: D5W t0: [21:00:00 20/11/2018] el: 1 ai: 168 cg: RN cu: CCU vu: ml id: D5W t0: [22:00:00 20/11/2018] el: 1 ai: 168 cg: RN cu: CCU vo: 20 vu: ml id: Urine Out Foley t0: [22:00:00 20/11/2018] el: 1 cg: RN cu: CCU vo: 33 vu: ml
id: Heparin t0: [22:00:00 20/11/2018] el: 1 cg: RN cu: CCU vo: 0 do: 900 du: Uhr so: D5W sv: 250 su: ml rt: IV Drip
id: Service Type t0: [00:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: CCU st: NotStopd id: Service Type t0: [23:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: CCU st: NotStopd id: Code Status t0: [00:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Full Code st: NotStopd id: Code Status t0: [23:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Full Code st: NotStopd id: Risk for Falls t0: [00:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Yes st: NotStopd id: Risk for Falls t0: [23:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Yes st: NotStopd id: Ectopy Frequency t0: [00:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: None st: NotStopd id: Ectopy Frequency t0: [23:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: None st: NotStopd id: Ectopy Type t0: [00:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: None st: NotStopd id: Ectopy Type t0: [23:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: None st: NotStopd id: Alarms t0: [00:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: ON st: NotStopd id: Parameters Checked t0: [00:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Yes st: NotStopd id: Heart Rate t0: [00:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 72 n1: 72 u1: BPM st: NotStopd id: Heart Rate t0: [23:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 74 n1: 74 u1: BPM st: NotStopd id: Heart Rhythm t0: [00:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Atrial Fib st: NotStopd id: Heart Rhythm t0: [23:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Atrial Fib st: NotStopd id: Arterial BP t0: [00:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 118 n1: 118 u1: mmHg v2: 48 n2: 48 u2: mmHg st: NotStopd id: Arterial BP t0: [23:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 134 n1: 134 u1: mmHg v2: 52 n2: 52 u2: mmHg st: NotStopd id: Arterial BP Mean t0: [00:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 70 n1: 70 u1: mmHg st: NotStopd id: Arterial BP Mean t0: [23:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 79 n1: 79 u1: mmHg st: NotStopd id: Precautions t0: [00:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Contact st: NotStopd id: Precautions t0: [23:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Contact st: NotStopd id: ABP Alarm (Lo/Hi) t0: [00:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 85 n1: 85 u1: mmHg v2: 145 n2: 145 u2: mmHg st: NotStopd id: ABP Alarm (Lo/Hi) t0: [23:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 85 n1: 85 u1: mmHg v2: 145 n2: 145 u2: mmHg st: NotStopd id: HR Alarm (Lo/Hi) t0: [00:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 60 n1: 60 u1: BPM v2: 125 n2: 125 u2: BPM st: NotStopd id: HR Alarm (Lo/Hi) t0: [23:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 60 n1: 60 u1: BPM v2: 125 n2: 125 u2: BPM st: NotStopd id: Resp Alarm (Lo/Hi) t0: [00:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 8 n1: 8 u1: BPM v2: 40 n2: 40 u2: BPM st: NotStopd id: Resp Alarm (Lo/Hi) t0: [23:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 8 n1: 8 u1: BPM v2: 40 n2: 40 u2: BPM st: NotStopd id: SpO2 Alarm (Lo/Hi) t0: [00:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 90 n1: 90 u1: % v2: 100 n2: 100 u2: % st: NotStopd id: SpO2 Alarm (Lo/Hi) t0: [23:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 90 n1: 90 u1: % v2: 100 n2: 100 u2: % st: NotStopd id: Respiratory Rate t0: [00:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 33 n1: 33 u1: BPM st: NotStopd id: Respiratory Rate t0: [23:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 22 n1: 22 u1: BPM st: NotStopd id: SpO2 t0: [00:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 97 n1: 97 u1: % st: NotStopd id: SpO2 t0: [23:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 100 n1: 100 u1: % st: NotStopd id: calprevflg t0: [00:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 1 n1: 1 u1: kg st: NotStopd id: calprevflg t0: [23:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: 1 n1: 1 u1: kg st: NotStopd
id: D5W 250.0ml + 25000Uhr Heparin t0: [00:00:00 21/11/2018] el: 1 ai: 117 cg: RN cu: CCU vo: 9 vu: ml id: D5W 250.0ml + 25000Uhr Heparin t0: [23:00:00 20/11/2018] el: 1 ai: 117 cg: RN cu: CCU vo: 9 vu: ml id: D5W t0: [00:00:00 21/11/2018] el: 1 ai: 168 cg: RN cu: CCU vo: 10 vu: ml id: D5W t0: [23:00:00 20/11/2018] el: 1 ai: 168 cg: RN cu: CCU vo: 10 vu: ml id: Urine Out Foley t0: [00:00:00 21/11/2018] el: 1 cg: RN cu: CCU vo: 40 vu: ml
id: Heparin t0: [00:00:00 21/11/2018] el: 1 cg: RN cu: CCU vo: 0 do: 900 du: Uhr so: D5W sv: 250 su: ml rt: IV Drip id: Heparin t0: [23:00:00 20/11/2018] el: 1 cg: RN cu: CCU vo: 0 do: 900 du: Uhr so: D5W sv: 250 su: ml rt: IV Drip
id: Service Type t0: [01:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: CCU st: NotStopd id: Code Status t0: [01:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Full Code st: NotStopd id: Riker-SAS Scale t0: [00:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Calm/Cooperative st: NotStopd id: Risk for Falls t0: [01:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Yes st: NotStopd id: Ectopy Frequency t0: [01:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: None st: NotStopd id: Ectopy Type t0: [01:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: None st: NotStopd id: Heart Rate t0: [01:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 56 n1: 56 u1: BPM st: NotStopd id: Heart Rhythm t0: [01:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Atrial Fib st: NotStopd id: Arterial BP t0: [01:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 107 n1: 107 u1: mmHg v2: 46 n2: 46 u2: mmHg st: NotStopd id: Arterial BP Mean t0: [01:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 65 n1: 65 u1: mmHg st: NotStopd id: Precautions t0: [01:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Contact st: NotStopd id: ABP Alarm (Lo/Hi) t0: [01:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 85 n1: 85 u1: mmHg v2: 145 n2: 145 u2: mmHg st: NotStopd id: HR Alarm (Lo/Hi) t0: [01:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 60 n1: 60 u1: BPM v2: 125 n2: 125 u2: BPM st: NotStopd id: Resp Alarm (Lo/Hi) t0: [01:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 8 n1: 8 u1: BPM v2: 40 n2: 40 u2: BPM st: NotStopd id: SpO2 Alarm (Lo/Hi) t0: [01:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 90 n1: 90 u1: % v2: 100 n2: 100 u2: % st: NotStopd id: Respiratory Rate t0: [01:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 30 n1: 30 u1: BPM st: NotStopd id: SpO2 t0: [01:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 100 n1: 100 u1: % st: NotStopd id: calprevflg t0: [01:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 1 n1: 1 u1: kg st: NotStopd
id: D5W 250.0ml + 25000Uhr Heparin t0: [01:00:00 21/11/2018] el: 1 ai: 117 cg: RN cu: CCU vo: 9 vu: ml id: D5W t0: [01:00:00 21/11/2018] el: 1 ai: 168 cg: RN cu: CCU vo: 10 vu: ml id: Urine Out Foley t0: [01:00:00 21/11/2018] el: 1 cg: RN cu: CCU vo: 30 vu: ml
id: Heparin t0: [01:00:00 21/11/2018] el: 1 cg: RN cu: CCU vo: 0 do: 900 du: Uhr so: D5W sv: 250 su: ml rt: IV Drip
id: BUN t0: [23:44:00 20/11/2018] el: 0 cg: 1663 cu: CCU v1: 12 n1: 12 rs: Final st: NotStopd id: Calcium t0: [23:44:00 20/11/2018] el: 0 cg: 1663 cu: CCU v1: 8.5 n1: 8.5 u1: mg/dl rs: Final st: NotStopd id: Chloride t0: [23:44:00 20/11/2018] el: 0 cg: 1663 cu: CCU v1: 108 n1: 108 rs: Final st: NotStopd id: Creatinine t0: [23:44:00 20/11/2018] el: 0 cg: 1663 cu: CCU v1: 0.8 n1: 0.8 rs: Final st: NotStopd id: Glucose t0: [23:44:00 20/11/2018] el: 0 cg: 1663 cu: CCU v1: 169 n1: 169 rs: Final st: NotStopd id: Magnesium t0: [23:44:00 20/11/2018] el: 0 cg: 1663 cu: CCU v1: 2.5 n1: 2.5 rs: Final st: NotStopd id: Phosphorous t0: [23:44:00 20/11/2018] el: 0 cg: 1663 cu: CCU v1: 2.1 n1: 2.1 u1: mEq/L rs: Final st: NotStopd id: Potassium t0: [23:44:00 20/11/2018] el: 0 cg: 1663 cu: CCU v1: 3.8 n1: 3.8 rs: Final st: NotStopd id: Sodium t0: [23:44:00 20/11/2018] el: 0 cg: 1663 cu: CCU v1: 148 n1: 148 rs: Final st: NotStopd id: BUN (6-20) t0: [23:44:00 20/11/2018] el: 0 cg: 1663 cu: CCU v1: 12 n1: 12 rs: Final st: NotStopd id: Calcium (8.4-10.2) t0: [23:44:00 20/11/2018] el: 0 cg: 1663 cu: CCU v1: 8.5 n1: 8.5 u1: mg/dl rs: Final st: NotStopd id: Carbon Dioxide t0: [23:44:00 20/11/2018] el: 0 cg: 1663 cu: CCU v1: 30 n1: 30 rs: Final st: NotStopd id: Chloride (100-112) t0: [23:44:00 20/11/2018] el: 0 cg: 1663 cu: CCU v1: 108 n1: 108 rs: Final st: NotStopd id: Creatinine (0-1.3) t0: [23:44:00 20/11/2018] el: 0 cg: 1663 cu: CCU v1: 0.8 n1: 0.8 rs: Final st: NotStopd id: Glucose (70-105) t0: [23:44:00 20/11/2018] el: 0 cg: 1663 cu: CCU v1: 169 n1: 169 rs: Final st: NotStopd id: Magnesium (1.6-2.6) t0: [23:44:00 20/11/2018] el: 0 cg: 1663 cu: CCU v1: 2.5 n1: 2.5 rs: Final st: NotStopd id: Phosphorous(2.7-4.5) t0: [23:44:00 20/11/2018] el: 0 cg: 1663 cu: CCU v1: 2.1 n1: 2.1 u1: mEq/L rs: Final st: NotStopd id: Potassium (3.5-5.3) t0: [23:44:00 20/11/2018] el: 0 cg: 1663 cu: CCU v1: 3.8 n1: 3.8 rs: Final st: NotStopd id: Sodium (135-148) t0: [23:44:00 20/11/2018] el: 0 cg: 1663 cu: CCU v1: 148 n1: 148 rs: Final st: NotStopd
pi: 4076562 hi: 10161 t0: [03:00:00 21/11/2018] tf: [08:00:00 21/11/2018] pt: IV Large Volume st: Expired rt: IV fr: ASDIR iv: 500 ml D5W Continuous at 75 ml/hr for 400 ml ir: 75 it: C ss: N dt: 5 di: Hours xu: Enter on Label pi: 4076563 hi: 10161 t0: [03:00:00 21/11/2018] tf: [02:00:00 22/11/2018] mn: Neutra-Phos pt: Unit Dose st: Expired rt: PO fr: ONCE ds: 3 dn: 1 dt: 1 di: Doses xv: 36 xu: Hours
id: Service Type t0: [02:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: CCU st: NotStopd id: Service Type t0: [03:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: CCU st: NotStopd id: Code Status t0: [02:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Full Code st: NotStopd id: Code Status t0: [03:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Full Code st: NotStopd id: Risk for Falls t0: [02:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Yes st: NotStopd id: Risk for Falls t0: [03:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Yes st: NotStopd id: Ectopy Frequency t0: [02:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: None st: NotStopd id: Ectopy Frequency t0: [03:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: None st: NotStopd id: Ectopy Type t0: [02:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: None st: NotStopd id: Ectopy Type t0: [03:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: None st: NotStopd id: Heart Rate t0: [02:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 68 n1: 68 u1: BPM st: NotStopd id: Heart Rate t0: [03:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 66 n1: 66 u1: BPM st: NotStopd id: Heart Rhythm t0: [02:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Atrial Fib st: NotStopd id: Heart Rhythm t0: [03:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Atrial Fib st: NotStopd id: Arterial BP t0: [02:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 98 n1: 98 u1: mmHg v2: 43 n2: 43 u2: mmHg st: NotStopd id: Arterial BP t0: [03:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 106 n1: 106 u1: mmHg v2: 43 n2: 43 u2: mmHg st: NotStopd id: Arterial BP Mean t0: [02:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 60 n1: 60 u1: mmHg st: NotStopd id: Arterial BP Mean t0: [03:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 63 n1: 63 u1: mmHg st: NotStopd id: Precautions t0: [02:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Contact st: NotStopd id: Precautions t0: [03:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Contact st: NotStopd id: ABP Alarm (Lo/Hi) t0: [02:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 85 n1: 85 u1: mmHg v2: 145 n2: 145 u2: mmHg st: NotStopd id: ABP Alarm (Lo/Hi) t0: [03:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 85 n1: 85 u1: mmHg v2: 145 n2: 145 u2: mmHg st: NotStopd id: HR Alarm (Lo/Hi) t0: [02:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 60 n1: 60 u1: BPM v2: 125 n2: 125 u2: BPM st: NotStopd id: HR Alarm (Lo/Hi) t0: [03:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 60 n1: 60 u1: BPM v2: 125 n2: 125 u2: BPM st: NotStopd id: Resp Alarm (Lo/Hi) t0: [02:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 8 n1: 8 u1: BPM v2: 40 n2: 40 u2: BPM st: NotStopd id: Resp Alarm (Lo/Hi) t0: [03:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 8 n1: 8 u1: BPM v2: 40 n2: 40 u2: BPM st: NotStopd id: SpO2 Alarm (Lo/Hi) t0: [02:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 90 n1: 90 u1: % v2: 100 n2: 100 u2: % st: NotStopd id: SpO2 Alarm (Lo/Hi) t0: [03:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 90 n1: 90 u1: % v2: 100 n2: 100 u2: % st: NotStopd id: Respiratory Rate t0: [02:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 34 n1: 34 u1: BPM st: NotStopd id: Respiratory Rate t0: [03:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 20 n1: 20 u1: BPM st: NotStopd id: SpO2 t0: [02:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 100 n1: 100 u1: % st: NotStopd id: SpO2 t0: [03:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 100 n1: 100 u1: % st: NotStopd id: calprevflg t0: [02:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 1 n1: 1 u1: kg st: NotStopd id: calprevflg t0: [03:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 1 n1: 1 u1: kg st: NotStopd
id: D5W 250.0ml + 25000Uhr Heparin t0: [02:00:00 21/11/2018] el: 1 ai: 117 cg: RN cu: CCU vo: 9 vu: ml id: D5W 250.0ml + 25000Uhr Heparin t0: [03:00:00 21/11/2018] el: 1 ai: 117 cg: RN cu: CCU vo: 9 vu: ml id: D5W t0: [02:00:00 21/11/2018] el: 1 ai: 168 cg: RN cu: CCU vo: 75 vu: ml nb: 1 id: D5W t0: [03:00:00 21/11/2018] el: 1 ai: 168 cg: RN cu: CCU vo: 75 vu: ml id: Urine Out Foley t0: [02:00:00 21/11/2018] el: 1 cg: RN cu: CCU vo: 28 vu: ml
id: Heparin t0: [02:00:00 21/11/2018] el: 1 cg: RN cu: CCU vo: 0 do: 900 du: Uhr so: D5W sv: 250 su: ml rt: IV Drip id: Heparin t0: [03:00:00 21/11/2018] el: 1 cg: RN cu: CCU vo: 0 do: 900 du: Uhr so: D5W sv: 250 su: ml rt: IV Drip
id: Service Type t0: [04:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: CCU st: NotStopd id: Code Status t0: [04:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Full Code st: NotStopd id: Risk for Falls t0: [04:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Yes st: NotStopd id: Ectopy Frequency t0: [04:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: None st: NotStopd id: Ectopy Type t0: [04:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: None st: NotStopd id: Alarms t0: [04:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: ON st: NotStopd id: Parameters Checked t0: [04:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Yes st: NotStopd id: Heart Rate t0: [04:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 72 n1: 72 u1: BPM st: NotStopd id: Heart Rhythm t0: [04:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Atrial Fib st: NotStopd id: Arterial BP t0: [04:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 91 n1: 91 u1: mmHg v2: 38 n2: 38 u2: mmHg st: NotStopd id: Arterial BP Mean t0: [04:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 55 n1: 55 u1: mmHg st: NotStopd id: Precautions t0: [04:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Contact st: NotStopd id: ABP Alarm (Lo/Hi) t0: [04:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 85 n1: 85 u1: mmHg v2: 145 n2: 145 u2: mmHg st: NotStopd id: HR Alarm (Lo/Hi) t0: [04:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 60 n1: 60 u1: BPM v2: 125 n2: 125 u2: BPM st: NotStopd id: Resp Alarm (Lo/Hi) t0: [04:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 8 n1: 8 u1: BPM v2: 40 n2: 40 u2: BPM st: NotStopd id: SpO2 Alarm (Lo/Hi) t0: [04:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 90 n1: 90 u1: % v2: 100 n2: 100 u2: % st: NotStopd id: Respiratory Rate t0: [04:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 31 n1: 31 u1: BPM st: NotStopd id: SpO2 t0: [04:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 100 n1: 100 u1: % st: NotStopd id: Temp. Site t0: [04:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Oral st: NotStopd id: Temperature C (calc) t0: [04:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 37.1111 n1: 37.1111 u1: Deg. C st: NotStopd id: Temperature F t0: [04:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 98.8 n1: 98.8 u1: Deg. F st: NotStopd id: calprevflg t0: [04:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 1 n1: 1 u1: kg st: NotStopd
id: D5W 250.0ml + 25000Uhr Heparin t0: [04:00:00 21/11/2018] el: 1 ai: 117 cg: RN cu: CCU vo: 9 vu: ml id: D5W t0: [04:00:00 21/11/2018] el: 1 ai: 168 cg: RN cu: CCU vo: 75 vu: ml
id: Heparin t0: [04:00:00 21/11/2018] el: 1 cg: RN cu: CCU vo: 0 do: 900 du: Uhr so: D5W sv: 250 su: ml rt: IV Drip
id: Art.pH t0: [04:36:00 21/11/2018] el: 0 cg: 1663 cu: CCU v1: 7.42 n1: 7.42 rs: Final st: NotStopd id: Arterial Base Excess t0: [04:36:00 21/11/2018] el: 0 cg: 1663 cu: CCU v1: 4 n1: 4 rs: Final st: NotStopd id: Arterial CO2(Calc) t0: [04:36:00 21/11/2018] el: 0 cg: 1663 cu: CCU v1: 32 n1: 32 rs: Final st: NotStopd id: Arterial PaCO2 t0: [04:36:00 21/11/2018] el: 0 cg: 1663 cu: CCU v1: 47 n1: 47 u1: mmHg rs: Final st: NotStopd id: Arterial PaO2 t0: [04:36:00 21/11/2018] el: 0 cg: 1663 cu: CCU v1: 103 n1: 103 u1: mmHg rs: Final st: NotStopd id: Arterial pH t0: [04:36:00 21/11/2018] el: 0 cg: 1663 cu: CCU v1: 7.42 n1: 7.42 rs: Final st: NotStopd
pi: 4076796 hi: 10161 t0: [06:00:00 21/11/2018] tf: [05:00:00 22/11/2018] mn: Potassium Chloride pt: Unit Dose st: Expired rt: PO fr: ONCE ds: 6 dn: 1 dt: 1 di: Doses xv: 36 xu: Hours pi: 4076797 hi: 10161 t0: [06:00:00 21/11/2018] tf: [05:00:00 22/11/2018] mn: Potassium Chloride pt: Unit Dose st: Expired rt: PO fr: ONCE ds: 6 dn: 1 dt: 1 di: Doses xv: 36 xu: Hours
id: WBC (4-11,000) t0: [04:12:00 21/11/2018] el: 0 cg: 1663 cu: CCU v1: 5.3 n1: 5.3 rs: Final st: NotStopd id: WBC t0: [04:12:00 21/11/2018] el: 0 cg: 1663 cu: CCU v1: 5.3 n1: 5.3 rs: Final st: NotStopd id: Hematocrit t0: [04:12:00 21/11/2018] el: 0 cg: 1663 cu: CCU v1: 28.8 n1: 28.8 u1: % rs: Final st: NotStopd id: Hemoglobin t0: [04:12:00 21/11/2018] el: 0 cg: 1663 cu: CCU v1: 9.9 n1: 9.9 u1: gm/dl rs: Final st: NotStopd id: Platelets t0: [04:12:00 21/11/2018] el: 0 cg: 1663 cu: CCU v1: 152 n1: 152 rs: Final st: NotStopd id: RBC t0: [04:12:00 21/11/2018] el: 0 cg: 1663 cu: CCU v1: 3.53 n1: 3.53 u1: /mic l rs: Final st: NotStopd id: WBC (4-11,000) t0: [04:12:00 21/11/2018] el: 0 cg: 1663 cu: CCU v1: 5.3 n1: 5.3 rs: Final st: NotStopd
id: Service Type t0: [05:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: CCU st: NotStopd id: Code Status t0: [05:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Full Code st: NotStopd id: Risk for Falls t0: [05:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Yes st: NotStopd id: INV Line#3 Type/Site t0: [00:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: A-Line v2: Left Radial st: NotStopd id: INV Line#3 Type/Site t0: [04:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: A-Line v2: Left Radial st: NotStopd id: INV Line#3 Zero/Cal t0: [00:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: No st: NotStopd id: INV Line#3 Zero/Cal t0: [04:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: No st: NotStopd id: INV Line#3InsertDate t0: [00:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 9 n1: 9 v2: 24 n2: 24 st: NotStopd id: INV Line#3InsertDate t0: [04:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 9 n1: 9 v2: 24 n2: 24 st: NotStopd id: INV Line#3SiteAppear t0: [00:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: WNL st: NotStopd id: INV Line#3SiteAppear t0: [04:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: WNL st: NotStopd id: INV#3 WaveformAppear t0: [00:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Sharp st: NotStopd id: INV#3 WaveformAppear t0: [04:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Sharp st: NotStopd id: IV #2 Insert Date t0: [00:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 9 n1: 9 v2: 25 n2: 25 st: NotStopd id: IV #2 Insert Date t0: [04:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 9 n1: 9 v2: 25 n2: 25 st: NotStopd id: IV #2 Site/Size t0: [00:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Right Wrist v2: 20 gauge st: NotStopd id: IV #2 Site/Size t0: [04:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Right Wrist v2: 20 gauge st: NotStopd id: IV #3 Insert Date t0: [00:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 9 n1: 9 v2: 27 n2: 27 st: NotStopd id: IV #3 Insert Date t0: [04:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 9 n1: 9 v2: 27 n2: 27 st: NotStopd id: IV #3 Site/Size t0: [00:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Left Hand v2: 20 gauge st: NotStopd id: IV #3 Site/Size t0: [04:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Left Hand v2: 20 gauge st: NotStopd id: IV Site Appear #2 t0: [00:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: WNL st: NotStopd id: IV Site Appear #2 t0: [04:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: WNL st: NotStopd id: IV Site Appear #3 t0: [00:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: WNL st: NotStopd id: IV Site Appear #3 t0: [04:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: WNL st: NotStopd id: Precautions t0: [05:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Contact st: NotStopd id: INV#3 Dsg Change t0: [00:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 9 n1: 9 v2: 24 n2: 24 st: NotStopd id: INV#3 Dsg Change t0: [04:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 9 n1: 9 v2: 24 n2: 24 st: NotStopd id: ABP Alarm (Lo/Hi) t0: [05:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 85 n1: 85 u1: mmHg v2: 145 n2: 145 u2: mmHg st: NotStopd id: HR Alarm (Lo/Hi) t0: [05:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 60 n1: 60 u1: BPM v2: 125 n2: 125 u2: BPM st: NotStopd id: Resp Alarm (Lo/Hi) t0: [05:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 8 n1: 8 u1: BPM v2: 40 n2: 40 u2: BPM st: NotStopd id: SpO2 Alarm (Lo/Hi) t0: [05:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 90 n1: 90 u1: % v2: 100 n2: 100 u2: % st: NotStopd id: INV#3 Cap Change t0: [00:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 9 n1: 9 v2: 24 n2: 24 st: NotStopd id: INV#3 Cap Change t0: [04:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 9 n1: 9 v2: 24 n2: 24 st: NotStopd id: INV#3 Tubing Change t0: [00:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 9 n1: 9 v2: 24 n2: 24 st: NotStopd id: INV#3 Tubing Change t0: [04:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 9 n1: 9 v2: 24 n2: 24 st: NotStopd
id: D5W 250.0ml + 25000Uhr Heparin t0: [05:00:00 21/11/2018] el: 1 ai: 117 cg: RN cu: CCU vo: 9 vu: ml id: D5W t0: [05:00:00 21/11/2018] el: 1 ai: 168 cg: RN cu: CCU vo: 75 vu: ml id: Urine Out Foley t0: [04:00:00 21/11/2018] el: 1 cg: RN cu: CCU vo: 40 vu: ml
id: Heparin t0: [05:00:00 21/11/2018] el: 1 cg: RN cu: CCU vo: 0 do: 900 du: Uhr so: D5W sv: 250 su: ml rt: IV Drip
id: Pain Level t0: [00:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 3-Mild to Mod st: NotStopd id: Pain Level t0: [03:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 3-Mild to Mod st: NotStopd id: Pain Present t0: [00:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Yes st: NotStopd id: Pain Present t0: [03:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Yes st: NotStopd id: Pain Present t0: [20:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: No st: NotStopd id: Pain Assess Method t0: [00:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Pt Verbalized st: NotStopd id: Pain Assess Method t0: [03:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Pt Verbalized st: NotStopd id: Pain Assess Method t0: [20:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Pt Verbalized st: NotStopd id: GI Prophylaxis t0: [00:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Proton/Pump/Inhi st: NotStopd id: GI Prophylaxis t0: [04:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Proton/Pump/Inhi st: NotStopd id: Diet Type t0: [00:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Soft Solid st: NotStopd id: Diet Type t0: [04:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Soft Solid st: NotStopd id: Eye Opening t0: [00:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 4 Spontaneously st: NotStopd id: Eye Opening t0: [04:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 4 Spontaneously st: NotStopd id: FiO2 Set t0: [00:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 0.4 n1: 0.4 u1: torr st: NotStopd id: FiO2 Set t0: [04:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 0.4 n1: 0.4 u1: torr st: NotStopd id: GCS Total t0: [00:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 15 n1: 15 u1: points st: NotStopd id: GCS Total t0: [04:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 15 n1: 15 u1: points st: NotStopd id: Abdominal Assessment t0: [00:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Obese st: NotStopd id: Abdominal Assessment t0: [04:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Obese st: NotStopd id: LLL Lung Sounds t0: [00:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Diminished st: NotStopd id: LLL Lung Sounds t0: [04:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Diminished st: NotStopd id: LUL Lung Sounds t0: [00:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Clear st: NotStopd id: LUL Lung Sounds t0: [04:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Clear st: NotStopd id: Level of Conscious t0: [00:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Sleeping st: NotStopd id: Level of Conscious t0: [04:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Sleeping st: NotStopd id: Angio Appearance #1 t0: [00:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Clean and Dry v2: Clean and Dry st: NotStopd id: Angio Appearance #2 t0: [00:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Ecchymotic v2: Clean and Dry st: NotStopd id: Motor Response t0: [00:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 6 Obeys Commands st: NotStopd id: Motor Response t0: [04:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 6 Obeys Commands st: NotStopd id: Angio Dressing #1 t0: [00:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Transparent st: NotStopd id: Angio Dressing #1 t0: [04:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Transparent st: NotStopd id: O2 Delivery Device t0: [00:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Aerosol-Cool st: NotStopd id: O2 Delivery Device t0: [04:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Aerosol-Cool st: NotStopd id: Angio Dressing #2 t0: [00:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Dry Sterile Dsg st: NotStopd id: Angio Dressing #2 t0: [04:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Dry Sterile Dsg st: NotStopd id: Oral Cavity t0: [00:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Teeth/Tissue WNL st: NotStopd id: Oral Cavity t0: [04:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Teeth/Tissue WNL st: NotStopd id: Orientation t0: [00:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Oriented x 3 st: NotStopd id: Orientation t0: [04:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Oriented x 3 st: NotStopd id: Angio Site #1 t0: [00:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: R Femoral st: NotStopd id: Angio Site #1 t0: [04:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: R Femoral st: NotStopd id: Angio Site #2 t0: [00:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: L Femoral st: NotStopd id: Angio Site #2 t0: [04:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: L Femoral st: NotStopd id: Pain Cause t0: [00:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: At Rest st: NotStopd id: Pain Cause t0: [03:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: At Rest st: NotStopd id: Pain Level (Rest) t0: [00:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 3-Mild to Mod st: NotStopd id: Pain Level (Rest) t0: [03:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 3-Mild to Mod st: NotStopd id: Pain Location t0: [00:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Both Legs st: NotStopd id: Pain Location t0: [03:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Both Legs st: NotStopd id: Pain Location t0: [20:00:00 20/11/2018] el: 0 cg: RN cu: CCU v1: Not Indicated st: NotStopd id: Pain Management t0: [00:00:00 21/11/2018] el: 1 cg: RN cu: CCU v1: IV Push st: NotStopd id: Pain Management t0: [03:00:00 21/11/2018] el: 1 cg: RN cu: CCU v1: IV Gtt v2: PO Med st: NotStopd id: Pain Type t0: [00:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Aching st: NotStopd id: Pain Type t0: [03:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Aching st: NotStopd id: RLL Lung Sounds t0: [00:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Diminished st: NotStopd id: RLL Lung Sounds t0: [04:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Diminished st: NotStopd id: RUL Lung Sounds t0: [00:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Clear st: NotStopd id: RUL Lung Sounds t0: [04:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Clear st: NotStopd id: Respiratory Pattern t0: [00:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Regular st: NotStopd id: Respiratory Pattern t0: [04:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Regular st: NotStopd id: Urine Color/Appear t0: [00:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Yellow v2: Clear st: NotStopd id: Urine Color/Appear t0: [04:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Yellow v2: Clear st: NotStopd id: Urine Source t0: [00:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Indwelling Cath st: NotStopd id: Urine Source t0: [04:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Indwelling Cath st: NotStopd id: Verbal Response t0: [00:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 5 Oriented st: NotStopd id: Verbal Response t0: [04:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 5 Oriented st: NotStopd id: Bowel Sounds t0: [00:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Present st: NotStopd id: Bowel Sounds t0: [04:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Present st: NotStopd
id: Education Topic #1 t0: [00:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Plan of Care st: NotStopd id: Education Topic #1 t0: [04:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Plan of Care st: NotStopd id: HOB t0: [00:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 30 degrees st: NotStopd id: HOB t0: [04:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 30 degrees st: NotStopd id: Activity t0: [00:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Bedrest st: NotStopd id: Activity t0: [04:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Bedrest st: NotStopd id: Activity Tolerance t0: [00:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Good st: NotStopd id: Activity Tolerance t0: [04:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Good st: NotStopd id: ImpSkin Treatment #1 t0: [00:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Dry Sterile Dsg st: NotStopd id: ImpSkin Treatment #1 t0: [04:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Dry Sterile Dsg st: NotStopd id: Impaired Skin Site#1 t0: [00:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Abdomen st: NotStopd id: Impaired Skin Site#1 t0: [04:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Abdomen st: NotStopd id: PT Splint Loc/Stat#1 t0: [00:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Left Leg v2: On st: NotStopd id: PT Splint Loc/Stat#1 t0: [04:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Left Leg v2: On st: NotStopd id: Assistance Device t0: [00:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 2 Person Assist st: NotStopd id: Assistance Device t0: [04:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 2 Person Assist st: NotStopd id: Side Rails t0: [00:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: All rails up st: NotStopd id: Side Rails t0: [04:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: All rails up st: NotStopd id: Skin Care t0: [04:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Done st: NotStopd id: Skin Integrity t0: [00:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Intact st: NotStopd id: Skin Integrity t0: [04:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Intact st: NotStopd id: Support Systems t0: [00:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Children st: NotStopd id: Support Systems t0: [04:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Children st: NotStopd id: Therapeutic Bed t0: [00:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: AtmosAir Mattres st: NotStopd id: Therapeutic Bed t0: [04:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: AtmosAir Mattres st: NotStopd id: Turn t0: [00:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Right Side st: NotStopd id: Turn t0: [04:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Left Side st: NotStopd id: Back Care t0: [00:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Done st: NotStopd id: Back Care t0: [04:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Done st: NotStopd id: Behavior t0: [00:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Appropriate st: NotStopd id: Behavior t0: [04:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Appropriate st: NotStopd id: Braden Activity t0: [00:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Bedfast st: NotStopd id: Braden Activity t0: [04:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Bedfast st: NotStopd id: Braden Frict/Shear t0: [00:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Potential Prob st: NotStopd id: Braden Frict/Shear t0: [04:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Potential Prob st: NotStopd id: Braden Mobility t0: [00:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Comp. Immobile st: NotStopd id: Braden Mobility t0: [04:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Comp. Immobile st: NotStopd id: Braden Moisture t0: [00:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Rarely Moist st: NotStopd id: Braden Moisture t0: [04:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Rarely Moist st: NotStopd id: Braden Nutrition t0: [00:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Very Poor st: NotStopd id: Braden Nutrition t0: [04:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Very Poor st: NotStopd id: Braden Score t0: [00:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 10 n1: 10 u1: number st: NotStopd id: Braden Score t0: [04:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 10 n1: 10 u1: number st: NotStopd id: Braden SensoryPercep t0: [00:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Comp. Limited st: NotStopd id: Braden SensoryPercep t0: [04:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Comp. Limited st: NotStopd
id: PT t0: [04:12:00 21/11/2018] el: 0 cg: 1663 cu: CCU v1: 21.9 n1: 21.9 rs: Final st: NotStopd id: INR t0: [04:12:00 21/11/2018] el: 0 cg: 1663 cu: CCU v1: 2.1 n1: 2.1 rs: Final st: NotStopd id: PTT t0: [04:12:00 21/11/2018] el: 0 cg: 1663 cu: CCU v1: 83 n1: 83 rs: Final st: NotStopd id: INR (2-4 ref. range) t0: [04:12:00 21/11/2018] el: 0 cg: 1663 cu: CCU v1: 2.1 n1: 2.1 rs: Final st: NotStopd id: PT(11-13.5) t0: [04:12:00 21/11/2018] el: 0 cg: 1663 cu: CCU v1: 21.9 n1: 21.9 rs: Final st: NotStopd id: PTT(22-35) t0: [04:12:00 21/11/2018] el: 0 cg: 1663 cu: CCU v1: 83 n1: 83 rs: Final st: NotStopd
id: Ectopy Frequency t0: [05:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: None st: NotStopd id: Ectopy Type t0: [05:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: None st: NotStopd id: Heart Rate t0: [05:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 74 n1: 74 u1: BPM st: NotStopd id: Heart Rhythm t0: [05:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Atrial Fib st: NotStopd id: Arterial BP t0: [05:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 98 n1: 98 u1: mmHg v2: 41 n2: 41 u2: mmHg st: NotStopd id: Arterial BP Mean t0: [05:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 60 n1: 60 u1: mmHg st: NotStopd id: Respiratory Rate t0: [05:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 11 n1: 11 u1: BPM st: NotStopd id: SpO2 t0: [05:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 97 n1: 97 u1: % st: NotStopd id: calprevflg t0: [05:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 1 n1: 1 u1: kg st: NotStopd
id: BUN t0: [04:12:00 21/11/2018] el: 0 cg: 1663 cu: CCU v1: 10 n1: 10 rs: Final st: NotStopd id: Calcium t0: [04:12:00 21/11/2018] el: 0 cg: 1663 cu: CCU v1: 8 n1: 8 u1: mg/dl rs: Final st: NotStopd id: Chloride t0: [04:12:00 21/11/2018] el: 0 cg: 1663 cu: CCU v1: 106 n1: 106 rs: Final st: NotStopd id: Creatinine t0: [04:12:00 21/11/2018] el: 0 cg: 1663 cu: CCU v1: 0.7 n1: 0.7 rs: Final st: NotStopd id: Glucose t0: [04:12:00 21/11/2018] el: 0 cg: 1663 cu: CCU v1: 154 n1: 154 rs: Final st: NotStopd id: Magnesium t0: [04:12:00 21/11/2018] el: 0 cg: 1663 cu: CCU v1: 2.5 n1: 2.5 rs: Final st: NotStopd id: Phosphorous t0: [04:12:00 21/11/2018] el: 0 cg: 1663 cu: CCU v1: 2.2 n1: 2.2 u1: mEq/L rs: Final st: NotStopd id: Potassium t0: [04:12:00 21/11/2018] el: 0 cg: 1663 cu: CCU v1: 3.4 n1: 3.4 rs: Final st: NotStopd id: Sodium t0: [04:12:00 21/11/2018] el: 0 cg: 1663 cu: CCU v1: 145 n1: 145 rs: Final st: NotStopd id: BUN (6-20) t0: [04:12:00 21/11/2018] el: 0 cg: 1663 cu: CCU v1: 10 n1: 10 rs: Final st: NotStopd id: Calcium (8.4-10.2) t0: [04:12:00 21/11/2018] el: 0 cg: 1663 cu: CCU v1: 8 n1: 8 u1: mg/dl rs: Final st: NotStopd id: Carbon Dioxide t0: [04:12:00 21/11/2018] el: 0 cg: 1663 cu: CCU v1: 33 n1: 33 rs: Final st: NotStopd id: Chloride (100-112) t0: [04:12:00 21/11/2018] el: 0 cg: 1663 cu: CCU v1: 106 n1: 106 rs: Final st: NotStopd id: Creatinine (0-1.3) t0: [04:12:00 21/11/2018] el: 0 cg: 1663 cu: CCU v1: 0.7 n1: 0.7 rs: Final st: NotStopd id: Glucose (70-105) t0: [04:12:00 21/11/2018] el: 0 cg: 1663 cu: CCU v1: 154 n1: 154 rs: Final st: NotStopd id: Magnesium (1.6-2.6) t0: [04:12:00 21/11/2018] el: 0 cg: 1663 cu: CCU v1: 2.5 n1: 2.5 rs: Final st: NotStopd id: Phosphorous(2.7-4.5) t0: [04:12:00 21/11/2018] el: 0 cg: 1663 cu: CCU v1: 2.2 n1: 2.2 u1: mEq/L rs: Final st: NotStopd id: Potassium (3.5-5.3) t0: [04:12:00 21/11/2018] el: 0 cg: 1663 cu: CCU v1: 3.4 n1: 3.4 rs: Final st: NotStopd id: Sodium (135-148) t0: [04:12:00 21/11/2018] el: 0 cg: 1663 cu: CCU v1: 145 n1: 145 rs: Final st: NotStopd
id: Service Type t0: [06:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: CCU st: NotStopd id: Code Status t0: [06:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Full Code st: NotStopd id: Risk for Falls t0: [06:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Yes st: NotStopd id: Ectopy Frequency t0: [06:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: None st: NotStopd id: Ectopy Type t0: [06:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: None st: NotStopd id: Heart Rate t0: [06:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 72 n1: 72 u1: BPM st: NotStopd id: Heart Rhythm t0: [06:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Atrial Fib st: NotStopd id: Arterial BP t0: [06:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 93 n1: 93 u1: mmHg v2: 38 n2: 38 u2: mmHg st: NotStopd id: Arterial BP Mean t0: [06:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 56 n1: 56 u1: mmHg st: NotStopd id: Precautions t0: [06:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Contact st: NotStopd id: ABP Alarm (Lo/Hi) t0: [06:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 85 n1: 85 u1: mmHg v2: 145 n2: 145 u2: mmHg st: NotStopd id: HR Alarm (Lo/Hi) t0: [06:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 60 n1: 60 u1: BPM v2: 125 n2: 125 u2: BPM st: NotStopd id: Resp Alarm (Lo/Hi) t0: [06:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 8 n1: 8 u1: BPM v2: 40 n2: 40 u2: BPM st: NotStopd id: SpO2 Alarm (Lo/Hi) t0: [06:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 90 n1: 90 u1: % v2: 100 n2: 100 u2: % st: NotStopd id: Respiratory Rate t0: [06:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 13 n1: 13 u1: BPM st: NotStopd id: SpO2 t0: [06:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 96 n1: 96 u1: % st: NotStopd id: calprevflg t0: [06:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 1 n1: 1 u1: kg st: NotStopd
id: Heparin t0: [06:00:00 21/11/2018] el: 1 cg: RN cu: CCU vo: 0 do: 700 du: Uhr so: D5W sv: 250 su: ml rt: IV Drip
id: Po Intake t0: [00:00:00 21/11/2018] el: 1 ai: 103 cg: RN cu: CCU vo: 30 vu: ml id: Po Intake t0: [03:00:00 21/11/2018] el: 1 ai: 103 cg: RN cu: CCU vo: 30 vu: ml id: Po Intake t0: [06:00:00 21/11/2018] el: 1 ai: 103 cg: RN cu: CCU vo: 30 vu: ml id: Po Intake t0: [22:00:00 20/11/2018] el: 1 ai: 103 cg: RN cu: CCU vo: 30 vu: ml id: D5W 250.0ml + 25000Uhr Heparin t0: [06:00:00 21/11/2018] el: 1 ai: 117 cg: RN cu: CCU vo: 9 vu: ml id: Promote w/fiber t0: [06:00:00 21/11/2018] el: 1 ai: 1109 cg: -1 cu: CCU vo: 0 st: D/C'd id: Urine Out Foley t0: [06:00:00 21/11/2018] el: 1 cg: RN cu: CCU vo: 45 vu: ml
id: Riker-SAS Scale t0: [04:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Calm/Cooperative st: NotStopd id: Eye Care t0: [06:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Done st: NotStopd id: Oral Care t0: [06:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Done st: NotStopd
id: Service Type t0: [07:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: CCU st: NotStopd id: Code Status t0: [07:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Full Code st: NotStopd id: Risk for Falls t0: [07:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Yes st: NotStopd id: Ectopy Frequency t0: [07:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: None st: NotStopd id: Ectopy Type t0: [07:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: None st: NotStopd id: Heart Rate t0: [07:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 74 n1: 74 u1: BPM st: NotStopd id: Heart Rhythm t0: [07:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Atrial Fib st: NotStopd id: Arterial BP t0: [07:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 108 n1: 108 u1: mmHg v2: 52 n2: 52 u2: mmHg st: NotStopd id: Arterial BP Mean t0: [07:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 70 n1: 70 u1: mmHg st: NotStopd id: Precautions t0: [07:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Contact st: NotStopd id: ABP Alarm (Lo/Hi) t0: [07:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 85 n1: 85 u1: mmHg v2: 145 n2: 145 u2: mmHg st: NotStopd id: HR Alarm (Lo/Hi) t0: [07:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 60 n1: 60 u1: BPM v2: 125 n2: 125 u2: BPM st: NotStopd id: Resp Alarm (Lo/Hi) t0: [07:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 8 n1: 8 u1: BPM v2: 40 n2: 40 u2: BPM st: NotStopd id: SpO2 Alarm (Lo/Hi) t0: [07:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 90 n1: 90 u1: % v2: 100 n2: 100 u2: % st: NotStopd id: Respiratory Rate t0: [07:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 20 n1: 20 u1: BPM st: NotStopd id: SpO2 t0: [07:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 96 n1: 96 u1: % st: NotStopd id: calprevflg t0: [07:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 1 n1: 1 u1: kg st: NotStopd
id: D5W 250.0ml + 25000Uhr Heparin t0: [07:00:00 21/11/2018] el: 1 ai: 117 cg: RN cu: CCU vo: 7 vu: ml id: D5W t0: [06:00:00 21/11/2018] el: 1 ai: 168 cg: RN cu: CCU vo: 75 vu: ml id: D5W t0: [07:00:00 21/11/2018] el: 1 ai: 168 cg: RN cu: CCU vo: 75 vu: ml
id: Heparin t0: [07:00:00 21/11/2018] el: 1 cg: RN cu: CCU vo: 0 do: 700 du: Uhr so: D5W sv: 250 su: ml rt: IV Drip
pi: 4077021 hi: 10161 t0: [09:00:00 21/11/2018] tf: [08:00:00 22/11/2018] mn: Morphine Sulfate pt: Unit Dose st: Expired rt: IV fr: ONCE ds: 9 dn: 1 dt: 1 di: Doses xv: 36 xu: Hours
pi: 4077093 hi: 10161 t0: [10:00:00 21/11/2018] tf: [09:00:00 22/11/2018] mn: Morphine Sulfate pt: Unit Dose st: Expired rt: IV fr: ONCE ds: 10 dn: 1 dt: 1 di: Doses xv: 36 xu: Hours pi: 4077094 hi: 10161 t0: [10:00:00 21/11/2018] tf: [00:00:00 22/11/2018] mn: Morphine Sulfate pt: Unit Dose st: Discontinued rt: IV fr: Q6H:PRN di: Ongoing xv: 36 xu: Hours
id: GI Guaiac/ph t0: [10:00:00 21/11/2018] el: 0 cg: -1 cu: CCU st: D/C'd id: PT Splint Loc/Stat#1 t0: [10:00:00 21/11/2018] el: 0 cg: -1 cu: CCU st: D/C'd id: In-Line Sx Change t0: [10:00:00 21/11/2018] el: 0 cg: -1 cu: CCU st: D/C'd
pi: 4077268 hi: 10161 t0: [20:00:00 21/11/2018] tf: [11:00:00 25/11/2018] mn: Metoprolol pt: Unit Dose st: Discontinued rt: PO fr: BID ds: 08, 20 dn: 2 di: Ongoing xv: 36 xu: Hours pi: 4077269 hi: 10161 t0: [11:00:00 21/11/2018] tf: [05:00:00 23/11/2018] mn: Morphine Sulfate IR pt: Unit Dose st: Inactive (Due to a change order) rt: PO fr: Q6H:PRN di: Ongoing xv: 36 xu: Hours pi: 4077328 hi: 10161 t0: [11:00:00 21/11/2018] tf: [22:00:00 26/11/2018] mn: Acetaminophen pt: Unit Dose st: Discontinued via patient discharge rt: PO fr: Q6H ds: 11, 17, 23, 5 dn: 4 di: Ongoing xv: 36 xu: Hours pi: 4077329 hi: 10161 t0: [11:00:00 21/11/2018] tf: [22:00:00 26/11/2018] mn: Acetaminophen pt: Unit Dose st: Discontinued via patient discharge rt: PO fr: Q6H ds: 11, 17, 23, 5 dn: 4 di: Ongoing xv: 36 xu: Hours pi: 4077330 hi: 10161 t0: [11:00:00 21/11/2018] tf: [22:00:00 26/11/2018] mn: Acetaminophen pt: Unit Dose st: Discontinued via patient discharge rt: PR fr: Q6H ds: 11, 17, 23, 5 dn: 4 di: Ongoing xv: 36 xu: Hours
id: Pain Level t0: [08:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 8-Severe st: NotStopd id: Pain Level/Response t0: [08:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 3-Mild to Mod st: NotStopd id: Pain Present t0: [08:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Yes st: NotStopd id: Pain Assess Method t0: [08:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Pt Verbalized st: NotStopd id: PainLevel Acceptable t0: [08:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Yes st: NotStopd id: Service Type t0: [08:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: CCU st: NotStopd id: Service Type t0: [09:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: CCU st: NotStopd id: Service Type t0: [10:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: CCU st: NotStopd id: Code Status t0: [08:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Full Code st: NotStopd id: Code Status t0: [09:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Full Code st: NotStopd id: Code Status t0: [10:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Full Code st: NotStopd id: Riker-SAS Scale t0: [08:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Calm/Cooperative st: NotStopd id: Daily Wake Up t0: [08:00:00 21/11/2018] el: 1 cg: RN cu: CCU v1: No/Not Sedated st: NotStopd id: GI Prophylaxis t0: [08:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Proton/Pump/Inhi st: NotStopd id: Risk for Falls t0: [08:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Yes st: NotStopd id: Risk for Falls t0: [09:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Yes st: NotStopd id: Risk for Falls t0: [10:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Yes st: NotStopd id: Diet Type t0: [08:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Soft Solid st: NotStopd id: ETT Mark/Location t0: [08:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 22cm v2: Lip st: NotStopd id: Ectopy Frequency t0: [08:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: None st: NotStopd id: Ectopy Frequency t0: [09:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: None st: NotStopd id: Ectopy Frequency t0: [10:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: None st: NotStopd id: Ectopy Type t0: [08:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: None st: NotStopd id: Ectopy Type t0: [09:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: None st: NotStopd id: Ectopy Type t0: [10:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: None st: NotStopd id: Alarms t0: [08:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: ON st: NotStopd id: Parameters Checked t0: [08:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Yes st: NotStopd id: Education Barrier t0: [08:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Anxiety st: NotStopd id: Education Handout t0: [08:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Not Given st: NotStopd id: Education Learner t0: [08:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Patient st: NotStopd id: Education Method t0: [08:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Explanation st: NotStopd id: Education Readiness t0: [08:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Yes st: NotStopd id: Education Response t0: [08:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Understands st: NotStopd id: Education Topic #1 t0: [08:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Plan of Care st: NotStopd id: Education Topic #2 t0: [08:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Medications st: NotStopd id: Extubation Date t0: [08:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 6 n1: 6 v2: 26 n2: 26 st: NotStopd id: Eye Care t0: [08:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Done st: NotStopd id: Eye Opening t0: [08:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 4 Spontaneously st: NotStopd id: GCS Total t0: [08:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 15 n1: 15 u1: points st: NotStopd id: HOB t0: [08:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 45 degrees st: NotStopd id: Heart Rate t0: [08:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 75 n1: 75 u1: BPM st: NotStopd id: Heart Rate t0: [09:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 86 n1: 86 u1: BPM st: NotStopd id: Heart Rate t0: [10:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 97 n1: 97 u1: BPM st: NotStopd id: Heart Rhythm t0: [08:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Atrial Fib st: NotStopd id: Heart Rhythm t0: [09:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Atrial Fib st: NotStopd id: Heart Rhythm t0: [10:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Atrial Fib st: NotStopd id: INV Line#3 Type/Site t0: [08:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: A-Line v2: Left Radial st: NotStopd id: INV Line#3InsertDate t0: [08:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 9 n1: 9 v2: 24 n2: 24 st: NotStopd id: INV Line#3SiteAppear t0: [08:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: WNL st: NotStopd id: Abdominal Assessment t0: [08:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Obese st: NotStopd id: INV#3 WaveformAppear t0: [08:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Sharp st: NotStopd id: IV #2 Insert Date t0: [08:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 9 n1: 9 v2: 25 n2: 25 st: NotStopd id: IV #2 Site/Size t0: [08:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Right Wrist v2: 20 gauge st: NotStopd id: IV #3 Insert Date t0: [08:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 9 n1: 9 v2: 27 n2: 27 st: NotStopd id: IV #3 Site/Size t0: [08:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Left Hand v2: 20 gauge st: NotStopd id: Activity t0: [08:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Bedrest st: NotStopd id: IV Site Appear #2 t0: [08:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: WNL st: NotStopd id: IV Site Appear #3 t0: [08:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: WNL st: NotStopd id: Activity Tolerance t0: [08:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Good st: NotStopd id: ImpSkin Character #1 t0: [08:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Abrasion st: NotStopd id: ImpSkin Drain/Amt#1 t0: [08:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Serous v2: Small st: NotStopd id: ImpSkin Treatment #1 t0: [08:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Dry Sterile Dsg st: NotStopd id: ImpSkin Wound Base#1 t0: [08:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Pink st: NotStopd id: Impaired Skin Site#1 t0: [08:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Abdomen st: NotStopd id: Airway Size t0: [08:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 7.0 mm st: NotStopd id: Airway Type t0: [08:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Endotracheal st: NotStopd id: Intubation Date t0: [08:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 6 n1: 6 v2: 22 n2: 22 st: NotStopd id: LLE Temp/Color t0: [08:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Warm v2: Pink st: NotStopd id: LLL Lung Sounds t0: [08:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Diminished st: NotStopd id: LUL Lung Sounds t0: [08:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Clear st: NotStopd id: Level of Conscious t0: [08:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Alert st: NotStopd id: Angio Appearance #1 t0: [08:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Clean and Dry v2: Clean and Dry st: NotStopd id: Angio Appearance #2 t0: [08:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Clean and Dry v2: Clean and Dry st: NotStopd id: Motor Response t0: [08:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 6 Obeys Commands st: NotStopd id: Angio Dressing #1 t0: [08:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Dry Sterile Dsg st: NotStopd id: O2 Delivery Device t0: [08:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Aerosol-Cool st: NotStopd id: O2 Delivery Device t0: [10:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Nasal Cannula st: NotStopd id: Angio Dressing #2 t0: [08:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Dry Sterile Dsg st: NotStopd id: O2 Flow (lpm) t0: [10:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 2 n1: 2 u1: lpm st: NotStopd id: Oral Care t0: [08:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Done st: NotStopd id: Oral Cavity t0: [08:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Teeth/Tissue WNL st: NotStopd id: Orientation t0: [08:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Oriented x 3 st: NotStopd id: Angio Site #1 t0: [08:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: R Femoral st: NotStopd id: Angio Site #2 t0: [08:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: L Femoral st: NotStopd id: PT Splint Loc/Stat#1 t0: [08:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Left Leg v2: On st: NotStopd id: Arterial BP t0: [08:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 131 n1: 131 u1: mmHg v2: 53 n2: 53 u2: mmHg st: NotStopd id: Arterial BP t0: [09:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 137 n1: 137 u1: mmHg v2: 59 n2: 59 u2: mmHg st: NotStopd id: Arterial BP t0: [10:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 124 n1: 124 u1: mmHg v2: 59 n2: 59 u2: mmHg st: NotStopd id: Pain Cause t0: [08:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: At Rest st: NotStopd id: Pain Level (Rest) t0: [08:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 8-Severe st: NotStopd id: Pain Location t0: [08:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Left Leg st: NotStopd id: Pain Management t0: [08:00:00 21/11/2018] el: 1 cg: RN cu: CCU v1: PO Med v2: IV Push st: NotStopd id: Pain Type t0: [08:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Aching st: NotStopd id: Arterial BP Mean t0: [08:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 80 n1: 80 u1: mmHg st: NotStopd id: Arterial BP Mean t0: [09:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 85 n1: 85 u1: mmHg st: NotStopd id: Arterial BP Mean t0: [10:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 82 n1: 82 u1: mmHg st: NotStopd id: Precautions t0: [08:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Contact st: NotStopd id: Precautions t0: [09:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Contact st: NotStopd id: Precautions t0: [10:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Contact st: NotStopd id: INV#3 Dsg Change t0: [08:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 9 n1: 9 v2: 24 n2: 24 st: NotStopd id: ABP Alarm (Lo/Hi) t0: [08:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 85 n1: 85 u1: mmHg v2: 145 n2: 145 u2: mmHg st: NotStopd id: ABP Alarm (Lo/Hi) t0: [09:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 85 n1: 85 u1: mmHg v2: 145 n2: 145 u2: mmHg st: NotStopd id: ABP Alarm (Lo/Hi) t0: [10:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 85 n1: 85 u1: mmHg v2: 145 n2: 145 u2: mmHg st: NotStopd id: HR Alarm (Lo/Hi) t0: [08:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 60 n1: 60 u1: BPM v2: 125 n2: 125 u2: BPM st: NotStopd id: HR Alarm (Lo/Hi) t0: [09:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 60 n1: 60 u1: BPM v2: 125 n2: 125 u2: BPM st: NotStopd id: HR Alarm (Lo/Hi) t0: [10:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 60 n1: 60 u1: BPM v2: 125 n2: 125 u2: BPM st: NotStopd id: Resp Alarm (Lo/Hi) t0: [08:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 8 n1: 8 u1: BPM v2: 40 n2: 40 u2: BPM st: NotStopd id: Resp Alarm (Lo/Hi) t0: [09:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 8 n1: 8 u1: BPM v2: 40 n2: 40 u2: BPM st: NotStopd id: Resp Alarm (Lo/Hi) t0: [10:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 8 n1: 8 u1: BPM v2: 40 n2: 40 u2: BPM st: NotStopd id: SpO2 Alarm (Lo/Hi) t0: [08:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 90 n1: 90 u1: % v2: 100 n2: 100 u2: % st: NotStopd id: SpO2 Alarm (Lo/Hi) t0: [09:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 90 n1: 90 u1: % v2: 100 n2: 100 u2: % st: NotStopd id: SpO2 Alarm (Lo/Hi) t0: [10:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 90 n1: 90 u1: % v2: 100 n2: 100 u2: % st: NotStopd id: RLL Lung Sounds t0: [08:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Diminished st: NotStopd id: RUL Lung Sounds t0: [08:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Clear st: NotStopd id: Respiratory Pattern t0: [08:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Regular st: NotStopd id: Respiratory Rate t0: [08:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 23 n1: 23 u1: BPM st: NotStopd id: Respiratory Rate t0: [10:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 26 n1: 26 u1: BPM st: NotStopd id: Side Rails t0: [08:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: All rails up st: NotStopd id: Skin Care t0: [08:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Done st: NotStopd id: Skin Integrity t0: [08:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Impaired st: NotStopd id: SpO2 t0: [08:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 99 n1: 99 u1: % st: NotStopd id: SpO2 t0: [09:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 96 n1: 96 u1: % st: NotStopd id: SpO2 t0: [10:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 95 n1: 95 u1: % st: NotStopd id: Stool Color/Consist t0: [08:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Brown v2: Liquid st: NotStopd id: Stool Guaiac t0: [08:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Positive st: NotStopd id: Support Systems t0: [08:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Children st: NotStopd id: INV#3 Cap Change t0: [08:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 9 n1: 9 v2: 24 n2: 24 st: NotStopd id: INV#3 Tubing Change t0: [08:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 9 n1: 9 v2: 24 n2: 24 st: NotStopd id: Temp. Site t0: [08:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Oral st: NotStopd id: Temperature C (calc) t0: [08:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 36.5556 n1: 36.5556 u1: Deg. C st: NotStopd id: Temperature F t0: [08:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 97.8 n1: 97.8 u1: Deg. F st: NotStopd id: Therapeutic Bed t0: [08:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: AtmosAir Mattres st: NotStopd id: Turn t0: [08:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Back st: NotStopd id: Urine Color/Appear t0: [08:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Yellow v2: Clear st: NotStopd id: Urine Source t0: [08:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Indwelling Cath st: NotStopd id: Verbal Response t0: [08:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 5 Oriented st: NotStopd id: Back Care t0: [08:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Done st: NotStopd id: calprevflg t0: [08:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 1 n1: 1 u1: kg st: NotStopd id: calprevflg t0: [09:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 1 n1: 1 u1: kg st: NotStopd id: calprevflg t0: [10:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 1 n1: 1 u1: kg st: NotStopd id: Bowel Sounds t0: [08:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Present st: NotStopd id: Braden Activity t0: [08:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Bedfast st: NotStopd id: Braden Frict/Shear t0: [08:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Potential Prob st: NotStopd id: Braden Mobility t0: [08:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Very Limited st: NotStopd id: Braden Moisture t0: [08:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Occ. Moist st: NotStopd id: Braden Nutrition t0: [08:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Adequate st: NotStopd id: Braden Score t0: [08:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 13 n1: 13 u1: number st: NotStopd id: Braden SensoryPercep t0: [08:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Very Limited st: NotStopd
id: D5W 100.0ml t0: [08:00:00 21/11/2018] el: 1 ai: 105 cg: RN cu: CCU vo: 200 vu: ml id: D5W 250.0ml + 25000Uhr Heparin t0: [10:00:00 21/11/2018] el: 1 ai: 117 cg: RN cu: CCU vo: 21 vu: ml id: Gastric Meds t0: [08:00:00 21/11/2018] el: 1 ai: 155 cg: RN cu: CCU vo: 200 vu: ml id: D5W t0: [10:00:00 21/11/2018] el: 1 ai: 168 cg: RN cu: CCU vo: 30 vu: ml id: Urine Out Foley t0: [08:00:00 21/11/2018] el: 1 cg: RN cu: CCU vo: 30 vu: ml id: Urine Out Foley t0: [10:00:00 21/11/2018] el: 1 cg: RN cu: CCU vo: 35 vu: ml
id: Heparin t0: [08:00:00 21/11/2018] el: 1 cg: RN cu: CCU vo: 0 do: 700 du: Uhr so: D5W sv: 250 su: ml rt: IV Drip id: Heparin t0: [09:00:00 21/11/2018] el: 1 cg: RN cu: CCU vo: 0 do: 700 du: Uhr so: D5W sv: 250 su: ml rt: IV Drip id: Heparin t0: [10:00:00 21/11/2018] el: 1 cg: RN cu: CCU vo: 0 do: 700 du: Uhr so: D5W sv: 250 su: ml rt: IV Drip
id: Service Type t0: [11:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: CCU st: NotStopd id: Code Status t0: [11:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Full Code st: NotStopd id: Risk for Falls t0: [11:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Yes st: NotStopd id: Ectopy Frequency t0: [11:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: None st: NotStopd id: Ectopy Type t0: [11:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: None st: NotStopd id: Heart Rate t0: [11:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 75 n1: 75 u1: BPM st: NotStopd id: Heart Rhythm t0: [11:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Atrial Fib st: NotStopd id: Arterial BP t0: [11:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 124 n1: 124 u1: mmHg v2: 57 n2: 57 u2: mmHg st: NotStopd id: Arterial BP Mean t0: [11:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 80 n1: 80 u1: mmHg st: NotStopd id: Precautions t0: [11:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Contact st: NotStopd id: ABP Alarm (Lo/Hi) t0: [11:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 85 n1: 85 u1: mmHg v2: 145 n2: 145 u2: mmHg st: NotStopd id: HR Alarm (Lo/Hi) t0: [11:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 60 n1: 60 u1: BPM v2: 125 n2: 125 u2: BPM st: NotStopd id: Resp Alarm (Lo/Hi) t0: [11:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 8 n1: 8 u1: BPM v2: 40 n2: 40 u2: BPM st: NotStopd id: SpO2 Alarm (Lo/Hi) t0: [11:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 90 n1: 90 u1: % v2: 100 n2: 100 u2: % st: NotStopd id: Respiratory Rate t0: [11:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 25 n1: 25 u1: BPM st: NotStopd id: SpO2 t0: [11:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 95 n1: 95 u1: % st: NotStopd id: calprevflg t0: [11:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 1 n1: 1 u1: kg st: NotStopd
id: D5W 250.0ml + 25000Uhr Heparin t0: [11:00:00 21/11/2018] el: 1 ai: 117 cg: RN cu: CCU vo: 7 vu: ml id: D5W t0: [11:00:00 21/11/2018] el: 1 ai: 168 cg: RN cu: CCU vo: 10 vu: ml id: Urine Out Foley t0: [11:00:00 21/11/2018] el: 1 cg: RN cu: CCU vo: 30 vu: ml
id: Heparin t0: [11:00:00 21/11/2018] el: 1 cg: RN cu: CCU vo: 0 do: 700 du: Uhr so: D5W sv: 250 su: ml rt: IV Drip
id: Fingerstick Glucose t0: [12:00:00 21/11/2018] el: 0 cg: CoWker cu: CCU v1: 231 n1: 231 rs: Manual st: NotStopd
id: Compliance (40-60ml) t0: [12:00:00 21/11/2018] el: 0 cg: -1 cu: CCU st: D/C'd id: Cuff Pressure-Airway t0: [12:00:00 21/11/2018] el: 0 cg: -1 cu: CCU st: D/C'd id: ETT Position Change t0: [12:00:00 21/11/2018] el: 0 cg: -1 cu: CCU st: D/C'd id: FiO2 Set t0: [12:00:00 21/11/2018] el: 0 cg: -1 cu: CCU st: D/C'd id: High Insp. Pressure t0: [12:00:00 21/11/2018] el: 0 cg: -1 cu: CCU st: D/C'd id: I:E Ratio t0: [12:00:00 21/11/2018] el: 0 cg: -1 cu: CCU st: D/C'd id: Inspired Gas Temp t0: [12:00:00 21/11/2018] el: 0 cg: -1 cu: CCU st: D/C'd id: MDI #1 (Puff/Drug) t0: [12:00:00 21/11/2018] el: 0 cg: -1 cu: CCU st: D/C'd id: Mean Airway Pressure t0: [12:00:00 21/11/2018] el: 0 cg: -1 cu: CCU st: D/C'd id: Minute Volume(Obser) t0: [12:00:00 21/11/2018] el: 0 cg: -1 cu: CCU st: D/C'd id: PEEP Set t0: [12:00:00 21/11/2018] el: 0 cg: -1 cu: CCU st: D/C'd id: Peak Insp. Pressure t0: [12:00:00 21/11/2018] el: 0 cg: -1 cu: CCU st: D/C'd id: Plateau Pressure t0: [12:00:00 21/11/2018] el: 0 cg: -1 cu: CCU st: D/C'd id: Pressure Support t0: [12:00:00 21/11/2018] el: 0 cg: -1 cu: CCU st: D/C'd id: Resp Rate (Spont) t0: [12:00:00 21/11/2018] el: 0 cg: -1 cu: CCU st: D/C'd id: Resp Rate (Total) t0: [12:00:00 21/11/2018] el: 0 cg: -1 cu: CCU st: D/C'd id: Respiratory Rate Set t0: [12:00:00 21/11/2018] el: 0 cg: -1 cu: CCU st: D/C'd id: Tank A psi. t0: [12:00:00 21/11/2018] el: 0 cg: -1 cu: CCU st: D/C'd id: Tank B psi. t0: [12:00:00 21/11/2018] el: 0 cg: -1 cu: CCU st: D/C'd id: Ve High t0: [12:00:00 21/11/2018] el: 0 cg: -1 cu: CCU st: D/C'd id: Sensitivity-Vent t0: [12:00:00 21/11/2018] el: 0 cg: -1 cu: CCU st: D/C'd id: Sputum Color/Consist t0: [12:00:00 21/11/2018] el: 0 cg: -1 cu: CCU st: D/C'd id: Sputum Source/Amt t0: [12:00:00 21/11/2018] el: 0 cg: -1 cu: CCU st: D/C'd id: Tidal Volume (Obser) t0: [12:00:00 21/11/2018] el: 0 cg: -1 cu: CCU st: D/C'd id: Tidal Volume (Set) t0: [12:00:00 21/11/2018] el: 0 cg: -1 cu: CCU st: D/C'd id: Tidal Volume (Spont) t0: [12:00:00 21/11/2018] el: 0 cg: -1 cu: CCU st: D/C'd id: Ventilator Mode t0: [12:00:00 21/11/2018] el: 0 cg: -1 cu: CCU st: D/C'd id: Ventilator Type t0: [12:00:00 21/11/2018] el: 0 cg: -1 cu: CCU st: D/C'd id: Waveform-Vent t0: [12:00:00 21/11/2018] el: 0 cg: -1 cu: CCU st: D/C'd
id: Pain Level t0: [12:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 5-Moderate st: NotStopd id: Pain Level/Response t0: [12:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 3-Mild to Mod st: NotStopd id: Pain Present t0: [12:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Yes st: NotStopd id: Pain Assess Method t0: [12:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Pt Verbalized st: NotStopd id: PainLevel Acceptable t0: [12:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Yes st: NotStopd id: Service Type t0: [12:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: CCU st: NotStopd id: Code Status t0: [12:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Full Code st: NotStopd id: Riker-SAS Scale t0: [12:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Calm/Cooperative st: NotStopd id: Daily Wake Up t0: [12:00:00 21/11/2018] el: 1 cg: RN cu: CCU v1: No/Not Sedated st: NotStopd id: GI Prophylaxis t0: [12:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Proton/Pump/Inhi st: NotStopd id: Risk for Falls t0: [12:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Yes st: NotStopd id: Diet Type t0: [12:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Soft Solid st: NotStopd id: ETT Mark/Location t0: [12:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 22cm v2: Lip st: NotStopd id: Ectopy Frequency t0: [12:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: None st: NotStopd id: Ectopy Type t0: [12:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: None st: NotStopd id: Alarms t0: [12:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: ON st: NotStopd id: Parameters Checked t0: [12:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Yes st: NotStopd id: Extubation Date t0: [12:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 6 n1: 6 v2: 26 n2: 26 st: NotStopd id: Eye Opening t0: [12:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 4 Spontaneously st: NotStopd id: GCS Total t0: [12:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 15 n1: 15 u1: points st: NotStopd id: HOB t0: [12:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 45 degrees st: NotStopd id: Heart Rate t0: [12:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 73 n1: 73 u1: BPM st: NotStopd id: Heart Rhythm t0: [12:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Atrial Fib st: NotStopd id: Abdominal Assessment t0: [12:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Obese st: NotStopd id: Activity t0: [12:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Bedrest st: NotStopd id: Activity Tolerance t0: [12:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Tolerated Well st: NotStopd id: Airway Size t0: [12:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 7.0 mm st: NotStopd id: Airway Type t0: [12:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Endotracheal st: NotStopd id: Intubation Date t0: [12:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 6 n1: 6 v2: 22 n2: 22 st: NotStopd id: LLE Temp/Color t0: [12:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Warm v2: Normal st: NotStopd id: LLL Lung Sounds t0: [12:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Diminished st: NotStopd id: LUL Lung Sounds t0: [12:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Clear st: NotStopd id: Level of Conscious t0: [12:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Alert st: NotStopd id: Motor Response t0: [12:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 6 Obeys Commands st: NotStopd id: O2 Delivery Device t0: [12:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Nasal Cannula st: NotStopd id: O2 Flow (lpm) t0: [12:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 2 n1: 2 u1: lpm st: NotStopd id: Oral Cavity t0: [12:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Teeth/Tissue WNL st: NotStopd id: Orientation t0: [12:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Oriented x 3 st: NotStopd id: Angio Site #1 t0: [12:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: R Femoral st: NotStopd id: Angio Site #2 t0: [12:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: L Femoral st: NotStopd id: Arterial BP t0: [12:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 120 n1: 120 u1: mmHg v2: 49 n2: 49 u2: mmHg st: NotStopd id: Pain Cause t0: [12:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Activity st: NotStopd id: Pain Level (Rest) t0: [12:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 5-Moderate st: NotStopd id: Pain Location t0: [12:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Left Leg st: NotStopd id: Pain Management t0: [12:00:00 21/11/2018] el: 1 cg: RN cu: CCU v1: PO Med st: NotStopd id: Pain Type t0: [12:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Aching st: NotStopd id: Arterial BP Mean t0: [12:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 72 n1: 72 u1: mmHg st: NotStopd id: Assistance Device t0: [12:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 2 Person Assist st: NotStopd id: Precautions t0: [12:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Contact st: NotStopd id: ABP Alarm (Lo/Hi) t0: [12:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 85 n1: 85 u1: mmHg v2: 145 n2: 145 u2: mmHg st: NotStopd id: HR Alarm (Lo/Hi) t0: [12:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 60 n1: 60 u1: BPM v2: 125 n2: 125 u2: BPM st: NotStopd id: Resp Alarm (Lo/Hi) t0: [12:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 8 n1: 8 u1: BPM v2: 40 n2: 40 u2: BPM st: NotStopd id: SpO2 Alarm (Lo/Hi) t0: [12:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 90 n1: 90 u1: % v2: 100 n2: 100 u2: % st: NotStopd id: RLL Lung Sounds t0: [12:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Diminished st: NotStopd id: RUL Lung Sounds t0: [12:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Clear st: NotStopd id: Respiratory Pattern t0: [12:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Regular st: NotStopd id: Respiratory Rate t0: [12:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 24 n1: 24 u1: BPM st: NotStopd id: Skin Care t0: [12:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Done st: NotStopd id: SpO2 t0: [12:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 97 n1: 97 u1: % st: NotStopd id: Temp. Site t0: [12:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Oral st: NotStopd id: Temperature C (calc) t0: [12:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 36.7778 n1: 36.7778 u1: Deg. C st: NotStopd id: Temperature F t0: [12:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 98.2 n1: 98.2 u1: Deg. F st: NotStopd id: Therapeutic Bed t0: [12:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: AtmosAir Mattres st: NotStopd id: Turn t0: [12:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Right Side st: NotStopd id: Urine Color/Appear t0: [12:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Yellow v2: Clear st: NotStopd id: Urine Source t0: [12:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Indwelling Cath st: NotStopd id: Verbal Response t0: [12:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 5 Oriented st: NotStopd id: Back Care t0: [12:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Done st: NotStopd id: calprevflg t0: [12:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 1 n1: 1 u1: kg st: NotStopd id: Bowel Sounds t0: [12:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Present st: NotStopd
id: D5W 100.0ml t0: [12:00:00 21/11/2018] el: 1 ai: 105 cg: RN cu: CCU vo: 100 vu: ml id: D5W 250.0ml + 25000Uhr Heparin t0: [12:00:00 21/11/2018] el: 1 ai: 117 cg: RN cu: CCU vo: 7 vu: ml id: D5W t0: [12:00:00 21/11/2018] el: 1 ai: 168 cg: RN cu: CCU vo: 10 vu: ml id: Urine Out Foley t0: [12:00:00 21/11/2018] el: 1 cg: RN cu: CCU vo: 840 vu: ml
id: Heparin t0: [12:00:00 21/11/2018] el: 1 cg: RN cu: CCU vo: 0 do: 700 du: Uhr so: D5W sv: 250 su: ml rt: IV Drip
pi: 4077931 hi: 10161 t0: [14:00:00 21/11/2018] tf: [14:00:00 21/11/2018] mn: Insulin pt: Unit Dose st: Discontinued rt: SC fr: ASDIR ss: Y di: Ongoing xv: 36 xu: Hours pi: 4077932 hi: 10161 t0: [22:00:00 21/11/2018] tf: [14:00:00 21/11/2018] mn: Insulin pt: Unit Dose st: Discontinued rt: SC fr: HS ds: 22 dn: 1 di: Ongoing xv: 36 xu: Hours
id: Service Type t0: [13:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: CCU st: NotStopd id: Code Status t0: [13:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Full Code st: NotStopd id: Risk for Falls t0: [13:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Yes st: NotStopd id: Ectopy Frequency t0: [13:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: None st: NotStopd id: Ectopy Type t0: [13:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: None st: NotStopd id: Heart Rate t0: [13:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 69 n1: 69 u1: BPM st: NotStopd id: Heart Rhythm t0: [13:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Atrial Fib st: NotStopd id: Arterial BP t0: [13:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 112 n1: 112 u1: mmHg v2: 46 n2: 46 u2: mmHg st: NotStopd id: Arterial BP Mean t0: [13:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 68 n1: 68 u1: mmHg st: NotStopd id: Precautions t0: [13:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Contact st: NotStopd id: ABP Alarm (Lo/Hi) t0: [13:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 85 n1: 85 u1: mmHg v2: 145 n2: 145 u2: mmHg st: NotStopd id: HR Alarm (Lo/Hi) t0: [13:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 60 n1: 60 u1: BPM v2: 125 n2: 125 u2: BPM st: NotStopd id: Resp Alarm (Lo/Hi) t0: [13:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 8 n1: 8 u1: BPM v2: 40 n2: 40 u2: BPM st: NotStopd id: SpO2 Alarm (Lo/Hi) t0: [13:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 90 n1: 90 u1: % v2: 100 n2: 100 u2: % st: NotStopd id: Respiratory Rate t0: [13:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 46 n1: 46 u1: BPM st: NotStopd id: SpO2 t0: [13:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 97 n1: 97 u1: % st: NotStopd id: calprevflg t0: [13:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 1 n1: 1 u1: kg st: NotStopd
id: D5W 250.0ml + 25000Uhr Heparin t0: [13:00:00 21/11/2018] el: 1 ai: 117 cg: RN cu: CCU vo: 7 vu: ml id: D5W t0: [13:00:00 21/11/2018] el: 1 ai: 168 cg: RN cu: CCU vo: 10 vu: ml
id: Heparin t0: [13:00:00 21/11/2018] el: 1 cg: RN cu: CCU vo: 0 do: 700 du: Uhr so: D5W sv: 250 su: ml rt: IV Drip
pi: 4078187 hi: 10161 t0: [15:00:00 21/11/2018] tf: [22:00:00 22/11/2018] mn: Insulin pt: Unit Dose st: Discontinued rt: SC fr: ASDIR ss: Y di: Ongoing xv: 36 xu: Hours pi: 4078188 hi: 10161 t0: [22:00:00 21/11/2018] tf: [22:00:00 22/11/2018] mn: Insulin pt: Unit Dose st: Discontinued rt: SC fr: HS ds: 22 dn: 1 di: Ongoing xv: 36 xu: Hours
id: BUN t0: [14:25:00 21/11/2018] el: 0 cg: 1663 cu: CCU v1: 9 n1: 9 rs: Final st: NotStopd id: Calcium t0: [14:25:00 21/11/2018] el: 0 cg: 1663 cu: CCU v1: 8.1 n1: 8.1 u1: mg/dl rs: Final st: NotStopd id: Chloride t0: [14:25:00 21/11/2018] el: 0 cg: 1663 cu: CCU v1: 102 n1: 102 rs: Final st: NotStopd id: Creatinine t0: [14:25:00 21/11/2018] el: 0 cg: 1663 cu: CCU v1: 0.7 n1: 0.7 rs: Final st: NotStopd id: Glucose t0: [14:25:00 21/11/2018] el: 0 cg: 1663 cu: CCU v1: 209 n1: 209 rs: Final st: NotStopd id: Magnesium t0: [14:25:00 21/11/2018] el: 0 cg: 1663 cu: CCU v1: 2 n1: 2 rs: Final st: NotStopd id: Potassium t0: [14:25:00 21/11/2018] el: 0 cg: 1663 cu: CCU v1: 3.6 n1: 3.6 rs: Final st: NotStopd id: Sodium t0: [14:25:00 21/11/2018] el: 0 cg: 1663 cu: CCU v1: 141 n1: 141 rs: Final st: NotStopd id: BUN (6-20) t0: [14:25:00 21/11/2018] el: 0 cg: 1663 cu: CCU v1: 9 n1: 9 rs: Final st: NotStopd id: Calcium (8.4-10.2) t0: [14:25:00 21/11/2018] el: 0 cg: 1663 cu: CCU v1: 8.1 n1: 8.1 u1: mg/dl rs: Final st: NotStopd id: Carbon Dioxide t0: [14:25:00 21/11/2018] el: 0 cg: 1663 cu: CCU v1: 32 n1: 32 rs: Final st: NotStopd id: Chloride (100-112) t0: [14:25:00 21/11/2018] el: 0 cg: 1663 cu: CCU v1: 102 n1: 102 rs: Final st: NotStopd id: Creatinine (0-1.3) t0: [14:25:00 21/11/2018] el: 0 cg: 1663 cu: CCU v1: 0.7 n1: 0.7 rs: Final st: NotStopd id: Glucose (70-105) t0: [14:25:00 21/11/2018] el: 0 cg: 1663 cu: CCU v1: 209 n1: 209 rs: Final st: NotStopd id: Magnesium (1.6-2.6) t0: [14:25:00 21/11/2018] el: 0 cg: 1663 cu: CCU v1: 2 n1: 2 rs: Final st: NotStopd id: Potassium (3.5-5.3) t0: [14:25:00 21/11/2018] el: 0 cg: 1663 cu: CCU v1: 3.6 n1: 3.6 rs: Final st: NotStopd id: Sodium (135-148) t0: [14:25:00 21/11/2018] el: 0 cg: 1663 cu: CCU v1: 141 n1: 141 rs: Final st: NotStopd
id: Pain Level t0: [16:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 6-Mod to Severe st: NotStopd id: Pain Level/Response t0: [16:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 3-Mild to Mod st: NotStopd id: Pain Present t0: [16:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Yes st: NotStopd id: Pain Assess Method t0: [16:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Pt Verbalized st: NotStopd id: PainLevel Acceptable t0: [16:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Yes st: NotStopd id: Service Type t0: [14:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: CCU st: NotStopd id: Service Type t0: [15:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: CCU st: NotStopd id: Service Type t0: [16:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: CCU st: NotStopd id: Service Type t0: [17:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: CCU st: NotStopd id: Code Status t0: [14:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Full Code st: NotStopd id: Code Status t0: [15:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Full Code st: NotStopd id: Code Status t0: [16:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Full Code st: NotStopd id: Code Status t0: [17:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Full Code st: NotStopd id: Riker-SAS Scale t0: [16:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Calm/Cooperative st: NotStopd id: Daily Wake Up t0: [16:00:00 21/11/2018] el: 1 cg: RN cu: CCU v1: Yes st: NotStopd id: GI Prophylaxis t0: [16:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Proton/Pump/Inhi st: NotStopd id: Risk for Falls t0: [14:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Yes st: NotStopd id: Risk for Falls t0: [15:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Yes st: NotStopd id: Risk for Falls t0: [16:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Yes st: NotStopd id: Risk for Falls t0: [17:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Yes st: NotStopd id: Diet Type t0: [16:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Soft Solid st: NotStopd id: Dorsal PedPulse R/L t0: [16:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Not Applicable v2: Doppler st: NotStopd id: Ectopy Frequency t0: [14:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: None st: NotStopd id: Ectopy Frequency t0: [15:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: None st: NotStopd id: Ectopy Frequency t0: [16:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: None st: NotStopd id: Ectopy Frequency t0: [17:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: None st: NotStopd id: Ectopy Type t0: [14:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: None st: NotStopd id: Ectopy Type t0: [15:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: None st: NotStopd id: Ectopy Type t0: [16:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: None st: NotStopd id: Ectopy Type t0: [17:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: None st: NotStopd id: Alarms t0: [16:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: ON st: NotStopd id: Parameters Checked t0: [16:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Yes st: NotStopd id: Education Topic #1 t0: [17:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Plan of Care st: NotStopd id: Eye Opening t0: [16:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 4 Spontaneously st: NotStopd id: GCS Total t0: [16:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 15 n1: 15 u1: points st: NotStopd id: Heart Rate t0: [14:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 82 n1: 82 u1: BPM st: NotStopd id: Heart Rate t0: [15:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 86 n1: 86 u1: BPM st: NotStopd id: Heart Rate t0: [16:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 85 n1: 85 u1: BPM st: NotStopd id: Heart Rate t0: [17:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 80 n1: 80 u1: BPM st: NotStopd id: Heart Rhythm t0: [14:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Atrial Fib st: NotStopd id: Heart Rhythm t0: [15:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Atrial Fib st: NotStopd id: Heart Rhythm t0: [16:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Atrial Fib st: NotStopd id: Heart Rhythm t0: [17:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Atrial Fib st: NotStopd id: INV Line#3 Type/Site t0: [16:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: A-Line v2: Left Radial st: NotStopd id: INV Line#3InsertDate t0: [16:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 9 n1: 9 v2: 24 n2: 24 st: NotStopd id: Abdominal Assessment t0: [16:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Obese st: NotStopd id: IV #2 Insert Date t0: [16:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 9 n1: 9 v2: 25 n2: 25 st: NotStopd id: IV #2 Site/Size t0: [16:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Right Wrist v2: 20 gauge st: NotStopd id: IV #3 Insert Date t0: [16:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 9 n1: 9 v2: 27 n2: 27 st: NotStopd id: IV #3 Site/Size t0: [16:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Left Hand v2: 20 gauge st: NotStopd id: Impaired Skin Site#1 t0: [17:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Abdomen st: NotStopd id: LLE Temp/Color t0: [16:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Warm v2: Normal st: NotStopd id: LLL Lung Sounds t0: [16:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Diminished st: NotStopd id: LUL Lung Sounds t0: [16:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Clear st: NotStopd id: Level of Conscious t0: [16:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Alert st: NotStopd id: Angio Appearance #1 t0: [16:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Clean and Dry v2: Clean and Dry st: NotStopd id: Angio Appearance #2 t0: [16:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Clean and Dry v2: Clean and Dry st: NotStopd id: Motor Response t0: [16:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 6 Obeys Commands st: NotStopd id: Angio Dressing #1 t0: [16:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Dry Sterile Dsg st: NotStopd id: O2 Delivery Device t0: [16:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Nasal Cannula st: NotStopd id: O2 Flow (lpm) t0: [16:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 2 n1: 2 u1: lpm st: NotStopd id: Oral Cavity t0: [16:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Teeth/Tissue WNL st: NotStopd id: Orientation t0: [16:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Oriented x 3 st: NotStopd id: Angio Site #1 t0: [16:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: R Femoral st: NotStopd id: Angio Site #2 t0: [16:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: L Femoral st: NotStopd id: Arterial BP t0: [14:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 138 n1: 138 u1: mmHg v2: 62 n2: 62 u2: mmHg st: NotStopd id: Arterial BP t0: [15:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 114 n1: 114 u1: mmHg v2: 53 n2: 53 u2: mmHg st: NotStopd id: Arterial BP t0: [16:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 133 n1: 133 u1: mmHg v2: 55 n2: 55 u2: mmHg st: NotStopd id: Pain Cause t0: [16:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Activity st: NotStopd id: Pain Level (Rest) t0: [16:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 6-Mod to Severe st: NotStopd id: Pain Location t0: [16:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Left Leg st: NotStopd id: Pain Management t0: [16:00:00 21/11/2018] el: 1 cg: RN cu: CCU v1: Repositioned v2: PO Med st: NotStopd id: Pain Type t0: [16:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Aching st: NotStopd id: Arterial BP Mean t0: [14:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 88 n1: 88 u1: mmHg st: NotStopd id: Arterial BP Mean t0: [15:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 72 n1: 72 u1: mmHg st: NotStopd id: Arterial BP Mean t0: [16:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 80 n1: 80 u1: mmHg st: NotStopd id: PostTib. Pulses R/L t0: [16:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Absent v2: Doppler st: NotStopd id: Precautions t0: [14:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Contact st: NotStopd id: Precautions t0: [15:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Contact st: NotStopd id: Precautions t0: [16:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Contact st: NotStopd id: Precautions t0: [17:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Contact st: NotStopd id: INV#3 Dsg Change t0: [16:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 9 n1: 9 v2: 24 n2: 24 st: NotStopd id: ABP Alarm (Lo/Hi) t0: [14:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 85 n1: 85 u1: mmHg v2: 145 n2: 145 u2: mmHg st: NotStopd id: ABP Alarm (Lo/Hi) t0: [15:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 85 n1: 85 u1: mmHg v2: 145 n2: 145 u2: mmHg st: NotStopd id: ABP Alarm (Lo/Hi) t0: [16:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 85 n1: 85 u1: mmHg v2: 145 n2: 145 u2: mmHg st: NotStopd id: ABP Alarm (Lo/Hi) t0: [17:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 85 n1: 85 u1: mmHg v2: 145 n2: 145 u2: mmHg st: NotStopd id: HR Alarm (Lo/Hi) t0: [14:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 60 n1: 60 u1: BPM v2: 125 n2: 125 u2: BPM st: NotStopd id: HR Alarm (Lo/Hi) t0: [15:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 60 n1: 60 u1: BPM v2: 125 n2: 125 u2: BPM st: NotStopd id: HR Alarm (Lo/Hi) t0: [16:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 60 n1: 60 u1: BPM v2: 125 n2: 125 u2: BPM st: NotStopd id: HR Alarm (Lo/Hi) t0: [17:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 60 n1: 60 u1: BPM v2: 125 n2: 125 u2: BPM st: NotStopd id: Resp Alarm (Lo/Hi) t0: [14:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 8 n1: 8 u1: BPM v2: 40 n2: 40 u2: BPM st: NotStopd id: Resp Alarm (Lo/Hi) t0: [15:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 8 n1: 8 u1: BPM v2: 40 n2: 40 u2: BPM st: NotStopd id: Resp Alarm (Lo/Hi) t0: [16:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 8 n1: 8 u1: BPM v2: 40 n2: 40 u2: BPM st: NotStopd id: Resp Alarm (Lo/Hi) t0: [17:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 8 n1: 8 u1: BPM v2: 40 n2: 40 u2: BPM st: NotStopd id: SpO2 Alarm (Lo/Hi) t0: [14:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 90 n1: 90 u1: % v2: 100 n2: 100 u2: % st: NotStopd id: SpO2 Alarm (Lo/Hi) t0: [15:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 90 n1: 90 u1: % v2: 100 n2: 100 u2: % st: NotStopd id: SpO2 Alarm (Lo/Hi) t0: [16:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 90 n1: 90 u1: % v2: 100 n2: 100 u2: % st: NotStopd id: SpO2 Alarm (Lo/Hi) t0: [17:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 90 n1: 90 u1: % v2: 100 n2: 100 u2: % st: NotStopd id: RLL Lung Sounds t0: [16:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Diminished st: NotStopd id: RUL Lung Sounds t0: [16:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Clear st: NotStopd id: Respiratory Pattern t0: [16:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Regular st: NotStopd id: Respiratory Rate t0: [14:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 24 n1: 24 u1: BPM st: NotStopd id: Respiratory Rate t0: [15:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 22 n1: 22 u1: BPM st: NotStopd id: Respiratory Rate t0: [16:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 30 n1: 30 u1: BPM st: NotStopd id: Respiratory Rate t0: [17:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 36 n1: 36 u1: BPM st: NotStopd id: Side Rails t0: [17:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: All rails up st: NotStopd id: SpO2 t0: [14:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 95 n1: 95 u1: % st: NotStopd id: SpO2 t0: [15:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 98 n1: 98 u1: % st: NotStopd id: SpO2 t0: [16:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 93 n1: 93 u1: % st: NotStopd id: SpO2 t0: [17:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 95 n1: 95 u1: % st: NotStopd id: Support Systems t0: [17:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Children st: NotStopd id: INV#3 Cap Change t0: [16:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 9 n1: 9 v2: 24 n2: 24 st: NotStopd id: INV#3 Tubing Change t0: [16:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 9 n1: 9 v2: 24 n2: 24 st: NotStopd id: Urine Color/Appear t0: [16:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Yellow v2: Clear st: NotStopd id: Urine Source t0: [16:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Indwelling Cath st: NotStopd id: Verbal Response t0: [16:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 5 Oriented st: NotStopd id: calprevflg t0: [14:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 1 n1: 1 u1: kg st: NotStopd id: calprevflg t0: [15:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 1 n1: 1 u1: kg st: NotStopd id: calprevflg t0: [16:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 1 n1: 1 u1: kg st: NotStopd id: calprevflg t0: [17:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 1 n1: 1 u1: kg st: NotStopd id: Bowel Sounds t0: [16:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Present st: NotStopd
id: D5W 250.0ml + 25000Uhr Heparin t0: [14:00:00 21/11/2018] el: 1 ai: 117 cg: RN cu: CCU vo: 7 vu: ml id: D5W 250.0ml + 25000Uhr Heparin t0: [16:00:00 21/11/2018] el: 1 ai: 117 cg: RN cu: CCU vo: 14 vu: ml id: D5W 250.0ml + 25000Uhr Heparin t0: [17:00:00 21/11/2018] el: 1 ai: 117 cg: RN cu: CCU vo: 7 vu: ml id: Gastric Meds t0: [12:00:00 21/11/2018] el: 1 ai: 155 cg: RN cu: CCU vo: 250 vu: ml id: Gastric Meds t0: [15:00:00 21/11/2018] el: 1 ai: 155 cg: RN cu: CCU vo: 50 vu: ml id: D5W t0: [14:00:00 21/11/2018] el: 1 ai: 168 cg: RN cu: CCU vo: 10 vu: ml id: D5W t0: [16:00:00 21/11/2018] el: 1 ai: 168 cg: RN cu: CCU vo: 20 vu: ml id: D5W t0: [17:00:00 21/11/2018] el: 1 ai: 168 cg: RN cu: CCU vo: 10 vu: ml id: Urine Out Foley t0: [14:00:00 21/11/2018] el: 1 cg: RN cu: CCU vo: 200 vu: ml id: Urine Out Foley t0: [15:00:00 21/11/2018] el: 1 cg: RN cu: CCU vo: 350 vu: ml
id: Heparin t0: [14:00:00 21/11/2018] el: 1 cg: RN cu: CCU vo: 0 do: 700 du: Uhr so: D5W sv: 250 su: ml rt: IV Drip id: Heparin t0: [15:00:00 21/11/2018] el: 1 cg: RN cu: CCU vo: 0 do: 700 du: Uhr so: D5W sv: 250 su: ml rt: IV Drip id: Heparin t0: [16:00:00 21/11/2018] el: 1 cg: RN cu: CCU vo: 0 do: 700 du: Uhr so: D5W sv: 250 su: ml rt: IV Drip id: Heparin t0: [17:00:00 21/11/2018] el: 1 cg: RN cu: CCU vo: 0 do: 700 du: Uhr so: D5W sv: 250 su: ml rt: IV Drip
id: Fingerstick Glucose t0: [17:00:00 21/11/2018] el: 0 cg: CoWker cu: CCU v1: 199 n1: 199 rs: Manual st: NotStopd
id: Arterial BP t0: [17:00:00 21/11/2018] el: 0 cg: -1 cu: CCU st: D/C'd id: Arterial BP Mean t0: [17:00:00 21/11/2018] el: 0 cg: -1 cu: CCU st: D/C'd
id: Service Type t0: [18:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: CCU st: NotStopd id: Code Status t0: [18:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Full Code st: NotStopd id: Risk for Falls t0: [18:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Yes st: NotStopd id: Ectopy Frequency t0: [18:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: None st: NotStopd id: Ectopy Type t0: [18:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: None st: NotStopd id: Heart Rate t0: [18:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 79 n1: 79 u1: BPM st: NotStopd id: Heart Rhythm t0: [18:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Atrial Fib st: NotStopd id: NBP t0: [18:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 126 n1: 126 u1: mmHg v2: 41 n2: 41 u2: mmHg st: NotStopd id: NBP Mean t0: [18:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 69.3333 n1: 69.3333 u1: mmHg st: NotStopd id: Precautions t0: [18:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Contact st: NotStopd id: ABP Alarm (Lo/Hi) t0: [18:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 85 n1: 85 u1: mmHg v2: 145 n2: 145 u2: mmHg st: NotStopd id: HR Alarm (Lo/Hi) t0: [18:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 60 n1: 60 u1: BPM v2: 125 n2: 125 u2: BPM st: NotStopd id: Resp Alarm (Lo/Hi) t0: [18:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 8 n1: 8 u1: BPM v2: 40 n2: 40 u2: BPM st: NotStopd id: SpO2 Alarm (Lo/Hi) t0: [18:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 90 n1: 90 u1: % v2: 100 n2: 100 u2: % st: NotStopd id: Respiratory Rate t0: [18:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 21 n1: 21 u1: BPM st: NotStopd id: SpO2 t0: [18:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 95 n1: 95 u1: % st: NotStopd id: Temp. Site t0: [16:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Oral st: NotStopd id: Temperature C (calc) t0: [16:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 36.7778 n1: 36.7778 u1: Deg. C st: NotStopd id: Temperature F t0: [16:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 98.2 n1: 98.2 u1: Deg. F st: NotStopd id: calprevflg t0: [18:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 1 n1: 1 u1: kg st: NotStopd
id: Urine Out Foley t0: [17:00:00 21/11/2018] el: 1 cg: RN cu: CCU vo: 200 vu: ml
id: Heparin t0: [18:00:00 21/11/2018] el: 1 cg: RN cu: CCU vo: 0 do: 700 du: Uhr so: D5W sv: 250 su: ml rt: IV Drip
id: Service Type t0: [19:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: CCU st: NotStopd id: Code Status t0: [19:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Full Code st: NotStopd id: Risk for Falls t0: [19:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Yes st: NotStopd id: Ectopy Frequency t0: [19:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: None st: NotStopd id: Ectopy Type t0: [19:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: None st: NotStopd id: Heart Rate t0: [19:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 83 n1: 83 u1: BPM st: NotStopd id: Heart Rhythm t0: [19:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Atrial Fib st: NotStopd id: NBP t0: [19:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 125 n1: 125 u1: mmHg v2: 43 n2: 43 u2: mmHg st: NotStopd id: NBP Mean t0: [19:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 70.3333 n1: 70.3333 u1: mmHg st: NotStopd id: Precautions t0: [19:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Contact st: NotStopd id: ABP Alarm (Lo/Hi) t0: [19:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 85 n1: 85 u1: mmHg v2: 145 n2: 145 u2: mmHg st: NotStopd id: HR Alarm (Lo/Hi) t0: [19:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 60 n1: 60 u1: BPM v2: 125 n2: 125 u2: BPM st: NotStopd id: Resp Alarm (Lo/Hi) t0: [19:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 8 n1: 8 u1: BPM v2: 40 n2: 40 u2: BPM st: NotStopd id: SpO2 Alarm (Lo/Hi) t0: [19:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 90 n1: 90 u1: % v2: 100 n2: 100 u2: % st: NotStopd id: Respiratory Rate t0: [19:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 29 n1: 29 u1: BPM st: NotStopd id: SpO2 t0: [19:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 100 n1: 100 u1: % st: NotStopd id: calprevflg t0: [19:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 1 n1: 1 u1: kg st: NotStopd
id: D5W 250.0ml + 25000Uhr Heparin t0: [19:00:00 21/11/2018] el: 1 ai: 117 cg: RN cu: CCU vo: 14 vu: ml id: Gastric Meds t0: [18:00:00 21/11/2018] el: 1 ai: 155 cg: RN cu: CCU vo: 200 vu: ml id: D5W t0: [19:00:00 21/11/2018] el: 1 ai: 168 cg: RN cu: CCU vo: 20 vu: ml id: Urine Out Foley t0: [19:00:00 21/11/2018] el: 1 cg: RN cu: CCU vo: 280 vu: ml
id: Heparin t0: [19:00:00 21/11/2018] el: 1 cg: RN cu: CCU vo: 0 do: 700 du: Uhr so: D5W sv: 250 su: ml rt: IV Drip
pi: 4079413 hi: 10161 t0: [20:00:00 21/11/2018] tf: [19:00:00 22/11/2018] mn: Potassium Chloride pt: Unit Dose st: Expired rt: PO fr: ONCE ds: 20 dn: 1 dt: 1 di: Doses xv: 36 xu: Hours pi: 4079414 hi: 10161 t0: [22:00:00 21/11/2018] tf: [22:00:00 22/11/2018] mn: Captopril pt: Unit Dose st: Inactive (Due to a change order) rt: PO fr: TID ds: 08, 16, 22 dn: 3 di: Ongoing xv: 36 xu: Hours
id: INV Line#3 D/C Date t0: [16:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 9 n1: 9 v2: 27 n2: 27 st: NotStopd
pi: 4079594 hi: 10161 t0: [21:00:00 21/11/2018] tf: [20:00:00 22/11/2018] mn: Morphine Sulfate pt: Unit Dose st: Expired rt: IV fr: ONCE ds: 21 dn: 1 dt: 1 di: Doses xv: 36 xu: Hours
id: Eye Care t0: [21:00:00 21/11/2018] el: 0 cg: -1 cu: CCU st: D/C'd id: INV Line#3 D/C Date t0: [21:00:00 21/11/2018] el: 0 cg: -1 cu: CCU st: D/C'd id: INV Line#3 Type/Site t0: [21:00:00 21/11/2018] el: 0 cg: -1 cu: CCU st: D/C'd id: INV Line#3 Zero/Cal t0: [21:00:00 21/11/2018] el: 0 cg: -1 cu: CCU st: D/C'd id: INV Line#3InsertDate t0: [21:00:00 21/11/2018] el: 0 cg: -1 cu: CCU st: D/C'd id: INV Line#3SiteAppear t0: [21:00:00 21/11/2018] el: 0 cg: -1 cu: CCU st: D/C'd id: INV#3 WaveformAppear t0: [21:00:00 21/11/2018] el: 0 cg: -1 cu: CCU st: D/C'd id: Oral Care t0: [21:00:00 21/11/2018] el: 0 cg: -1 cu: CCU st: D/C'd id: INV#3 Dsg Change t0: [21:00:00 21/11/2018] el: 0 cg: -1 cu: CCU st: D/C'd id: INV#3 Cap Change t0: [21:00:00 21/11/2018] el: 0 cg: -1 cu: CCU st: D/C'd id: INV#3 Tubing Change t0: [21:00:00 21/11/2018] el: 0 cg: -1 cu: CCU st: D/C'd
id: Gastric Meds t0: [21:00:00 21/11/2018] el: 1 ai: 155 cg: -1 cu: CCU vo: 0 st: D/C'd id: GT Flush t0: [21:00:00 21/11/2018] el: 1 ai: 338 cg: -1 cu: CCU vo: 0 st: D/C'd
id: Pain Level t0: [21:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 6-Mod to Severe st: NotStopd id: Service Type t0: [20:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: CCU st: NotStopd id: Service Type t0: [21:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: CCU st: NotStopd id: Service Type t0: [22:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: CCU st: NotStopd id: Code Status t0: [20:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Full Code st: NotStopd id: Code Status t0: [21:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Full Code st: NotStopd id: Code Status t0: [22:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Full Code st: NotStopd id: Riker-SAS Scale t0: [21:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Calm/Cooperative st: NotStopd id: Daily Wake Up t0: [21:00:00 21/11/2018] el: 1 cg: RN cu: CCU v1: No/Not Sedated st: NotStopd id: GI Prophylaxis t0: [22:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Proton/Pump/Inhi st: NotStopd id: Risk for Falls t0: [20:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Yes st: NotStopd id: Risk for Falls t0: [21:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Yes st: NotStopd id: Risk for Falls t0: [22:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Yes st: NotStopd id: Diet Type t0: [22:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Soft Solid st: NotStopd id: Dorsal PedPulse R/L t0: [22:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Not Applicable v2: Doppler st: NotStopd id: Ectopy Frequency t0: [20:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: None st: NotStopd id: Ectopy Frequency t0: [21:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: None st: NotStopd id: Ectopy Frequency t0: [22:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: None st: NotStopd id: Ectopy Type t0: [20:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: None st: NotStopd id: Ectopy Type t0: [21:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: None st: NotStopd id: Ectopy Type t0: [22:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: None st: NotStopd id: Alarms t0: [21:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: ON st: NotStopd id: Parameters Checked t0: [21:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Yes st: NotStopd id: Education Barrier t0: [22:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: None st: NotStopd id: Education Handout t0: [22:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Not Given st: NotStopd id: Education Learner t0: [22:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Patient st: NotStopd id: Education Method t0: [22:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Explanation st: NotStopd id: Education Readiness t0: [22:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Yes st: NotStopd id: Education Response t0: [22:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Understands st: NotStopd id: Education Topic #1 t0: [22:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Plan of Care st: NotStopd id: Education Topic #2 t0: [22:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Pain Scale st: NotStopd id: Eye Opening t0: [22:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 4 Spontaneously st: NotStopd id: GCS Total t0: [22:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 15 n1: 15 u1: points st: NotStopd id: HOB t0: [22:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 30 degrees st: NotStopd id: Heart Rate t0: [20:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 84 n1: 84 u1: BPM st: NotStopd id: Heart Rate t0: [21:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 86 n1: 86 u1: BPM st: NotStopd id: Heart Rate t0: [22:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 82 n1: 82 u1: BPM st: NotStopd id: Heart Rhythm t0: [20:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Atrial Fib st: NotStopd id: Heart Rhythm t0: [21:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Atrial Fib st: NotStopd id: Heart Rhythm t0: [22:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Atrial Fib st: NotStopd id: Abdominal Assessment t0: [22:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Obese st: NotStopd id: IV #2 Insert Date t0: [22:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 9 n1: 9 v2: 25 n2: 25 st: NotStopd id: IV #2 Site/Size t0: [22:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Right Wrist v2: 20 gauge st: NotStopd id: IV #3 Insert Date t0: [22:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 9 n1: 9 v2: 27 n2: 27 st: NotStopd id: IV #3 Site/Size t0: [22:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Left Hand v2: 20 gauge st: NotStopd id: Activity t0: [22:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Bedrest st: NotStopd id: IV Site Appear #2 t0: [22:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: WNL st: NotStopd id: IV Site Appear #3 t0: [22:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: WNL st: NotStopd id: ImpSkin Character #1 t0: [22:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Abrasion st: NotStopd id: ImpSkin Drain/Amt#1 t0: [22:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: None st: NotStopd id: ImpSkin Treatment #1 t0: [22:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Aquaphor st: NotStopd id: ImpSkin Wound Base#1 t0: [22:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Pink st: NotStopd id: Impaired Skin Site#1 t0: [22:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Abdomen st: NotStopd id: LLL Lung Sounds t0: [22:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Diminished st: NotStopd id: LUL Lung Sounds t0: [22:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Clear st: NotStopd id: Level of Conscious t0: [22:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Alert st: NotStopd id: Angio Appearance #1 t0: [22:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Clean and Dry st: NotStopd id: Angio Appearance #2 t0: [22:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Clean and Dry st: NotStopd id: Motor Response t0: [22:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 6 Obeys Commands st: NotStopd id: NBP t0: [20:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 116 n1: 116 u1: mmHg v2: 63 n2: 63 u2: mmHg st: NotStopd id: NBP t0: [21:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 128 n1: 128 u1: mmHg v2: 66 n2: 66 u2: mmHg st: NotStopd id: NBP Mean t0: [20:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 80.6667 n1: 80.6667 u1: mmHg st: NotStopd id: NBP Mean t0: [21:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 86.6667 n1: 86.6667 u1: mmHg st: NotStopd id: Angio Dressing #1 t0: [22:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Dry Sterile Dsg st: NotStopd id: O2 Delivery Device t0: [21:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Nasal Cannula st: NotStopd id: O2 Flow (lpm) t0: [21:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 2 n1: 2 u1: lpm st: NotStopd id: Oral Cavity t0: [22:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Teeth/Tissue WNL st: NotStopd id: Orientation t0: [22:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Oriented x 3 st: NotStopd id: Angio Site #1 t0: [22:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: R Femoral st: NotStopd id: Angio Site #2 t0: [22:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: L Femoral st: NotStopd id: Pain Cause t0: [21:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Activity st: NotStopd id: Pain Level (Rest) t0: [21:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 6-Mod to Severe st: NotStopd id: Pain Location t0: [21:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Left Leg st: NotStopd id: Pain Type t0: [21:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Aching st: NotStopd id: Position t0: [22:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Supine st: NotStopd id: Assistance Device t0: [22:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 2 Person Assist st: NotStopd id: Precautions t0: [20:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Contact st: NotStopd id: Precautions t0: [21:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Contact st: NotStopd id: Precautions t0: [22:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Contact st: NotStopd id: ABP Alarm (Lo/Hi) t0: [20:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 85 n1: 85 u1: mmHg v2: 145 n2: 145 u2: mmHg st: NotStopd id: ABP Alarm (Lo/Hi) t0: [21:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 85 n1: 85 u1: mmHg v2: 145 n2: 145 u2: mmHg st: NotStopd id: ABP Alarm (Lo/Hi) t0: [22:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 85 n1: 85 u1: mmHg v2: 145 n2: 145 u2: mmHg st: NotStopd id: HR Alarm (Lo/Hi) t0: [20:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 60 n1: 60 u1: BPM v2: 125 n2: 125 u2: BPM st: NotStopd id: HR Alarm (Lo/Hi) t0: [21:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 60 n1: 60 u1: BPM v2: 125 n2: 125 u2: BPM st: NotStopd id: HR Alarm (Lo/Hi) t0: [22:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 60 n1: 60 u1: BPM v2: 125 n2: 125 u2: BPM st: NotStopd id: Resp Alarm (Lo/Hi) t0: [20:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 8 n1: 8 u1: BPM v2: 40 n2: 40 u2: BPM st: NotStopd id: Resp Alarm (Lo/Hi) t0: [21:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 8 n1: 8 u1: BPM v2: 40 n2: 40 u2: BPM st: NotStopd id: Resp Alarm (Lo/Hi) t0: [22:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 8 n1: 8 u1: BPM v2: 40 n2: 40 u2: BPM st: NotStopd id: SpO2 Alarm (Lo/Hi) t0: [20:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 90 n1: 90 u1: % v2: 100 n2: 100 u2: % st: NotStopd id: SpO2 Alarm (Lo/Hi) t0: [21:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 90 n1: 90 u1: % v2: 100 n2: 100 u2: % st: NotStopd id: SpO2 Alarm (Lo/Hi) t0: [22:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 90 n1: 90 u1: % v2: 100 n2: 100 u2: % st: NotStopd id: RLL Lung Sounds t0: [22:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Diminished st: NotStopd id: RUL Lung Sounds t0: [22:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Clear st: NotStopd id: Respiratory Pattern t0: [22:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Regular st: NotStopd id: Respiratory Rate t0: [20:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 50 n1: 50 u1: BPM st: NotStopd id: Respiratory Rate t0: [21:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 15 n1: 15 u1: BPM st: NotStopd id: Respiratory Rate t0: [22:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 33 n1: 33 u1: BPM st: NotStopd id: Restraint Location t0: [22:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: None st: NotStopd id: Side Rails t0: [22:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: All rails up st: NotStopd id: Skin Care t0: [22:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Done st: NotStopd id: Skin Integrity t0: [22:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Impaired st: NotStopd id: SpO2 t0: [20:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 100 n1: 100 u1: % st: NotStopd id: SpO2 t0: [21:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 100 n1: 100 u1: % st: NotStopd id: SpO2 t0: [22:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 99 n1: 99 u1: % st: NotStopd id: Support Systems t0: [22:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Children st: NotStopd id: Temp. Site t0: [21:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Oral st: NotStopd id: Temperature C (calc) t0: [21:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 36.8889 n1: 36.8889 u1: Deg. C st: NotStopd id: Temperature F t0: [21:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 98.4 n1: 98.4 u1: Deg. F st: NotStopd id: Therapeutic Bed t0: [22:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: AtmosAir Mattres st: NotStopd id: Urine Color/Appear t0: [22:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Yellow v2: Clear st: NotStopd id: Urine Source t0: [22:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Indwelling Cath st: NotStopd id: Verbal Response t0: [22:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 5 Oriented st: NotStopd id: Back Care t0: [22:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Done st: NotStopd id: calprevflg t0: [20:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 1 n1: 1 u1: kg st: NotStopd id: calprevflg t0: [21:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 1 n1: 1 u1: kg st: NotStopd id: calprevflg t0: [22:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 1 n1: 1 u1: kg st: NotStopd id: Bowel Sounds t0: [22:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Present st: NotStopd
id: Po Intake t0: [21:00:00 21/11/2018] el: 1 ai: 103 cg: RN cu: CCU vo: 100 vu: ml id: D5W 100.0ml t0: [21:00:00 21/11/2018] el: 1 ai: 105 cg: RN cu: CCU vo: 100 vu: ml id: D5W 250.0ml + 25000Uhr Heparin t0: [21:00:00 21/11/2018] el: 1 ai: 117 cg: RN cu: CCU vo: 14 vu: ml id: D5W t0: [21:00:00 21/11/2018] el: 1 ai: 168 cg: RN cu: CCU vo: 20 vu: ml id: Urine Out Foley t0: [21:00:00 21/11/2018] el: 1 cg: RN cu: CCU vo: 50 vu: ml
id: Heparin t0: [20:00:00 21/11/2018] el: 1 cg: RN cu: CCU vo: 0 do: 700 du: Uhr so: D5W sv: 250 su: ml rt: IV Drip id: Heparin t0: [21:00:00 21/11/2018] el: 1 cg: RN cu: CCU vo: 0 do: 700 du: Uhr so: D5W sv: 250 su: ml rt: IV Drip id: Heparin t0: [22:00:00 21/11/2018] el: 1 cg: RN cu: CCU vo: 0 do: 700 du: Uhr so: D5W sv: 250 su: ml rt: IV Drip
id: Service Type t0: [23:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: CCU st: NotStopd id: Code Status t0: [23:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Full Code st: NotStopd id: Risk for Falls t0: [23:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Yes st: NotStopd id: Ectopy Frequency t0: [23:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: None st: NotStopd id: Ectopy Type t0: [23:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: None st: NotStopd id: Heart Rate t0: [23:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 76 n1: 76 u1: BPM st: NotStopd id: Heart Rhythm t0: [23:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Atrial Fib st: NotStopd id: NBP t0: [22:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 132 n1: 132 u1: mmHg v2: 68 n2: 68 u2: mmHg st: NotStopd id: NBP t0: [23:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 142 n1: 142 u1: mmHg v2: 61 n2: 61 u2: mmHg st: NotStopd id: NBP Mean t0: [22:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 89.3333 n1: 89.3333 u1: mmHg st: NotStopd id: NBP Mean t0: [23:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 88 n1: 88 u1: mmHg st: NotStopd id: Precautions t0: [23:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Contact st: NotStopd id: ABP Alarm (Lo/Hi) t0: [23:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 85 n1: 85 u1: mmHg v2: 145 n2: 145 u2: mmHg st: NotStopd id: HR Alarm (Lo/Hi) t0: [23:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 60 n1: 60 u1: BPM v2: 125 n2: 125 u2: BPM st: NotStopd id: Resp Alarm (Lo/Hi) t0: [23:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 8 n1: 8 u1: BPM v2: 40 n2: 40 u2: BPM st: NotStopd id: SpO2 Alarm (Lo/Hi) t0: [23:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 90 n1: 90 u1: % v2: 100 n2: 100 u2: % st: NotStopd id: Respiratory Rate t0: [23:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 18 n1: 18 u1: BPM st: NotStopd id: SpO2 t0: [23:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 99 n1: 99 u1: % st: NotStopd id: calprevflg t0: [23:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 1 n1: 1 u1: kg st: NotStopd
id: Po Intake t0: [23:00:00 21/11/2018] el: 1 ai: 103 cg: RN cu: CCU vo: 100 vu: ml id: D5W 250.0ml + 25000Uhr Heparin t0: [23:00:00 21/11/2018] el: 1 ai: 117 cg: RN cu: CCU vo: 14 vu: ml id: D5W t0: [23:00:00 21/11/2018] el: 1 ai: 168 cg: RN cu: CCU vo: 20 vu: ml id: Urine Out Foley t0: [23:00:00 21/11/2018] el: 1 cg: RN cu: CCU vo: 80 vu: ml
id: Heparin t0: [23:00:00 21/11/2018] el: 1 cg: RN cu: CCU vo: 0 do: 700 du: Uhr so: D5W sv: 250 su: ml rt: IV Drip
id: IV Infusion In Total t0: [23:00:00 21/11/2018] el: 2 cg: RN cu: CCU pv: 34 cv: 1212 ac: 24 ap: none re: 0 id: 24h Total In t0: [23:00:00 21/11/2018] el: 2 cg: RN cu: CCU pv: 134 cv: 2202 ac: 24 ap: none re: 0 id: PO/Gastric In Total t0: [23:00:00 21/11/2018] el: 2 cg: RN cu: CCU pv: 100 cv: 990 ac: 24 ap: none re: 0 id: Total Hourly Output t0: [23:00:00 21/11/2018] el: 2 cg: RN cu: CCU pv: 80 cv: 80 ac: 1 ap: none re: 0 id: Urine Out Total t0: [23:00:00 21/11/2018] el: 2 cg: RN cu: CCU pv: 80 cv: 2278 ac: 24 ap: none re: 0 id: 24h Net Body Balance t0: [23:00:00 21/11/2018] el: 2 cg: RN cu: CCU pv: 54 cv: -76 ac: 24 ap: none re: 0 id: LOS Net Body Balance t0: [23:00:00 21/11/2018] el: 2 cg: RN cu: CCU pv: 54 cv: 1798.75 ac: multiple days ap: carryForward re: 0 id: Net Hourly Balance t0: [23:00:00 21/11/2018] el: 2 cg: RN cu: CCU pv: 54 cv: 54 ac: 1 ap: none re: 0 id: 24h Total Out t0: [23:00:00 21/11/2018] el: 2 cg: RN cu: CCU pv: 80 cv: 2278 ac: 24 ap: none re: 0
pi: 4080092 hi: 10161 t0: [01:00:00 22/11/2018] tf: [12:00:00 22/11/2018] mn: Hydromorphone pt: Unit Dose st: Inactive (Due to a change order) rt: SC fr: Q4-6H:PRN di: Ongoing xv: 36 xu: Hours
id: Pain Level t0: [01:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: 6-Mod to Severe st: NotStopd id: Pain Present t0: [01:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Yes st: NotStopd id: Pain Present t0: [21:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Yes st: NotStopd id: Service Type t0: [00:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: CCU st: NotStopd id: Service Type t0: [01:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: CCU st: NotStopd id: Code Status t0: [00:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Full Code st: NotStopd id: Code Status t0: [01:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Full Code st: NotStopd id: Riker-SAS Scale t0: [01:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Calm/Cooperative st: NotStopd id: Daily Wake Up t0: [01:00:00 22/11/2018] el: 1 cg: RN cu: CCU v1: No/Not Sedated st: NotStopd id: Risk for Falls t0: [00:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Yes st: NotStopd id: Risk for Falls t0: [01:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Yes st: NotStopd id: Dorsal PedPulse R/L t0: [01:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Not Applicable v2: Doppler st: NotStopd id: Ectopy Frequency t0: [00:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: None st: NotStopd id: Ectopy Frequency t0: [01:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: None st: NotStopd id: Ectopy Type t0: [00:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: None st: NotStopd id: Ectopy Type t0: [01:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: None st: NotStopd id: Eye Opening t0: [01:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: 4 Spontaneously st: NotStopd id: GCS Total t0: [01:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: 15 n1: 15 u1: points st: NotStopd id: Heart Rate t0: [00:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: 73 n1: 73 u1: BPM st: NotStopd id: Heart Rate t0: [01:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: 76 n1: 76 u1: BPM st: NotStopd id: Heart Rhythm t0: [00:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Atrial Fib st: NotStopd id: Heart Rhythm t0: [01:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Atrial Fib st: NotStopd id: Level of Conscious t0: [01:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Alert st: NotStopd id: Angio Appearance #1 t0: [01:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Clean and Dry st: NotStopd id: Angio Appearance #2 t0: [01:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Clean and Dry st: NotStopd id: Motor Response t0: [01:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: 6 Obeys Commands st: NotStopd id: NBP t0: [00:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: 121 n1: 121 u1: mmHg v2: 54 n2: 54 u2: mmHg st: NotStopd id: NBP t0: [01:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: 121 n1: 121 u1: mmHg v2: 54 n2: 54 u2: mmHg st: NotStopd id: NBP Mean t0: [00:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: 76.3333 n1: 76.3333 u1: mmHg st: NotStopd id: NBP Mean t0: [01:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: 76.3333 n1: 76.3333 u1: mmHg st: NotStopd id: O2 Delivery Device t0: [00:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Nasal Cannula st: NotStopd id: O2 Flow (lpm) t0: [00:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: 2 n1: 2 u1: lpm st: NotStopd id: Orientation t0: [01:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Oriented x 3 st: NotStopd id: Angio Site #1 t0: [01:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: R Femoral st: NotStopd id: Angio Site #2 t0: [01:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: L Femoral st: NotStopd id: Pain Cause t0: [01:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Activity st: NotStopd id: Pain Level (Rest) t0: [01:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: 6-Mod to Severe st: NotStopd id: Pain Location t0: [01:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Left Leg st: NotStopd id: Pain Management t0: [01:00:00 22/11/2018] el: 1 cg: RN cu: CCU v1: IV Push v2: Emotional Suppor st: NotStopd id: Pain Type t0: [01:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Aching st: NotStopd id: PostTib. Pulses R/L t0: [01:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Not Applicable v2: Doppler st: NotStopd id: PostTib. Pulses R/L t0: [22:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Not Applicable v2: Doppler st: NotStopd id: Precautions t0: [00:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Contact st: NotStopd id: Precautions t0: [01:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Contact st: NotStopd id: ABP Alarm (Lo/Hi) t0: [00:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: 85 n1: 85 u1: mmHg v2: 145 n2: 145 u2: mmHg st: NotStopd id: ABP Alarm (Lo/Hi) t0: [01:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: 85 n1: 85 u1: mmHg v2: 145 n2: 145 u2: mmHg st: NotStopd id: HR Alarm (Lo/Hi) t0: [00:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: 60 n1: 60 u1: BPM v2: 125 n2: 125 u2: BPM st: NotStopd id: HR Alarm (Lo/Hi) t0: [01:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: 60 n1: 60 u1: BPM v2: 125 n2: 125 u2: BPM st: NotStopd id: Resp Alarm (Lo/Hi) t0: [00:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: 8 n1: 8 u1: BPM v2: 40 n2: 40 u2: BPM st: NotStopd id: Resp Alarm (Lo/Hi) t0: [01:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: 8 n1: 8 u1: BPM v2: 40 n2: 40 u2: BPM st: NotStopd id: SpO2 Alarm (Lo/Hi) t0: [00:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: 90 n1: 90 u1: % v2: 100 n2: 100 u2: % st: NotStopd id: SpO2 Alarm (Lo/Hi) t0: [01:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: 90 n1: 90 u1: % v2: 100 n2: 100 u2: % st: NotStopd id: Respiratory Rate t0: [00:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: 25 n1: 25 u1: BPM st: NotStopd id: Respiratory Rate t0: [01:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: 23 n1: 23 u1: BPM st: NotStopd id: SpO2 t0: [00:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: 98 n1: 98 u1: % st: NotStopd id: SpO2 t0: [01:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: 98 n1: 98 u1: % st: NotStopd id: Temp. Site t0: [00:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Oral st: NotStopd id: Verbal Response t0: [01:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: 5 Oriented st: NotStopd id: calprevflg t0: [00:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: 1 n1: 1 u1: kg st: NotStopd id: calprevflg t0: [01:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: 1 n1: 1 u1: kg st: NotStopd
id: D5W 250.0ml + 25000Uhr Heparin t0: [00:00:00 22/11/2018] el: 1 ai: 117 cg: RN cu: CCU vo: 7 vu: ml id: D5W t0: [00:00:00 22/11/2018] el: 1 ai: 168 cg: RN cu: CCU vo: 10 vu: ml id: Urine Out Foley t0: [00:00:00 22/11/2018] el: 1 cg: RN cu: CCU vo: 40 vu: ml
id: Heparin t0: [00:00:00 22/11/2018] el: 1 cg: RN cu: CCU vo: 0 do: 700 du: Uhr so: D5W sv: 250 su: ml rt: IV Drip id: Heparin t0: [01:00:00 22/11/2018] el: 1 cg: RN cu: CCU vo: 0 do: 700 du: Uhr so: D5W sv: 250 su: ml rt: IV Drip
id: Total Hourly Output t0: [23:00:00 22/11/2018] el: 2 cg: RN cu: CCU cv: 0 ac: 1 ap: none re: 0 id: Urine Out Total t0: [23:00:00 22/11/2018] el: 2 cg: RN cu: CCU cv: 1380 ac: 24 ap: none re: 0 id: 24h Total Out t0: [23:00:00 22/11/2018] el: 2 cg: RN cu: CCU cv: 1380 ac: 24 ap: carryForward re: 0
id: Pain Level/Response t0: [01:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: 5-Moderate st: NotStopd id: Pain Level/Response t0: [21:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 1-None to Mild st: NotStopd id: Pain Assess Method t0: [01:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Pt Verbalized st: NotStopd id: Pain Assess Method t0: [21:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Pt Verbalized st: NotStopd id: PainLevel Acceptable t0: [21:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Yes st: NotStopd id: Alarms t0: [01:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: ON st: NotStopd id: Parameters Checked t0: [01:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Yes st: NotStopd
id: D5W 250.0ml + 25000Uhr Heparin t0: [01:00:00 22/11/2018] el: 1 ai: 117 cg: RN cu: CCU vo: 7 vu: ml id: D5W t0: [01:00:00 22/11/2018] el: 1 ai: 168 cg: RN cu: CCU vo: 10 vu: ml
id: IV Infusion In Total t0: [23:00:00 22/11/2018] el: 2 cg: RN cu: CCU cv: 523 ac: 24 ap: none re: 0 id: 24h Total In t0: [23:00:00 22/11/2018] el: 2 cg: RN cu: CCU cv: 1383 ac: 24 ap: none re: 0 id: 24h Net Body Balance t0: [23:00:00 22/11/2018] el: 2 cg: RN cu: CCU cv: 3 ac: 24 ap: carryForward re: 0 id: LOS Net Body Balance t0: [23:00:00 22/11/2018] el: 2 cg: RN cu: CCU cv: 1801.75 ac: multiple days ap: carryForward re: 0 id: Net Hourly Balance t0: [23:00:00 22/11/2018] el: 2 cg: RN cu: CCU cv: 0 ac: 1 ap: none re: 0
id: Pain Present t0: [04:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: No st: NotStopd id: Service Type t0: [02:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: CCU st: NotStopd id: Service Type t0: [03:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: CCU st: NotStopd id: Service Type t0: [04:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: CCU st: NotStopd id: Code Status t0: [02:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Full Code st: NotStopd id: Code Status t0: [03:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Full Code st: NotStopd id: Code Status t0: [04:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Full Code st: NotStopd id: Riker-SAS Scale t0: [04:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Calm/Cooperative st: NotStopd id: Daily Wake Up t0: [04:00:00 22/11/2018] el: 1 cg: RN cu: CCU v1: No/Not Sedated st: NotStopd id: GI Prophylaxis t0: [04:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Proton/Pump/Inhi st: NotStopd id: Risk for Falls t0: [02:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Yes st: NotStopd id: Risk for Falls t0: [03:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Yes st: NotStopd id: Risk for Falls t0: [04:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Yes st: NotStopd id: Diet Type t0: [04:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Soft Solid st: NotStopd id: Dorsal PedPulse R/L t0: [04:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Not Applicable st: NotStopd id: Ectopy Frequency t0: [02:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: None st: NotStopd id: Ectopy Frequency t0: [03:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: None st: NotStopd id: Ectopy Frequency t0: [04:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: None st: NotStopd id: Ectopy Type t0: [02:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: None st: NotStopd id: Ectopy Type t0: [03:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: None st: NotStopd id: Ectopy Type t0: [04:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: None st: NotStopd id: Alarms t0: [04:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: ON st: NotStopd id: Parameters Checked t0: [04:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Yes st: NotStopd id: Education Barrier t0: [04:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: None st: NotStopd id: Education Handout t0: [04:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Not Given st: NotStopd id: Education Learner t0: [04:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Patient st: NotStopd id: Education Method t0: [04:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Explanation st: NotStopd id: Education Readiness t0: [04:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Yes st: NotStopd id: Education Response t0: [04:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Understands st: NotStopd id: Education Topic #1 t0: [04:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Plan of Care st: NotStopd id: Education Topic #2 t0: [04:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Coping st: NotStopd id: Eye Opening t0: [04:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: 4 Spontaneously st: NotStopd id: GCS Total t0: [04:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: 15 n1: 15 u1: points st: NotStopd id: HOB t0: [01:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: 30 degrees st: NotStopd id: HOB t0: [03:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: 30 degrees st: NotStopd id: Heart Rate t0: [02:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: 75 n1: 75 u1: BPM st: NotStopd id: Heart Rate t0: [03:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: 68 n1: 68 u1: BPM st: NotStopd id: Heart Rate t0: [04:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: 68 n1: 68 u1: BPM st: NotStopd id: Heart Rhythm t0: [02:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Atrial Fib st: NotStopd id: Heart Rhythm t0: [03:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Atrial Fib st: NotStopd id: Heart Rhythm t0: [04:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Atrial Fib st: NotStopd id: Abdominal Assessment t0: [04:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Obese st: NotStopd id: IV #2 Insert Date t0: [04:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: 9 n1: 9 v2: 25 n2: 25 st: NotStopd id: IV #2 Site/Size t0: [04:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Right Wrist v2: 20 gauge st: NotStopd id: IV #3 Insert Date t0: [04:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: 9 n1: 9 v2: 27 n2: 27 st: NotStopd id: IV #3 Site/Size t0: [04:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Left Hand v2: 20 gauge st: NotStopd id: Activity t0: [01:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Bedrest st: NotStopd id: Activity t0: [03:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Bedrest st: NotStopd id: IV Site Appear #2 t0: [04:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: WNL st: NotStopd id: IV Site Appear #3 t0: [04:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: WNL st: NotStopd id: Activity Tolerance t0: [03:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Fair st: NotStopd id: ImpSkin Character #1 t0: [04:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Abrasion st: NotStopd id: ImpSkin Drain/Amt#1 t0: [04:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: None st: NotStopd id: ImpSkin Wound Base#1 t0: [04:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Pink st: NotStopd id: Impaired Skin Site#1 t0: [04:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Abdomen st: NotStopd id: LLL Lung Sounds t0: [04:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Diminished st: NotStopd id: LUL Lung Sounds t0: [04:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Clear st: NotStopd id: Level of Conscious t0: [04:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Sleeping st: NotStopd id: Angio Appearance #1 t0: [04:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Clean and Dry st: NotStopd id: Angio Appearance #2 t0: [04:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Clean and Dry st: NotStopd id: Motor Response t0: [04:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: 6 Obeys Commands st: NotStopd id: NBP t0: [02:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: 111 n1: 111 u1: mmHg v2: 56 n2: 56 u2: mmHg st: NotStopd id: NBP t0: [03:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: 111 n1: 111 u1: mmHg v2: 57 n2: 57 u2: mmHg st: NotStopd id: NBP t0: [04:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: 111 n1: 111 u1: mmHg v2: 57 n2: 57 u2: mmHg st: NotStopd id: NBP Mean t0: [02:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: 74.3333 n1: 74.3333 u1: mmHg st: NotStopd id: NBP Mean t0: [03:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: 75 n1: 75 u1: mmHg st: NotStopd id: NBP Mean t0: [04:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: 75 n1: 75 u1: mmHg st: NotStopd id: O2 Delivery Device t0: [03:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Nasal Cannula st: NotStopd id: O2 Flow (lpm) t0: [03:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: 2 n1: 2 u1: lpm st: NotStopd id: Oral Cavity t0: [04:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Teeth/Tissue WNL st: NotStopd id: Orientation t0: [04:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Oriented x 3 st: NotStopd id: Angio Site #1 t0: [04:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: R Femoral st: NotStopd id: Angio Site #2 t0: [04:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: L Femoral st: NotStopd id: AntiEmbDevice/Status t0: [03:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Compress Sleeves st: NotStopd id: Pain Location t0: [04:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Not Indicated st: NotStopd id: Pain Type t0: [04:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: None st: NotStopd id: PostTib. Pulses R/L t0: [04:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Not Applicable st: NotStopd id: Precautions t0: [02:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Contact st: NotStopd id: Precautions t0: [03:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Contact st: NotStopd id: Precautions t0: [04:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Contact st: NotStopd id: ABP Alarm (Lo/Hi) t0: [02:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: 85 n1: 85 u1: mmHg v2: 145 n2: 145 u2: mmHg st: NotStopd id: ABP Alarm (Lo/Hi) t0: [03:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: 85 n1: 85 u1: mmHg v2: 145 n2: 145 u2: mmHg st: NotStopd id: ABP Alarm (Lo/Hi) t0: [04:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: 85 n1: 85 u1: mmHg v2: 145 n2: 145 u2: mmHg st: NotStopd id: HR Alarm (Lo/Hi) t0: [02:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: 60 n1: 60 u1: BPM v2: 125 n2: 125 u2: BPM st: NotStopd id: HR Alarm (Lo/Hi) t0: [03:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: 60 n1: 60 u1: BPM v2: 125 n2: 125 u2: BPM st: NotStopd id: HR Alarm (Lo/Hi) t0: [04:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: 60 n1: 60 u1: BPM v2: 125 n2: 125 u2: BPM st: NotStopd id: Resp Alarm (Lo/Hi) t0: [02:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: 8 n1: 8 u1: BPM v2: 40 n2: 40 u2: BPM st: NotStopd id: Resp Alarm (Lo/Hi) t0: [03:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: 8 n1: 8 u1: BPM v2: 40 n2: 40 u2: BPM st: NotStopd id: Resp Alarm (Lo/Hi) t0: [04:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: 8 n1: 8 u1: BPM v2: 40 n2: 40 u2: BPM st: NotStopd id: SpO2 Alarm (Lo/Hi) t0: [02:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: 90 n1: 90 u1: % v2: 100 n2: 100 u2: % st: NotStopd id: SpO2 Alarm (Lo/Hi) t0: [03:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: 90 n1: 90 u1: % v2: 100 n2: 100 u2: % st: NotStopd id: SpO2 Alarm (Lo/Hi) t0: [04:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: 90 n1: 90 u1: % v2: 100 n2: 100 u2: % st: NotStopd id: RLL Lung Sounds t0: [04:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Diminished st: NotStopd id: RUL Lung Sounds t0: [04:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Clear st: NotStopd id: Respiratory Pattern t0: [04:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Regular st: NotStopd id: Respiratory Rate t0: [02:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: 26 n1: 26 u1: BPM st: NotStopd id: Respiratory Rate t0: [03:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: 33 n1: 33 u1: BPM st: NotStopd id: Respiratory Rate t0: [04:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: 32 n1: 32 u1: BPM st: NotStopd id: Side Rails t0: [04:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: All rails up st: NotStopd id: Skin Care t0: [03:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Done st: NotStopd id: Skin Integrity t0: [04:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Impaired st: NotStopd id: SpO2 t0: [02:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: 97 n1: 97 u1: % st: NotStopd id: SpO2 t0: [03:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: 97 n1: 97 u1: % st: NotStopd id: Support Systems t0: [04:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Children st: NotStopd id: Therapeutic Bed t0: [01:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: AtmosAir Mattres st: NotStopd id: Therapeutic Bed t0: [03:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: AtmosAir Mattres st: NotStopd id: Turn t0: [01:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Logroll st: NotStopd id: Turn t0: [03:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Logroll st: NotStopd id: Urine Color/Appear t0: [04:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Yellow v2: Clear st: NotStopd id: Urine Source t0: [04:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Indwelling Cath st: NotStopd id: Verbal Response t0: [04:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: 5 Oriented st: NotStopd id: Back Care t0: [03:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Done st: NotStopd id: calprevflg t0: [02:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: 1 n1: 1 u1: kg st: NotStopd id: calprevflg t0: [03:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: 1 n1: 1 u1: kg st: NotStopd id: calprevflg t0: [04:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: 1 n1: 1 u1: kg st: NotStopd id: Bowel Sounds t0: [04:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Present st: NotStopd
id: D5W 100.0ml t0: [04:00:00 22/11/2018] el: 1 ai: 105 cg: RN cu: CCU vo: 100 vu: ml id: D5W 250.0ml + 25000Uhr Heparin t0: [02:00:00 22/11/2018] el: 1 ai: 117 cg: RN cu: CCU vo: 7 vu: ml id: D5W 250.0ml + 25000Uhr Heparin t0: [03:00:00 22/11/2018] el: 1 ai: 117 cg: RN cu: CCU vo: 7 vu: ml id: D5W 250.0ml + 25000Uhr Heparin t0: [04:00:00 22/11/2018] el: 1 ai: 117 cg: RN cu: CCU vo: 7 vu: ml id: D5W t0: [02:00:00 22/11/2018] el: 1 ai: 168 cg: RN cu: CCU vo: 10 vu: ml id: D5W t0: [03:00:00 22/11/2018] el: 1 ai: 168 cg: RN cu: CCU vo: 10 vu: ml id: D5W t0: [04:00:00 22/11/2018] el: 1 ai: 168 cg: RN cu: CCU vo: 10 vu: ml
id: Heparin t0: [02:00:00 22/11/2018] el: 1 cg: RN cu: CCU vo: 0 do: 700 du: Uhr so: D5W sv: 250 su: ml rt: IV Drip id: Heparin t0: [03:00:00 22/11/2018] el: 1 cg: RN cu: CCU vo: 0 do: 700 du: Uhr so: D5W sv: 250 su: ml rt: IV Drip id: Heparin t0: [04:00:00 22/11/2018] el: 1 cg: RN cu: CCU vo: 0 do: 700 du: Uhr so: D5W sv: 250 su: ml rt: IV Drip
id: Urine Out Foley t0: [02:00:00 22/11/2018] el: 1 cg: RN cu: CCU vo: 40 vu: ml id: Urine Out Foley t0: [04:00:00 22/11/2018] el: 1 cg: RN cu: CCU vo: 40 vu: ml
id: Service Type t0: [05:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: CCU st: NotStopd id: Code Status t0: [05:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Full Code st: NotStopd id: Risk for Falls t0: [05:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Yes st: NotStopd id: Ectopy Frequency t0: [05:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: None st: NotStopd id: Ectopy Type t0: [05:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: None st: NotStopd id: HOB t0: [06:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: 30 degrees st: NotStopd id: Heart Rate t0: [05:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: 79 n1: 79 u1: BPM st: NotStopd id: Heart Rhythm t0: [05:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Atrial Fib st: NotStopd id: Activity t0: [06:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Bedrest st: NotStopd id: Activity Tolerance t0: [06:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Tolerated Well st: NotStopd id: ImpSkin Treatment #1 t0: [04:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Aquaphor st: NotStopd id: LLE Temp/Color t0: [04:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Warm v2: Normal st: NotStopd id: LLE Temp/Color t0: [22:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Warm v2: Normal st: NotStopd id: LUE Temp/Color t0: [04:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Cool v2: Normal st: NotStopd id: LUE Temp/Color t0: [22:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Cool v2: Normal st: NotStopd id: NBP t0: [05:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: 122 n1: 122 u1: mmHg v2: 54 n2: 54 u2: mmHg st: NotStopd id: NBP Mean t0: [05:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: 76.6667 n1: 76.6667 u1: mmHg st: NotStopd id: O2 Delivery Device t0: [05:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Nasal Cannula st: NotStopd id: O2 Flow (lpm) t0: [05:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: 2 n1: 2 u1: lpm st: NotStopd id: Position t0: [01:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Left Side st: NotStopd id: Position t0: [03:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Supine st: NotStopd id: Position t0: [06:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Right Side st: NotStopd id: Assistance Device t0: [01:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: 2 Person Assist st: NotStopd id: Assistance Device t0: [03:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: 1 Person Assist st: NotStopd id: Assistance Device t0: [06:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: 2 Person Assist st: NotStopd id: Precautions t0: [05:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Contact st: NotStopd id: ABP Alarm (Lo/Hi) t0: [05:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: 85 n1: 85 u1: mmHg v2: 145 n2: 145 u2: mmHg st: NotStopd id: HR Alarm (Lo/Hi) t0: [05:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: 60 n1: 60 u1: BPM v2: 125 n2: 125 u2: BPM st: NotStopd id: Resp Alarm (Lo/Hi) t0: [05:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: 8 n1: 8 u1: BPM v2: 40 n2: 40 u2: BPM st: NotStopd id: SpO2 Alarm (Lo/Hi) t0: [05:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: 90 n1: 90 u1: % v2: 100 n2: 100 u2: % st: NotStopd id: RUE Temp/Color t0: [04:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Cool v2: Normal st: NotStopd id: RUE Temp/Color t0: [22:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Cool v2: Normal st: NotStopd id: Respiratory Rate t0: [05:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: 18 n1: 18 u1: BPM st: NotStopd id: Restraint Location t0: [04:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: None st: NotStopd id: Skin Care t0: [06:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Done st: NotStopd id: SpO2 t0: [05:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: 98 n1: 98 u1: % st: NotStopd id: Stool Guaiac t0: [05:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Positive st: NotStopd id: Temp. Site t0: [05:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Oral st: NotStopd id: Temperature C (calc) t0: [00:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: 36.2222 n1: 36.2222 u1: Deg. C st: NotStopd id: Temperature C (calc) t0: [05:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: 36.1111 n1: 36.1111 u1: Deg. C st: NotStopd id: Temperature F t0: [00:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: 97.2 n1: 97.2 u1: Deg. F st: NotStopd id: Temperature F t0: [05:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: 97 n1: 97 u1: Deg. F st: NotStopd id: Therapeutic Bed t0: [06:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: AtmosAir Mattres st: NotStopd id: Turn t0: [06:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Logroll st: NotStopd id: Back Care t0: [06:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Done st: NotStopd id: calprevflg t0: [05:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: 1 n1: 1 u1: kg st: NotStopd id: Fingerstick Glucose t0: [05:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: 118 n1: 118 rs: Manual st: NotStopd id: Braden Activity t0: [04:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Bedfast st: NotStopd id: Braden Activity t0: [22:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Bedfast st: NotStopd id: Braden Frict/Shear t0: [04:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Potential Prob st: NotStopd id: Braden Frict/Shear t0: [22:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Potential Prob st: NotStopd id: Braden Mobility t0: [04:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Very Limited st: NotStopd id: Braden Mobility t0: [22:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Very Limited st: NotStopd id: Braden Moisture t0: [04:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Occ. Moist st: NotStopd id: Braden Moisture t0: [22:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Occ. Moist st: NotStopd id: Braden Nutrition t0: [04:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Adequate st: NotStopd id: Braden Nutrition t0: [22:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: Adequate st: NotStopd id: Braden Score t0: [04:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: 15 n1: 15 u1: number st: NotStopd id: Braden Score t0: [22:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: 15 n1: 15 u1: number st: NotStopd id: Braden SensoryPercep t0: [04:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: No Impairment st: NotStopd id: Braden SensoryPercep t0: [22:00:00 21/11/2018] el: 0 cg: RN cu: CCU v1: No Impairment st: NotStopd
id: Po Intake t0: [05:00:00 22/11/2018] el: 1 ai: 103 cg: RN cu: CCU vo: 60 vu: ml id: D5W 250.0ml + 25000Uhr Heparin t0: [05:00:00 22/11/2018] el: 1 ai: 117 cg: RN cu: CCU vo: 7 vu: ml id: D5W t0: [05:00:00 22/11/2018] el: 1 ai: 168 cg: RN cu: CCU vo: 10 vu: ml id: Stool Out Stool t0: [05:00:00 22/11/2018] el: 1 cg: RN cu: CCU vu: ml es: Small
id: Heparin t0: [05:00:00 22/11/2018] el: 1 cg: RN cu: CCU vo: 0 do: 700 du: Uhr so: D5W sv: 250 su: ml rt: IV Drip
id: Stool Out Total t0: [23:00:00 22/11/2018] el: 2 cg: RN cu: -1 cv: 0 ac: 24 ap: carryForward re: 0
id: WBC (4-11,000) t0: [05:32:00 22/11/2018] el: 0 cg: 1663 cu: CCU v1: 6.3 n1: 6.3 rs: Final st: NotStopd id: WBC t0: [05:32:00 22/11/2018] el: 0 cg: 1663 cu: CCU v1: 6.3 n1: 6.3 rs: Final st: NotStopd id: Hematocrit t0: [05:32:00 22/11/2018] el: 0 cg: 1663 cu: CCU v1: 35.6 n1: 35.6 u1: % rs: Final st: NotStopd id: Hemoglobin t0: [05:32:00 22/11/2018] el: 0 cg: 1663 cu: CCU v1: 12.1 n1: 12.1 u1: gm/dl rs: Final st: NotStopd id: Platelets t0: [05:32:00 22/11/2018] el: 0 cg: 1663 cu: CCU v1: 184 n1: 184 rs: Final st: NotStopd id: RBC t0: [05:32:00 22/11/2018] el: 0 cg: 1663 cu: CCU v1: 4.26 n1: 4.26 u1: /mic l rs: Final st: NotStopd id: WBC (4-11,000) t0: [05:32:00 22/11/2018] el: 0 cg: 1663 cu: CCU v1: 6.3 n1: 6.3 rs: Final st: NotStopd
id: BUN t0: [05:32:00 22/11/2018] el: 0 cg: 1663 cu: CCU v1: 9 n1: 9 rs: Final st: NotStopd id: PT t0: [05:32:00 22/11/2018] el: 0 cg: 1663 cu: CCU v1: 31.2 n1: 31.2 rs: Final st: NotStopd id: Calcium t0: [05:32:00 22/11/2018] el: 0 cg: 1663 cu: CCU v1: 8.7 n1: 8.7 u1: mg/dl rs: Final st: NotStopd id: Chloride t0: [05:32:00 22/11/2018] el: 0 cg: 1663 cu: CCU v1: 100 n1: 100 rs: Final st: NotStopd id: Creatinine t0: [05:32:00 22/11/2018] el: 0 cg: 1663 cu: CCU v1: 0.8 n1: 0.8 rs: Final st: NotStopd id: Glucose t0: [05:32:00 22/11/2018] el: 0 cg: 1663 cu: CCU v1: 139 n1: 139 rs: Final st: NotStopd id: INR t0: [05:32:00 22/11/2018] el: 0 cg: 1663 cu: CCU v1: 3.3 n1: 3.3 rs: Final st: NotStopd id: Magnesium t0: [05:32:00 22/11/2018] el: 0 cg: 1663 cu: CCU v1: 2.2 n1: 2.2 rs: Final st: NotStopd id: PTT t0: [05:32:00 22/11/2018] el: 0 cg: 1663 cu: CCU v1: 78.6 n1: 78.6 rs: Final st: NotStopd id: Phosphorous t0: [05:32:00 22/11/2018] el: 0 cg: 1663 cu: CCU v1: 3 n1: 3 u1: mEq/L rs: Final st: NotStopd id: Potassium t0: [05:32:00 22/11/2018] el: 0 cg: 1663 cu: CCU v1: 3.7 n1: 3.7 rs: Final st: NotStopd id: Sodium t0: [05:32:00 22/11/2018] el: 0 cg: 1663 cu: CCU v1: 139 n1: 139 rs: Final st: NotStopd id: BUN (6-20) t0: [05:32:00 22/11/2018] el: 0 cg: 1663 cu: CCU v1: 9 n1: 9 rs: Final st: NotStopd id: Calcium (8.4-10.2) t0: [05:32:00 22/11/2018] el: 0 cg: 1663 cu: CCU v1: 8.7 n1: 8.7 u1: mg/dl rs: Final st: NotStopd id: Carbon Dioxide t0: [05:32:00 22/11/2018] el: 0 cg: 1663 cu: CCU v1: 34 n1: 34 rs: Final st: NotStopd id: Chloride (100-112) t0: [05:32:00 22/11/2018] el: 0 cg: 1663 cu: CCU v1: 100 n1: 100 rs: Final st: NotStopd id: Creatinine (0-1.3) t0: [05:32:00 22/11/2018] el: 0 cg: 1663 cu: CCU v1: 0.8 n1: 0.8 rs: Final st: NotStopd id: Glucose (70-105) t0: [05:32:00 22/11/2018] el: 0 cg: 1663 cu: CCU v1: 139 n1: 139 rs: Final st: NotStopd id: INR (2-4 ref. range) t0: [05:32:00 22/11/2018] el: 0 cg: 1663 cu: CCU v1: 3.3 n1: 3.3 rs: Final st: NotStopd id: Magnesium (1.6-2.6) t0: [05:32:00 22/11/2018] el: 0 cg: 1663 cu: CCU v1: 2.2 n1: 2.2 rs: Final st: NotStopd id: PT(11-13.5) t0: [05:32:00 22/11/2018] el: 0 cg: 1663 cu: CCU v1: 31.2 n1: 31.2 rs: Final st: NotStopd id: PTT(22-35) t0: [05:32:00 22/11/2018] el: 0 cg: 1663 cu: CCU v1: 78.6 n1: 78.6 rs: Final st: NotStopd id: Phosphorous(2.7-4.5) t0: [05:32:00 22/11/2018] el: 0 cg: 1663 cu: CCU v1: 3 n1: 3 u1: mEq/L rs: Final st: NotStopd id: Potassium (3.5-5.3) t0: [05:32:00 22/11/2018] el: 0 cg: 1663 cu: CCU v1: 3.7 n1: 3.7 rs: Final st: NotStopd id: Sodium (135-148) t0: [05:32:00 22/11/2018] el: 0 cg: 1663 cu: CCU v1: 139 n1: 139 rs: Final st: NotStopd
id: Service Type t0: [06:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: CCU st: NotStopd id: Code Status t0: [06:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Full Code st: NotStopd id: Risk for Falls t0: [06:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Yes st: NotStopd id: Ectopy Frequency t0: [06:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: None st: NotStopd id: Ectopy Type t0: [06:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: None st: NotStopd id: Heart Rate t0: [06:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: 75 n1: 75 u1: BPM st: NotStopd id: Heart Rhythm t0: [06:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Atrial Fib st: NotStopd id: NBP t0: [06:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: 111 n1: 111 u1: mmHg v2: 46 n2: 46 u2: mmHg st: NotStopd id: NBP Mean t0: [06:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: 67.6667 n1: 67.6667 u1: mmHg st: NotStopd id: Precautions t0: [06:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Contact st: NotStopd id: ABP Alarm (Lo/Hi) t0: [06:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: 85 n1: 85 u1: mmHg v2: 145 n2: 145 u2: mmHg st: NotStopd id: HR Alarm (Lo/Hi) t0: [06:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: 60 n1: 60 u1: BPM v2: 125 n2: 125 u2: BPM st: NotStopd id: Resp Alarm (Lo/Hi) t0: [06:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: 8 n1: 8 u1: BPM v2: 40 n2: 40 u2: BPM st: NotStopd id: SpO2 Alarm (Lo/Hi) t0: [06:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: 90 n1: 90 u1: % v2: 100 n2: 100 u2: % st: NotStopd id: Respiratory Rate t0: [06:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: 28 n1: 28 u1: BPM st: NotStopd id: SpO2 t0: [06:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: 99 n1: 99 u1: % st: NotStopd id: calprevflg t0: [06:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: 1 n1: 1 u1: kg st: NotStopd
id: D5W 250.0ml + 25000Uhr Heparin t0: [06:00:00 22/11/2018] el: 1 ai: 117 cg: RN cu: CCU vo: 7 vu: ml id: D5W t0: [06:00:00 22/11/2018] el: 1 ai: 168 cg: RN cu: CCU vo: 10 vu: ml
id: Heparin t0: [06:00:00 22/11/2018] el: 1 cg: RN cu: CCU vo: 0 do: 700 du: Uhr so: D5W sv: 250 su: ml rt: IV Drip
pi: 4080525 hi: 10161 t0: [22:00:00 22/11/2018] tf: [11:00:00 23/11/2018] mn: Simvastatin pt: Unit Dose st: Discontinued rt: PO fr: QHS ds: 22 dn: 1 di: Ongoing xv: 36 xu: Hours pi: 4080530 hi: 10161 t0: [08:00:00 22/11/2018] tf: [07:00:00 23/11/2018] mn: Potassium Chloride pt: Unit Dose st: Expired rt: PO fr: ONCE ds: 8 dn: 1 dt: 1 di: Doses xv: 36 xu: Hours pi: 4080531 hi: 10161 t0: [08:00:00 22/11/2018] tf: [07:00:00 23/11/2018] mn: Potassium Chloride pt: Unit Dose st: Expired rt: PO fr: ONCE ds: 8 dn: 1 dt: 1 di: Doses xv: 36 xu: Hours pi: 4080532 hi: 10161 t0: [10:00:00 22/11/2018] tf: [11:00:00 23/11/2018] mn: Warfarin pt: Unit Dose st: Discontinued rt: PO fr: DAILY ds: 10 dn: 1 di: Ongoing xv: 36 xu: Hours
id: Pain Level t0: [07:30:00 22/11/2018] el: 0 cg: RN cu: CCU v1: 8-Severe st: NotStopd id: Pain Level t0: [08:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: 10-Worst st: NotStopd id: Pain Present t0: [07:30:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Yes st: NotStopd id: Pain Present t0: [08:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Yes st: NotStopd id: Pain Assess Method t0: [07:30:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Pt Verbalized st: NotStopd id: Pain Assess Method t0: [08:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Pt Verbalized st: NotStopd id: PainLevel Acceptable t0: [07:30:00 22/11/2018] el: 0 cg: RN cu: CCU v1: No st: NotStopd id: PainLevel Acceptable t0: [08:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: No st: NotStopd id: Service Type t0: [07:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: CCU st: NotStopd id: Service Type t0: [08:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: CCU st: NotStopd id: Code Status t0: [07:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Full Code st: NotStopd id: Code Status t0: [08:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Full Code st: NotStopd id: Riker-SAS Scale t0: [07:30:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Calm/Cooperative st: NotStopd id: Riker-SAS Scale t0: [08:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Calm/Cooperative st: NotStopd id: Daily Wake Up t0: [07:30:00 22/11/2018] el: 1 cg: RN cu: CCU v1: No/Not Sedated st: NotStopd id: Daily Wake Up t0: [08:00:00 22/11/2018] el: 1 cg: RN cu: CCU v1: No/Not Sedated st: NotStopd id: GI Prophylaxis t0: [08:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Proton/Pump/Inhi st: NotStopd id: Risk for Falls t0: [07:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Yes st: NotStopd id: Risk for Falls t0: [08:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Yes st: NotStopd id: Diet Type t0: [08:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Soft Solid st: NotStopd id: Ectopy Frequency t0: [07:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: None st: NotStopd id: Ectopy Frequency t0: [08:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: None st: NotStopd id: Ectopy Type t0: [07:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: None st: NotStopd id: Ectopy Type t0: [08:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: None st: NotStopd id: Alarms t0: [08:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: ON st: NotStopd id: Parameters Checked t0: [08:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Yes st: NotStopd id: Education Barrier t0: [08:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Anxiety st: NotStopd id: Education Handout t0: [08:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Not Applicable st: NotStopd id: Education Learner t0: [08:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Patient st: NotStopd id: Education Method t0: [08:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Explanation st: NotStopd id: Education Readiness t0: [08:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Yes st: NotStopd id: Education Response t0: [08:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Reinforced st: NotStopd id: Education Topic #1 t0: [08:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Coping st: NotStopd id: Education Topic #2 t0: [08:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Medications st: NotStopd id: Eye Opening t0: [08:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: 4 Spontaneously st: NotStopd id: GCS Total t0: [08:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: 15 n1: 15 u1: points st: NotStopd id: HOB t0: [08:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: 30 degrees st: NotStopd id: Heart Rate t0: [07:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: 81 n1: 81 u1: BPM st: NotStopd id: Heart Rate t0: [08:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: 83 n1: 83 u1: BPM st: NotStopd id: Heart Rhythm t0: [07:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Atrial Fib st: NotStopd id: Heart Rhythm t0: [08:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Atrial Fib st: NotStopd id: Abdominal Assessment t0: [08:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Obese st: NotStopd id: IV #3 Insert Date t0: [08:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: 9 n1: 9 v2: 27 n2: 27 st: NotStopd id: IV #3 Site/Size t0: [08:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Left Hand v2: 20 gauge st: NotStopd id: Activity t0: [08:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Bedrest st: NotStopd id: IV Site Appear #3 t0: [08:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: WNL st: NotStopd id: Activity Tolerance t0: [08:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Good st: NotStopd id: Impaired Skin Site#1 t0: [08:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Abdomen st: NotStopd id: LLE Temp/Color t0: [08:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Warm v2: Normal st: NotStopd id: LLL Lung Sounds t0: [08:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Diminished st: NotStopd id: LUE Temp/Color t0: [08:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Cool v2: Normal st: NotStopd id: LUL Lung Sounds t0: [08:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Clear st: NotStopd id: Level of Conscious t0: [08:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Alert st: NotStopd id: Motor Response t0: [08:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: 6 Obeys Commands st: NotStopd id: NBP t0: [07:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: 93 n1: 93 u1: mmHg v2: 38 n2: 38 u2: mmHg st: NotStopd id: NBP t0: [08:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: 131 n1: 131 u1: mmHg v2: 54 n2: 54 u2: mmHg st: NotStopd id: NBP Mean t0: [07:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: 56.3333 n1: 56.3333 u1: mmHg st: NotStopd id: NBP Mean t0: [08:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: 79.6667 n1: 79.6667 u1: mmHg st: NotStopd id: O2 Delivery Device t0: [08:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Nasal Cannula st: NotStopd id: O2 Flow (lpm) t0: [08:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: 2 n1: 2 u1: lpm st: NotStopd id: Oral Cavity t0: [08:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Dentures st: NotStopd id: Orientation t0: [08:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Oriented x 3 st: NotStopd id: Angio Site #1 t0: [08:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: R Femoral st: NotStopd id: Angio Site #2 t0: [08:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: L Femoral st: NotStopd id: AntiEmbDevice/Status t0: [08:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: None/Remarks st: NotStopd id: Pain Cause t0: [08:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Situational st: NotStopd id: Pain Level (Rest) t0: [07:30:00 22/11/2018] el: 0 cg: RN cu: CCU v1: 8-Severe st: NotStopd id: Pain Level (Rest) t0: [08:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: 10-Worst st: NotStopd id: Pain Location t0: [07:30:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Left Leg st: NotStopd id: Pain Location t0: [08:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Left Leg st: NotStopd id: Pain Type t0: [07:30:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Sharp st: NotStopd id: Pain Type t0: [08:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Sharp st: NotStopd id: Position t0: [08:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Supine st: NotStopd id: Assistance Device t0: [08:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: 1 Person Assist st: NotStopd id: Precautions t0: [07:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Contact st: NotStopd id: Precautions t0: [08:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Contact st: NotStopd id: ABP Alarm (Lo/Hi) t0: [07:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: 85 n1: 85 u1: mmHg v2: 145 n2: 145 u2: mmHg st: NotStopd id: ABP Alarm (Lo/Hi) t0: [08:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: 85 n1: 85 u1: mmHg v2: 145 n2: 145 u2: mmHg st: NotStopd id: HR Alarm (Lo/Hi) t0: [07:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: 60 n1: 60 u1: BPM v2: 125 n2: 125 u2: BPM st: NotStopd id: HR Alarm (Lo/Hi) t0: [08:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: 60 n1: 60 u1: BPM v2: 125 n2: 125 u2: BPM st: NotStopd id: Resp Alarm (Lo/Hi) t0: [07:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: 8 n1: 8 u1: BPM v2: 40 n2: 40 u2: BPM st: NotStopd id: Resp Alarm (Lo/Hi) t0: [08:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: 8 n1: 8 u1: BPM v2: 40 n2: 40 u2: BPM st: NotStopd id: SpO2 Alarm (Lo/Hi) t0: [07:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: 90 n1: 90 u1: % v2: 100 n2: 100 u2: % st: NotStopd id: SpO2 Alarm (Lo/Hi) t0: [08:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: 90 n1: 90 u1: % v2: 100 n2: 100 u2: % st: NotStopd id: RLL Lung Sounds t0: [08:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Diminished st: NotStopd id: RUE Temp/Color t0: [08:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Cool v2: Normal st: NotStopd id: RUL Lung Sounds t0: [08:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Clear st: NotStopd id: Respiratory Pattern t0: [08:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Regular st: NotStopd id: Respiratory Rate t0: [07:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: 17 n1: 17 u1: BPM st: NotStopd id: Respiratory Rate t0: [08:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: 26 n1: 26 u1: BPM st: NotStopd id: Restraint Location t0: [08:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: None st: NotStopd id: Side Rails t0: [08:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: All rails up st: NotStopd id: Skin Integrity t0: [08:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Impaired st: NotStopd id: SpO2 t0: [08:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: 94 n1: 94 u1: % st: NotStopd id: Stool Guaiac t0: [08:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Not Applicable st: NotStopd id: Support Systems t0: [08:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Children st: NotStopd id: Temp. Site t0: [08:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Oral st: NotStopd id: Temperature C (calc) t0: [08:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: 36.6667 n1: 36.6667 u1: Deg. C st: NotStopd id: Temperature F t0: [08:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: 98 n1: 98 u1: Deg. F st: NotStopd id: Therapeutic Bed t0: [08:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: AtmosAir Mattres st: NotStopd id: Turn t0: [08:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Back st: NotStopd id: Urine Color/Appear t0: [08:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Amber v2: Clear st: NotStopd id: Urine Source t0: [08:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Indwelling Cath st: NotStopd id: Verbal Response t0: [08:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: 5 Oriented st: NotStopd id: calprevflg t0: [07:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: 1 n1: 1 u1: kg st: NotStopd id: calprevflg t0: [08:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: 1 n1: 1 u1: kg st: NotStopd id: Behavior t0: [08:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Appropriate st: NotStopd id: Bowel Sounds t0: [08:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Present st: NotStopd id: Braden Activity t0: [08:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Bedfast st: NotStopd id: Braden Frict/Shear t0: [08:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Potential Prob st: NotStopd id: Braden Mobility t0: [08:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Sl. Limited st: NotStopd id: Braden Moisture t0: [08:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Rarely Moist st: NotStopd id: Braden Nutrition t0: [08:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Adequate st: NotStopd id: Braden Score t0: [08:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: 16 n1: 16 u1: number st: NotStopd id: Braden SensoryPercep t0: [08:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Sl. Limited st: NotStopd
id: Po Intake t0: [08:00:00 22/11/2018] el: 1 ai: 103 cg: RN cu: CCU vo: 60 vu: ml id: D5W 250.0ml + 25000Uhr Heparin t0: [08:00:00 22/11/2018] el: 1 ai: 117 cg: RN cu: CCU vo: 14 vu: ml id: D5W t0: [08:00:00 22/11/2018] el: 1 ai: 168 cg: RN cu: CCU vo: 20 vu: ml id: Urine Out Foley t0: [08:00:00 22/11/2018] el: 1 cg: RN cu: CCU vo: 85 vu: ml
id: Heparin t0: [07:00:00 22/11/2018] el: 1 cg: RN cu: CCU vo: 0 do: 700 du: Uhr so: D5W sv: 250 su: ml rt: IV Drip id: Heparin t0: [08:00:00 22/11/2018] el: 1 cg: RN cu: CCU vo: 0 do: 700 du: Uhr so: D5W sv: 250 su: ml rt: IV Drip
id: Pain Level t0: [08:15:00 22/11/2018] el: 0 cg: RN cu: CCU v1: 10-Worst st: NotStopd id: Pain Present t0: [08:15:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Yes st: NotStopd id: Riker-SAS Scale t0: [08:15:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Calm/Cooperative st: NotStopd id: Daily Wake Up t0: [08:15:00 22/11/2018] el: 1 cg: RN cu: CCU v1: No/Not Sedated st: NotStopd id: Pain Cause t0: [08:15:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Situational st: NotStopd id: Pain Level (Rest) t0: [08:15:00 22/11/2018] el: 0 cg: RN cu: CCU v1: 10-Worst st: NotStopd id: Pain Location t0: [08:15:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Left Leg st: NotStopd id: Pain Type t0: [08:15:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Throbbing st: NotStopd
id: Po Intake t0: [08:30:00 22/11/2018] el: 1 ai: 103 cg: RN cu: CCU vo: 60 vu: ml
id: Pain Level t0: [09:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: 6-Mod to Severe st: NotStopd id: Pain Present t0: [09:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Yes st: NotStopd id: Pain Assess Method t0: [09:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Pt Verbalized st: NotStopd id: PainLevel Acceptable t0: [09:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Yes st: NotStopd id: Service Type t0: [09:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: CCU st: NotStopd id: Code Status t0: [09:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Full Code st: NotStopd id: Riker-SAS Scale t0: [09:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Calm/Cooperative st: NotStopd id: Daily Wake Up t0: [09:00:00 22/11/2018] el: 1 cg: RN cu: CCU v1: No/Not Sedated st: NotStopd id: Risk for Falls t0: [09:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Yes st: NotStopd id: Dorsal PedPulse R/L t0: [08:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Not Applicable v2: Doppler st: NotStopd id: Ectopy Frequency t0: [09:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: None st: NotStopd id: Ectopy Type t0: [09:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: None st: NotStopd id: Heart Rate t0: [09:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: 83 n1: 83 u1: BPM st: NotStopd id: Heart Rhythm t0: [09:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Atrial Fib st: NotStopd id: Pain Cause t0: [09:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Movement/Turning st: NotStopd id: Pain Level (Rest) t0: [09:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: 6-Mod to Severe st: NotStopd id: Pain Location t0: [09:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Left Leg st: NotStopd id: Pain Type t0: [09:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Sharp st: NotStopd id: PostTib. Pulses R/L t0: [08:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Not Applicable v2: Doppler st: NotStopd id: Precautions t0: [09:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Contact st: NotStopd id: ABP Alarm (Lo/Hi) t0: [09:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: 85 n1: 85 u1: mmHg v2: 145 n2: 145 u2: mmHg st: NotStopd id: HR Alarm (Lo/Hi) t0: [09:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: 60 n1: 60 u1: BPM v2: 125 n2: 125 u2: BPM st: NotStopd id: Resp Alarm (Lo/Hi) t0: [09:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: 8 n1: 8 u1: BPM v2: 40 n2: 40 u2: BPM st: NotStopd id: SpO2 Alarm (Lo/Hi) t0: [09:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: 90 n1: 90 u1: % v2: 100 n2: 100 u2: % st: NotStopd id: Respiratory Rate t0: [09:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: 20 n1: 20 u1: BPM st: NotStopd id: SpO2 t0: [09:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: 98 n1: 98 u1: % st: NotStopd id: calprevflg t0: [09:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: 1 n1: 1 u1: kg st: NotStopd
id: Po Intake t0: [09:00:00 22/11/2018] el: 1 ai: 103 cg: RN cu: CCU vo: 120 vu: ml id: D5W 250.0ml + 25000Uhr Heparin t0: [09:00:00 22/11/2018] el: 1 ai: 117 cg: RN cu: CCU vo: 7 vu: ml id: D5W t0: [09:00:00 22/11/2018] el: 1 ai: 168 cg: RN cu: CCU vo: 10 vu: ml id: Urine Out Foley t0: [09:00:00 22/11/2018] el: 1 cg: RN cu: CCU vo: 600 vu: ml
id: Heparin t0: [09:00:00 22/11/2018] el: 1 cg: RN cu: CCU vo: 0 do: 700 du: Uhr so: D5W sv: 250 su: ml rt: IV Drip
id: NBP t0: [09:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: 113 n1: 113 u1: mmHg v2: 91 n2: 91 u2: mmHg st: NotStopd id: NBP Mean t0: [09:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: 98.3333 n1: 98.3333 u1: mmHg st: NotStopd
id: ImpSkin Drain/Amt#1 t0: [10:00:00 22/11/2018] el: 0 cg: -1 cu: CCU st: D/C'd
pi: 4080847 hi: 10161 t0: [11:00:00 22/11/2018] tf: [10:00:00 23/11/2018] mn: Hydromorphone pt: Unit Dose st: Expired rt: IV fr: ONCE ds: 11 dn: 1 dt: 1 di: Doses xv: 36 xu: Hours pi: 4080888 hi: 10161 t0: [10:00:00 22/11/2018] tf: [10:00:00 22/11/2018] mn: Furosemide pt: Unit Dose st: Inactive (Due to a change order) rt: PO fr: DAILY ds: 10 dn: 1 di: Ongoing xv: 36 xu: Hours pi: 4080954 hi: 10161 t0: [10:00:00 22/11/2018] tf: [22:00:00 26/11/2018] mn: Aspirin EC pt: Unit Dose st: Discontinued via patient discharge rt: PO fr: DAILY ds: 10 dn: 1 di: Ongoing xv: 36 xu: Hours pi: 4080955 hi: 10161 t0: [20:00:00 22/11/2018] tf: [11:00:00 25/11/2018] mn: Furosemide pt: Unit Dose st: Inactive (Due to a change order) rt: PO fr: BID ds: 08, 20 dn: 2 di: Ongoing xv: 36 xu: Hours
id: Service Type t0: [10:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: CCU st: NotStopd id: Code Status t0: [10:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Full Code st: NotStopd id: Risk for Falls t0: [10:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Yes st: NotStopd id: Ectopy Frequency t0: [10:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: None st: NotStopd id: Ectopy Type t0: [10:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: None st: NotStopd id: Alarms t0: [10:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: ON st: NotStopd id: Parameters Checked t0: [10:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Yes st: NotStopd id: Eye Care t0: [10:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Done st: NotStopd id: HOB t0: [10:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: 30 degrees st: NotStopd id: Heart Rate t0: [10:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: 81 n1: 81 u1: BPM st: NotStopd id: Heart Rhythm t0: [10:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Atrial Fib st: NotStopd id: Activity t0: [10:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Bedrest st: NotStopd id: Activity Tolerance t0: [10:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Good st: NotStopd id: NBP t0: [10:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: 99 n1: 99 u1: mmHg v2: 45 n2: 45 u2: mmHg st: NotStopd id: NBP Mean t0: [10:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: 63 n1: 63 u1: mmHg st: NotStopd id: O2 Delivery Device t0: [10:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Nasal Cannula st: NotStopd id: O2 Flow (lpm) t0: [10:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: 2 n1: 2 u1: lpm st: NotStopd id: Oral Care t0: [10:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Done st: NotStopd id: AntiEmbDevice/Status t0: [10:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: None/Remarks st: NotStopd id: Position t0: [10:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Left Side st: NotStopd id: Assistance Device t0: [10:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: 2 Person Assist st: NotStopd id: Precautions t0: [10:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Contact st: NotStopd id: ABP Alarm (Lo/Hi) t0: [10:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: 85 n1: 85 u1: mmHg v2: 145 n2: 145 u2: mmHg st: NotStopd id: HR Alarm (Lo/Hi) t0: [10:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: 60 n1: 60 u1: BPM v2: 125 n2: 125 u2: BPM st: NotStopd id: Resp Alarm (Lo/Hi) t0: [10:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: 8 n1: 8 u1: BPM v2: 40 n2: 40 u2: BPM st: NotStopd id: SpO2 Alarm (Lo/Hi) t0: [10:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: 90 n1: 90 u1: % v2: 100 n2: 100 u2: % st: NotStopd id: Respiratory Rate t0: [10:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: 23 n1: 23 u1: BPM st: NotStopd id: Skin Care t0: [10:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Done st: NotStopd id: SpO2 t0: [10:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: 96 n1: 96 u1: % st: NotStopd id: Therapeutic Bed t0: [10:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: AtmosAir Mattres st: NotStopd id: Turn t0: [10:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Logroll st: NotStopd id: Back Care t0: [10:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Done st: NotStopd id: calprevflg t0: [10:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: 1 n1: 1 u1: kg st: NotStopd
id: D5W 250.0ml + 25000Uhr Heparin t0: [10:00:00 22/11/2018] el: 1 ai: 117 cg: RN cu: CCU vo: 7 vu: ml id: D5W t0: [10:00:00 22/11/2018] el: 1 ai: 168 cg: RN cu: CCU vo: 10 vu: ml
id: Heparin t0: [10:00:00 22/11/2018] el: 1 cg: RN cu: CCU vo: 0 do: 700 du: Uhr so: D5W sv: 250 su: ml rt: IV Drip
id: Angio Appearance #1 t0: [08:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Clean and Dry st: NotStopd id: Angio Appearance #2 t0: [08:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Clean and Dry st: NotStopd id: Behavior t0: [10:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Calm st: NotStopd
id: Po Intake t0: [10:00:00 22/11/2018] el: 1 ai: 103 cg: RN cu: CCU vo: 60 vu: ml id: Urine Out Foley t0: [10:00:00 22/11/2018] el: 1 cg: RN cu: CCU vo: 175 vu: ml
id: Angio Dressing #1 t0: [08:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: None st: NotStopd id: Angio Dressing #2 t0: [08:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Other/Remarks st: NotStopd
id: Service Type t0: [11:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: CCU st: NotStopd id: Code Status t0: [11:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Full Code st: NotStopd id: Risk for Falls t0: [11:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Yes st: NotStopd id: Ectopy Frequency t0: [11:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: None st: NotStopd id: Ectopy Type t0: [11:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: None st: NotStopd id: Heart Rate t0: [11:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: 64 n1: 64 u1: BPM st: NotStopd id: Heart Rhythm t0: [11:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Atrial Fib st: NotStopd id: IV #2 Insert Date t0: [10:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: 9 n1: 9 v2: 28 n2: 28 st: NotStopd id: IV #2 Site/Size t0: [10:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Right Wrist v2: 22 gauge st: NotStopd id: IV Site Appear #2 t0: [10:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: WNL st: NotStopd id: NBP t0: [11:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: 114 n1: 114 u1: mmHg v2: 51 n2: 51 u2: mmHg st: NotStopd id: NBP Mean t0: [11:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: 72 n1: 72 u1: mmHg st: NotStopd id: Precautions t0: [11:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Contact st: NotStopd id: ABP Alarm (Lo/Hi) t0: [11:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: 85 n1: 85 u1: mmHg v2: 145 n2: 145 u2: mmHg st: NotStopd id: HR Alarm (Lo/Hi) t0: [11:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: 60 n1: 60 u1: BPM v2: 125 n2: 125 u2: BPM st: NotStopd id: Resp Alarm (Lo/Hi) t0: [11:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: 8 n1: 8 u1: BPM v2: 40 n2: 40 u2: BPM st: NotStopd id: SpO2 Alarm (Lo/Hi) t0: [11:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: 90 n1: 90 u1: % v2: 100 n2: 100 u2: % st: NotStopd id: Respiratory Rate t0: [11:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: 34 n1: 34 u1: BPM st: NotStopd id: SpO2 t0: [11:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: 97 n1: 97 u1: % st: NotStopd id: calprevflg t0: [11:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: 1 n1: 1 u1: kg st: NotStopd
id: Po Intake t0: [11:00:00 22/11/2018] el: 1 ai: 103 cg: RN cu: CCU vo: 100 vu: ml id: D5W 250.0ml + 25000Uhr Heparin t0: [11:00:00 22/11/2018] el: 1 ai: 117 cg: RN cu: CCU vo: 7 vu: ml id: D5W t0: [11:00:00 22/11/2018] el: 1 ai: 168 cg: RN cu: CCU vo: 10 vu: ml
id: Heparin t0: [11:00:00 22/11/2018] el: 1 cg: RN cu: CCU vo: 0 do: 700 du: Uhr so: D5W sv: 250 su: ml rt: IV Drip
pi: 4081270 hi: 10161 t0: [13:00:00 22/11/2018] tf: [14:00:00 22/11/2018] mn: Hydromorphone pt: Unit Dose st: Inactive (Due to a change order) rt: IV fr: Q4-6H:PRN di: Ongoing xv: 36 xu: Hours pi: 4081271 hi: 10161 t0: [10:00:00 22/11/2018] tf: [14:00:00 22/11/2018] mn: Potassium Chloride pt: Unit Dose st: Inactive (Due to a change order) rt: PO fr: DAILY ds: 10 dn: 1 dt: 24 di: Hours xv: 36 xu: Hours
id: Pain Level t0: [12:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: 5-Moderate st: NotStopd id: Pain Present t0: [12:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Yes st: NotStopd id: Pain Assess Method t0: [12:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Pt Verbalized st: NotStopd id: PainLevel Acceptable t0: [12:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Yes st: NotStopd id: Service Type t0: [12:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: CCU st: NotStopd id: Code Status t0: [12:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Full Code st: NotStopd id: Riker-SAS Scale t0: [12:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Calm/Cooperative st: NotStopd id: Daily Wake Up t0: [12:00:00 22/11/2018] el: 1 cg: RN cu: CCU v1: No/Not Sedated st: NotStopd id: Risk for Falls t0: [12:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Yes st: NotStopd id: Diet Type t0: [12:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Soft Solid st: NotStopd id: Ectopy Frequency t0: [12:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: None st: NotStopd id: Ectopy Type t0: [12:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: None st: NotStopd id: Education Topic #1 t0: [12:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Coping st: NotStopd id: Eye Opening t0: [12:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: 4 Spontaneously st: NotStopd id: GCS Total t0: [12:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: 15 n1: 15 u1: points st: NotStopd id: HOB t0: [12:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: 30 degrees st: NotStopd id: Heart Rate t0: [12:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: 73 n1: 73 u1: BPM st: NotStopd id: Heart Rhythm t0: [12:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Atrial Fib st: NotStopd id: IV #2 Insert Date t0: [12:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: 9 n1: 9 v2: 28 n2: 28 st: NotStopd id: IV #2 Site/Size t0: [12:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Right Wrist v2: 22 gauge st: NotStopd id: IV #3 Insert Date t0: [12:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: 9 n1: 9 v2: 27 n2: 27 st: NotStopd id: IV #3 Site/Size t0: [12:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Left Hand v2: 20 gauge st: NotStopd id: Level of Conscious t0: [12:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Alert st: NotStopd id: Motor Response t0: [12:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: 6 Obeys Commands st: NotStopd id: NBP t0: [12:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: 142 n1: 142 u1: mmHg v2: 58 n2: 58 u2: mmHg st: NotStopd id: NBP Mean t0: [12:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: 86 n1: 86 u1: mmHg st: NotStopd id: O2 Delivery Device t0: [12:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Nasal Cannula st: NotStopd id: O2 Flow (lpm) t0: [12:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: 2 n1: 2 u1: lpm st: NotStopd id: Orientation t0: [12:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Oriented x 3 st: NotStopd id: Angio Site #1 t0: [12:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: R Femoral st: NotStopd id: Angio Site #2 t0: [12:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: L Femoral st: NotStopd id: Pain Cause t0: [12:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Movement/Turning st: NotStopd id: Pain Level (Rest) t0: [12:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: 5-Moderate st: NotStopd id: Pain Location t0: [12:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Left Leg st: NotStopd id: Pain Management t0: [12:00:00 22/11/2018] el: 1 cg: RN cu: CCU v1: PO Med v2: PO Med st: NotStopd id: Pain Type t0: [12:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Sharp st: NotStopd id: Precautions t0: [12:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Contact st: NotStopd id: ABP Alarm (Lo/Hi) t0: [12:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: 85 n1: 85 u1: mmHg v2: 145 n2: 145 u2: mmHg st: NotStopd id: HR Alarm (Lo/Hi) t0: [12:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: 60 n1: 60 u1: BPM v2: 125 n2: 125 u2: BPM st: NotStopd id: Resp Alarm (Lo/Hi) t0: [12:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: 8 n1: 8 u1: BPM v2: 40 n2: 40 u2: BPM st: NotStopd id: SpO2 Alarm (Lo/Hi) t0: [12:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: 90 n1: 90 u1: % v2: 100 n2: 100 u2: % st: NotStopd id: Respiratory Pattern t0: [12:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Regular st: NotStopd id: Respiratory Rate t0: [12:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: 25 n1: 25 u1: BPM st: NotStopd id: Side Rails t0: [12:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: All rails up st: NotStopd id: Skin Integrity t0: [12:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Impaired st: NotStopd id: SpO2 t0: [12:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: 96 n1: 96 u1: % st: NotStopd id: Support Systems t0: [12:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Children st: NotStopd id: Temp. Site t0: [12:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Oral st: NotStopd id: Temperature C (calc) t0: [12:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: 36.5 n1: 36.5 u1: Deg. C st: NotStopd id: Temperature F t0: [12:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: 97.7 n1: 97.7 u1: Deg. F st: NotStopd id: Urine Color/Appear t0: [12:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Light Yellow v2: Clear st: NotStopd id: Urine Source t0: [12:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Indwelling Cath st: NotStopd id: Verbal Response t0: [12:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: 5 Oriented st: NotStopd id: calprevflg t0: [12:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: 1 n1: 1 u1: kg st: NotStopd id: Behavior t0: [12:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Appropriate st: NotStopd
id: D5W 250.0ml + 25000Uhr Heparin t0: [12:00:00 22/11/2018] el: 1 ai: 117 cg: RN cu: CCU vo: 7 vu: ml id: D5W t0: [12:00:00 22/11/2018] el: 1 ai: 168 cg: RN cu: CCU vo: 10 vu: ml id: Urine Out Foley t0: [12:00:00 22/11/2018] el: 1 cg: RN cu: CCU vo: 200 vu: ml
id: Heparin t0: [12:00:00 22/11/2018] el: 1 cg: RN cu: CCU vo: 0 do: 700 du: Uhr so: D5W sv: 250 su: ml rt: IV Drip
id: Service Type t0: [13:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: CCU st: NotStopd id: Code Status t0: [13:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Full Code st: NotStopd id: Risk for Falls t0: [13:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Yes st: NotStopd id: Ectopy Frequency t0: [13:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: None st: NotStopd id: Ectopy Type t0: [13:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: None st: NotStopd id: Heart Rate t0: [13:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: 72 n1: 72 u1: BPM st: NotStopd id: Heart Rhythm t0: [13:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Atrial Fib st: NotStopd id: NBP t0: [13:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: 130 n1: 130 u1: mmHg v2: 36 n2: 36 u2: mmHg st: NotStopd id: NBP Mean t0: [13:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: 67.3333 n1: 67.3333 u1: mmHg st: NotStopd id: Precautions t0: [13:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Contact st: NotStopd id: ABP Alarm (Lo/Hi) t0: [13:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: 85 n1: 85 u1: mmHg v2: 145 n2: 145 u2: mmHg st: NotStopd id: HR Alarm (Lo/Hi) t0: [13:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: 60 n1: 60 u1: BPM v2: 125 n2: 125 u2: BPM st: NotStopd id: Resp Alarm (Lo/Hi) t0: [13:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: 8 n1: 8 u1: BPM v2: 40 n2: 40 u2: BPM st: NotStopd id: SpO2 Alarm (Lo/Hi) t0: [13:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: 90 n1: 90 u1: % v2: 100 n2: 100 u2: % st: NotStopd id: Respiratory Rate t0: [13:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: 28 n1: 28 u1: BPM st: NotStopd id: calprevflg t0: [13:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: 1 n1: 1 u1: kg st: NotStopd
id: D5W 100.0ml t0: [12:00:00 22/11/2018] el: 1 ai: 105 cg: RN cu: CCU vo: 100 vu: ml id: D5W 250.0ml + 25000Uhr Heparin t0: [13:00:00 22/11/2018] el: 1 ai: 117 cg: RN cu: CCU vo: 7 vu: ml id: D5W t0: [13:00:00 22/11/2018] el: 1 ai: 168 cg: RN cu: CCU vo: 10 vu: ml
id: Heparin t0: [13:00:00 22/11/2018] el: 1 cg: RN cu: CCU vo: 0 do: 700 du: Uhr so: D5W sv: 250 su: ml rt: IV Drip
id: Triglyceride t0: [05:32:00 22/11/2018] el: 0 cg: 1663 cu: CCU v1: 167 n1: 167 rs: Final st: NotStopd id: Triglyceride (0-200) t0: [05:32:00 22/11/2018] el: 0 cg: 1663 cu: CCU v1: 167 n1: 167 rs: Final st: NotStopd
pi: 4081536 hi: 10161 t0: [10:00:00 22/11/2018] tf: [22:00:00 26/11/2018] mn: Potassium Chloride pt: Unit Dose st: Discontinued via patient discharge rt: PO fr: DAILY ds: 10 dn: 1 di: Ongoing xv: 36 xu: Hours pi: 4081537 hi: 10161 t0: [10:00:00 22/11/2018] tf: [22:00:00 26/11/2018] mn: Potassium Chloride pt: Unit Dose st: Discontinued via patient discharge rt: PO fr: DAILY ds: 10 dn: 1 di: Ongoing xv: 36 xu: Hours pi: 4081538 hi: 10161 t0: [15:00:00 22/11/2018] tf: [11:00:00 25/11/2018] mn: Hydromorphone pt: Unit Dose st: Inactive (Due to a change order) rt: IV fr: Q2H:PRN di: Ongoing xv: 36 xu: Hours
id: Angio Appearance #1 t0: [15:00:00 22/11/2018] el: 0 cg: -1 cu: CCU st: D/C'd id: Angio Appearance #2 t0: [15:00:00 22/11/2018] el: 0 cg: -1 cu: CCU st: D/C'd id: Angio Dressing #1 t0: [15:00:00 22/11/2018] el: 0 cg: -1 cu: CCU st: D/C'd id: Angio Dressing #2 t0: [15:00:00 22/11/2018] el: 0 cg: -1 cu: CCU st: D/C'd id: Angio Site #1 t0: [15:00:00 22/11/2018] el: 0 cg: -1 cu: CCU st: D/C'd id: Angio Site #2 t0: [15:00:00 22/11/2018] el: 0 cg: -1 cu: CCU st: D/C'd
id: Pain Level t0: [15:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: 3-Mild to Mod st: NotStopd id: Pain Present t0: [15:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Yes st: NotStopd id: Pain Assess Method t0: [15:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Pt Verbalized st: NotStopd id: PainLevel Acceptable t0: [15:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Yes st: NotStopd id: Service Type t0: [14:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: CCU st: NotStopd id: Service Type t0: [15:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: CCU st: NotStopd id: Code Status t0: [14:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Full Code st: NotStopd id: Code Status t0: [15:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Full Code st: NotStopd id: Riker-SAS Scale t0: [15:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Calm/Cooperative st: NotStopd id: Daily Wake Up t0: [15:00:00 22/11/2018] el: 1 cg: RN cu: CCU v1: No/Not Sedated st: NotStopd id: GI Prophylaxis t0: [12:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Proton/Pump/Inhi st: NotStopd id: Risk for Falls t0: [14:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Yes st: NotStopd id: Risk for Falls t0: [15:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Yes st: NotStopd id: Dorsal PedPulse R/L t0: [12:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Not Applicable v2: Diff to Palpate st: NotStopd id: Ectopy Frequency t0: [14:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: None st: NotStopd id: Ectopy Frequency t0: [15:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: None st: NotStopd id: Ectopy Type t0: [14:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: None st: NotStopd id: Ectopy Type t0: [15:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: None st: NotStopd id: Alarms t0: [12:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: ON st: NotStopd id: Alarms t0: [14:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: ON st: NotStopd id: Parameters Checked t0: [12:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Yes st: NotStopd id: Parameters Checked t0: [14:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Yes st: NotStopd id: HOB t0: [13:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: 30 degrees st: NotStopd id: Heart Rate t0: [14:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: 68 n1: 68 u1: BPM st: NotStopd id: Heart Rate t0: [15:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: 64 n1: 64 u1: BPM st: NotStopd id: Heart Rhythm t0: [14:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Atrial Fib st: NotStopd id: Heart Rhythm t0: [15:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Atrial Fib st: NotStopd id: Abdominal Assessment t0: [12:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Obese st: NotStopd id: Activity t0: [13:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Bedrest st: NotStopd id: Activity Tolerance t0: [13:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Good st: NotStopd id: LLE Temp/Color t0: [12:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Warm v2: Normal st: NotStopd id: LLL Lung Sounds t0: [12:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Diminished st: NotStopd id: LUE Temp/Color t0: [12:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Cool v2: Normal st: NotStopd id: LUL Lung Sounds t0: [12:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Clear st: NotStopd id: Angio Appearance #1 t0: [12:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Clean and Dry st: NotStopd id: Angio Appearance #2 t0: [12:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Clean and Dry st: NotStopd id: NBP t0: [14:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: 115 n1: 115 u1: mmHg v2: 61 n2: 61 u2: mmHg st: NotStopd id: NBP t0: [15:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: 100 n1: 100 u1: mmHg v2: 52 n2: 52 u2: mmHg st: NotStopd id: NBP Mean t0: [14:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: 79 n1: 79 u1: mmHg st: NotStopd id: NBP Mean t0: [15:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: 68 n1: 68 u1: mmHg st: NotStopd id: O2 Delivery Device t0: [14:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Nasal Cannula st: NotStopd id: O2 Flow (lpm) t0: [14:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: 2 n1: 2 u1: lpm st: NotStopd id: Oral Cavity t0: [12:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Dentures st: NotStopd id: AntiEmbDevice/Status t0: [13:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: None/Remarks st: NotStopd id: Pain Cause t0: [15:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Movement/Turning st: NotStopd id: Pain Level (Rest) t0: [15:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: 3-Mild to Mod st: NotStopd id: Pain Location t0: [15:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Left Leg st: NotStopd id: Pain Management t0: [15:00:00 22/11/2018] el: 1 cg: RN cu: CCU v1: Repositioned st: NotStopd id: Pain Type t0: [15:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Sharp st: NotStopd id: Position t0: [13:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Supine st: NotStopd id: PostTib. Pulses R/L t0: [12:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Not Applicable v2: Doppler st: NotStopd id: Assistance Device t0: [13:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: 2 Person Assist st: NotStopd id: Precautions t0: [14:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Contact st: NotStopd id: Precautions t0: [15:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Contact st: NotStopd id: ABP Alarm (Lo/Hi) t0: [14:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: 85 n1: 85 u1: mmHg v2: 145 n2: 145 u2: mmHg st: NotStopd id: ABP Alarm (Lo/Hi) t0: [15:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: 85 n1: 85 u1: mmHg v2: 145 n2: 145 u2: mmHg st: NotStopd id: HR Alarm (Lo/Hi) t0: [14:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: 60 n1: 60 u1: BPM v2: 125 n2: 125 u2: BPM st: NotStopd id: HR Alarm (Lo/Hi) t0: [15:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: 60 n1: 60 u1: BPM v2: 125 n2: 125 u2: BPM st: NotStopd id: Resp Alarm (Lo/Hi) t0: [14:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: 8 n1: 8 u1: BPM v2: 40 n2: 40 u2: BPM st: NotStopd id: Resp Alarm (Lo/Hi) t0: [15:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: 8 n1: 8 u1: BPM v2: 40 n2: 40 u2: BPM st: NotStopd id: SpO2 Alarm (Lo/Hi) t0: [14:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: 90 n1: 90 u1: % v2: 100 n2: 100 u2: % st: NotStopd id: SpO2 Alarm (Lo/Hi) t0: [15:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: 90 n1: 90 u1: % v2: 100 n2: 100 u2: % st: NotStopd id: RLL Lung Sounds t0: [12:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Diminished st: NotStopd id: RUE Temp/Color t0: [12:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Cool v2: Normal st: NotStopd id: RUL Lung Sounds t0: [12:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Clear st: NotStopd id: Respiratory Rate t0: [14:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: 24 n1: 24 u1: BPM st: NotStopd id: Respiratory Rate t0: [15:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: 35 n1: 35 u1: BPM st: NotStopd id: SpO2 t0: [15:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: 93 n1: 93 u1: % st: NotStopd id: Stool Guaiac t0: [12:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Not Applicable st: NotStopd id: Therapeutic Bed t0: [13:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: AtmosAir Mattres st: NotStopd id: Turn t0: [13:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Side to Side st: NotStopd id: calprevflg t0: [14:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: 1 n1: 1 u1: kg st: NotStopd id: calprevflg t0: [15:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: 1 n1: 1 u1: kg st: NotStopd id: Behavior t0: [14:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Calm st: NotStopd id: Bowel Sounds t0: [12:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Present st: NotStopd id: Braden Activity t0: [12:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Bedfast st: NotStopd id: Braden Frict/Shear t0: [12:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Potential Prob st: NotStopd id: Braden Mobility t0: [12:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Sl. Limited st: NotStopd id: Braden Moisture t0: [12:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Rarely Moist st: NotStopd id: Braden Nutrition t0: [12:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Adequate st: NotStopd id: Braden Score t0: [12:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: 16 n1: 16 u1: number st: NotStopd id: Braden SensoryPercep t0: [12:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Sl. Limited st: NotStopd
id: Po Intake t0: [14:00:00 22/11/2018] el: 1 ai: 103 cg: RN cu: CCU vo: 200 vu: ml id: D5W 250.0ml + 25000Uhr Heparin t0: [14:00:00 22/11/2018] el: 1 ai: 117 cg: RN cu: CCU vo: 7 vu: ml id: D5W 250.0ml + 25000Uhr Heparin t0: [15:00:00 22/11/2018] el: 1 ai: 117 cg: RN cu: CCU vo: 7 vu: ml id: D5W t0: [14:00:00 22/11/2018] el: 1 ai: 168 cg: RN cu: CCU vo: 10 vu: ml id: D5W t0: [15:00:00 22/11/2018] el: 1 ai: 168 cg: RN cu: CCU vo: 10 vu: ml id: Urine Out Foley t0: [14:00:00 22/11/2018] el: 1 cg: RN cu: CCU vo: 80 vu: ml
id: Heparin t0: [14:00:00 22/11/2018] el: 1 cg: RN cu: CCU vo: 0 do: 700 du: Uhr so: D5W sv: 250 su: ml rt: IV Drip id: Heparin t0: [15:00:00 22/11/2018] el: 1 cg: RN cu: CCU vo: 0 do: 700 du: Uhr so: D5W sv: 250 su: ml rt: IV Drip
id: Pain Level t0: [15:45:00 22/11/2018] el: 0 cg: RN cu: CCU v1: 6-Mod to Severe st: NotStopd id: Pain Present t0: [15:45:00 22/11/2018] el: 0 cg: RN cu: CCU v1: No st: NotStopd id: Pain Assess Method t0: [15:45:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Pt Verbalized st: NotStopd id: PainLevel Acceptable t0: [15:45:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Yes st: NotStopd id: Service Type t0: [16:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: CCU st: NotStopd id: Code Status t0: [16:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Full Code st: NotStopd id: Riker-SAS Scale t0: [15:45:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Calm/Cooperative st: NotStopd id: Daily Wake Up t0: [15:45:00 22/11/2018] el: 1 cg: RN cu: CCU v1: No/Not Sedated st: NotStopd id: GI Prophylaxis t0: [16:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Proton/Pump/Inhi st: NotStopd id: Risk for Falls t0: [16:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Yes st: NotStopd id: Diet Type t0: [16:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Soft Solid st: NotStopd id: Dorsal PedPulse R/L t0: [16:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Not Applicable v2: Diff to Palpate st: NotStopd id: Ectopy Frequency t0: [16:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: None st: NotStopd id: Ectopy Type t0: [16:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: None st: NotStopd id: Alarms t0: [16:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: ON st: NotStopd id: Parameters Checked t0: [16:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Yes st: NotStopd id: Education Barrier t0: [16:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: None st: NotStopd id: Education Handout t0: [16:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Not Applicable st: NotStopd id: Education Learner t0: [16:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Patient st: NotStopd id: Education Method t0: [16:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Explanation st: NotStopd id: Education Readiness t0: [16:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Yes st: NotStopd id: Education Response t0: [16:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Reinforced st: NotStopd id: Education Topic #1 t0: [16:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Activity st: NotStopd id: Education Topic #2 t0: [16:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Plan of Care st: NotStopd id: Eye Opening t0: [16:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: 4 Spontaneously st: NotStopd id: GCS Total t0: [16:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: 15 n1: 15 u1: points st: NotStopd id: HOB t0: [16:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: 30 degrees st: NotStopd id: Heart Rate t0: [16:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: 62 n1: 62 u1: BPM st: NotStopd id: Heart Rhythm t0: [16:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Atrial Fib st: NotStopd id: Abdominal Assessment t0: [16:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Obese st: NotStopd id: IV #2 Insert Date t0: [16:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: 9 n1: 9 v2: 28 n2: 28 st: NotStopd id: IV #2 Site/Size t0: [16:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Right Wrist v2: 22 gauge st: NotStopd id: IV #3 Insert Date t0: [16:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: 9 n1: 9 v2: 27 n2: 27 st: NotStopd id: IV #3 Site/Size t0: [16:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Left Hand v2: 20 gauge st: NotStopd id: Activity t0: [16:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Bedrest st: NotStopd id: IV Site Appear #2 t0: [16:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: WNL st: NotStopd id: IV Site Appear #3 t0: [16:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: WNL st: NotStopd id: Activity Tolerance t0: [16:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Good st: NotStopd id: LLE Temp/Color t0: [16:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Warm v2: Normal st: NotStopd id: LLL Lung Sounds t0: [16:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Diminished st: NotStopd id: LUE Temp/Color t0: [16:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Warm v2: Normal st: NotStopd id: LUL Lung Sounds t0: [16:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Clear st: NotStopd id: Level of Conscious t0: [16:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Alert st: NotStopd id: Motor Response t0: [16:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: 6 Obeys Commands st: NotStopd id: NBP t0: [16:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: 115 n1: 115 u1: mmHg v2: 54 n2: 54 u2: mmHg st: NotStopd id: NBP Mean t0: [16:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: 74.3333 n1: 74.3333 u1: mmHg st: NotStopd id: O2 Delivery Device t0: [16:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Nasal Cannula st: NotStopd id: O2 Flow (lpm) t0: [16:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: 2 n1: 2 u1: lpm st: NotStopd id: Oral Cavity t0: [16:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Teeth/Tissue WNL st: NotStopd id: Orientation t0: [16:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Oriented x 3 st: NotStopd id: AntiEmbDevice/Status t0: [16:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: None/Remarks st: NotStopd id: Pain Cause t0: [15:45:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Movement/Turning st: NotStopd id: Pain Level (Rest) t0: [15:45:00 22/11/2018] el: 0 cg: RN cu: CCU v1: 6-Mod to Severe st: NotStopd id: Pain Location t0: [15:45:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Not Indicated st: NotStopd id: Pain Type t0: [15:45:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Sharp st: NotStopd id: Position t0: [16:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Right Side st: NotStopd id: PostTib. Pulses R/L t0: [16:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Not Applicable st: NotStopd id: Assistance Device t0: [16:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: 2 Person Assist st: NotStopd id: Precautions t0: [16:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Contact st: NotStopd id: ABP Alarm (Lo/Hi) t0: [16:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: 85 n1: 85 u1: mmHg v2: 145 n2: 145 u2: mmHg st: NotStopd id: HR Alarm (Lo/Hi) t0: [16:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: 60 n1: 60 u1: BPM v2: 125 n2: 125 u2: BPM st: NotStopd id: Resp Alarm (Lo/Hi) t0: [16:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: 8 n1: 8 u1: BPM v2: 40 n2: 40 u2: BPM st: NotStopd id: SpO2 Alarm (Lo/Hi) t0: [16:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: 90 n1: 90 u1: % v2: 100 n2: 100 u2: % st: NotStopd id: RLL Lung Sounds t0: [16:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Diminished st: NotStopd id: RUE Temp/Color t0: [16:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Warm v2: Normal st: NotStopd id: RUL Lung Sounds t0: [16:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Clear st: NotStopd id: Respiratory Pattern t0: [16:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Regular st: NotStopd id: Respiratory Rate t0: [16:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: 37 n1: 37 u1: BPM st: NotStopd id: Restraint Location t0: [12:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: None st: NotStopd id: Restraint Location t0: [16:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: None st: NotStopd id: Side Rails t0: [16:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: All rails up st: NotStopd id: Skin Care t0: [16:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Done st: NotStopd id: Skin Integrity t0: [16:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Impaired st: NotStopd id: SpO2 t0: [16:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: 97 n1: 97 u1: % st: NotStopd id: Stool Guaiac t0: [16:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Not Applicable st: NotStopd id: Support Systems t0: [16:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Children st: NotStopd id: Temp. Site t0: [16:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Oral st: NotStopd id: Temperature C (calc) t0: [16:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: 36.2222 n1: 36.2222 u1: Deg. C st: NotStopd id: Temperature F t0: [16:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: 97.2 n1: 97.2 u1: Deg. F st: NotStopd id: Therapeutic Bed t0: [16:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: AtmosAir Mattres st: NotStopd id: Turn t0: [16:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Side to Side st: NotStopd id: Urine Color/Appear t0: [16:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Yellow v2: Clear st: NotStopd id: Urine Source t0: [16:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Indwelling Cath st: NotStopd id: Verbal Response t0: [16:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: 5 Oriented st: NotStopd id: Back Care t0: [16:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Done st: NotStopd id: calprevflg t0: [16:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: 1 n1: 1 u1: kg st: NotStopd id: Behavior t0: [16:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Calm st: NotStopd id: Bowel Sounds t0: [16:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Present st: NotStopd id: Braden Activity t0: [16:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Bedfast st: NotStopd id: Braden Frict/Shear t0: [16:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Potential Prob st: NotStopd id: Braden Mobility t0: [16:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Sl. Limited st: NotStopd id: Braden Moisture t0: [16:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Rarely Moist st: NotStopd id: Braden Nutrition t0: [16:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Adequate st: NotStopd id: Braden Score t0: [16:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: 16 n1: 16 u1: number st: NotStopd id: Braden SensoryPercep t0: [16:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Sl. Limited st: NotStopd
id: D5W 250.0ml + 25000Uhr Heparin t0: [16:00:00 22/11/2018] el: 1 ai: 117 cg: RN cu: CCU vo: 7 vu: ml id: D5W t0: [16:00:00 22/11/2018] el: 1 ai: 168 cg: RN cu: CCU vo: 10 vu: ml
id: Heparin t0: [16:00:00 22/11/2018] el: 1 cg: RN cu: CCU vo: 0 do: 700 du: Uhr so: D5W sv: 250 su: ml rt: IV Drip
id: Imp Skin Cleanse #1 t0: [16:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Soap & H20 st: NotStopd id: ImpSkin Character #1 t0: [16:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Abrasion st: NotStopd id: ImpSkin Wound Base#1 t0: [16:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Red st: NotStopd id: ImpSkin Wth/Lth #1 t0: [16:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: 2 cm v2: 4 cm st: NotStopd id: Impaired Skin Site#1 t0: [16:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Ankle, Left st: NotStopd id: PresSoreStage/Heal#1 t0: [16:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Red, Unbroken v2: No st: NotStopd id: PressSore Drng/Amt#1 t0: [16:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: None st: NotStopd id: PressSore Wth/Lth #1 t0: [16:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: 3 cm v2: 3 cm st: NotStopd id: PressSoreCleansing#1 t0: [16:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Soap & H20 st: NotStopd id: PressSoreWoundBase#1 t0: [16:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Red st: NotStopd id: Pressure Sore Odor#1 t0: [16:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Negative st: NotStopd id: Pressure Sore Site#1 t0: [16:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Heel, Left st: NotStopd
id: Service Type t0: [17:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: CCU st: NotStopd id: Code Status t0: [17:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Full Code st: NotStopd id: Risk for Falls t0: [17:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Yes st: NotStopd id: Ectopy Frequency t0: [17:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: None st: NotStopd id: Ectopy Type t0: [17:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: None st: NotStopd id: Heart Rate t0: [17:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: 68 n1: 68 u1: BPM st: NotStopd id: Heart Rhythm t0: [17:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Atrial Fib st: NotStopd id: NBP t0: [17:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: 99 n1: 99 u1: mmHg v2: 42 n2: 42 u2: mmHg st: NotStopd id: NBP Mean t0: [17:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: 61 n1: 61 u1: mmHg st: NotStopd id: Precautions t0: [17:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Contact st: NotStopd id: ABP Alarm (Lo/Hi) t0: [17:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: 85 n1: 85 u1: mmHg v2: 145 n2: 145 u2: mmHg st: NotStopd id: HR Alarm (Lo/Hi) t0: [17:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: 60 n1: 60 u1: BPM v2: 125 n2: 125 u2: BPM st: NotStopd id: Resp Alarm (Lo/Hi) t0: [17:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: 8 n1: 8 u1: BPM v2: 40 n2: 40 u2: BPM st: NotStopd id: SpO2 Alarm (Lo/Hi) t0: [17:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: 90 n1: 90 u1: % v2: 100 n2: 100 u2: % st: NotStopd id: Respiratory Rate t0: [17:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: 26 n1: 26 u1: BPM st: NotStopd id: calprevflg t0: [17:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: 1 n1: 1 u1: kg st: NotStopd
id: D5W 250.0ml + 25000Uhr Heparin t0: [17:00:00 22/11/2018] el: 1 ai: 117 cg: RN cu: CCU vo: 7 vu: ml id: D5W t0: [17:00:00 22/11/2018] el: 1 ai: 168 cg: RN cu: CCU vo: 10 vu: ml id: Urine Out Foley t0: [16:00:00 22/11/2018] el: 1 cg: RN cu: CCU vo: 60 vu: ml
id: Heparin t0: [17:00:00 22/11/2018] el: 1 cg: RN cu: CCU vo: 0 do: 700 du: Uhr so: D5W sv: 250 su: ml rt: IV Drip
id: Fingerstick Glucose t0: [17:00:00 22/11/2018] el: 0 cg: CoWker cu: CCU v1: 110 n1: 110 rs: Manual st: NotStopd
pi: 4082643 hi: 10161 t0: [19:00:00 22/11/2018] tf: [22:00:00 26/11/2018] mn: Sodium Chloride 0.9% Flush pt: Unit Dose st: Discontinued via patient discharge rt: IV fr: DAILY:PRN di: Ongoing xv: 36 xu: Hours
id: Service Type t0: [18:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: CCU st: NotStopd id: Code Status t0: [18:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Full Code st: NotStopd id: Risk for Falls t0: [18:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Yes st: NotStopd id: Ectopy Frequency t0: [18:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: None st: NotStopd id: Ectopy Type t0: [18:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: None st: NotStopd id: Heart Rate t0: [18:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: 73 n1: 73 u1: BPM st: NotStopd id: Heart Rhythm t0: [18:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Atrial Fib st: NotStopd id: NBP t0: [18:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: 146 n1: 146 u1: mmHg v2: 48 n2: 48 u2: mmHg st: NotStopd id: NBP Mean t0: [18:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: 80.6667 n1: 80.6667 u1: mmHg st: NotStopd id: Precautions t0: [18:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: Contact st: NotStopd id: ABP Alarm (Lo/Hi) t0: [18:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: 85 n1: 85 u1: mmHg v2: 145 n2: 145 u2: mmHg st: NotStopd id: HR Alarm (Lo/Hi) t0: [18:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: 60 n1: 60 u1: BPM v2: 125 n2: 125 u2: BPM st: NotStopd id: Resp Alarm (Lo/Hi) t0: [18:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: 8 n1: 8 u1: BPM v2: 40 n2: 40 u2: BPM st: NotStopd id: SpO2 Alarm (Lo/Hi) t0: [18:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: 90 n1: 90 u1: % v2: 100 n2: 100 u2: % st: NotStopd id: Respiratory Rate t0: [18:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: 15 n1: 15 u1: BPM st: NotStopd id: SpO2 t0: [18:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: 96 n1: 96 u1: % st: NotStopd id: calprevflg t0: [18:00:00 22/11/2018] el: 0 cg: RN cu: CCU v1: 1 n1: 1 u1: kg st: NotStopd
id: Po Intake t0: [18:00:00 22/11/2018] el: 1 ai: 103 cg: RN cu: CCU vo: 200 vu: ml id: D5W 250.0ml + 25000Uhr Heparin t0: [18:00:00 22/11/2018] el: 1 ai: 117 cg: RN cu: CCU vo: 7 vu: ml id: D5W t0: [18:00:00 22/11/2018] el: 1 ai: 168 cg: RN cu: CCU vo: 10 vu: ml id: Urine Out Foley t0: [18:00:00 22/11/2018] el: 1 cg: RN cu: CCU vo: 60 vu: ml
id: Heparin t0: [18:00:00 22/11/2018] el: 1 cg: RN cu: CCU vo: 0 do: 700 du: Uhr so: D5W sv: 250 su: ml rt: IV Drip
id: PO/Gastric In Total t0: [23:00:00 22/11/2018] el: 2 cg: RN cu: -1 cv: 860 ac: 24 ap: none re: 0
ci: 35456 t0: 1:47:00 cu: CCU de: Regular ward dt: 8641
pi: 4083069 hi: 10161 t0: [22:00:00 22/11/2018] tf: [21:00:00 23/11/2018] mn: Hydromorphone pt: Unit Dose st: Expired rt: IV fr: ONCE ds: 22 dn: 1 dt: 1 di: Doses xv: 36 xu: Hours
pi: 4083204 hi: 10161 t0: [20:00:00 22/11/2018] tf: [19:00:00 23/11/2018] mn: Captopril pt: Unit Dose st: Expired rt: PO fr: TID ds: 08, 14, 20 dn: 3 dt: 1 di: Doses xv: 36 xu: Hours pi: 4083205 hi: 10161 t0: [10:00:00 22/11/2018] tf: [10:00:00 26/11/2018] mn: Lisinopril pt: Unit Dose st: Inactive (Due to a change order) rt: PO fr: DAILY ds: 10 dn: 1 di: Ongoing xv: 36 xu: Hours pi: 4083274 hi: 10161 t0: [23:00:00 22/11/2018] tf: [19:00:00 23/11/2018] mn: Insulin pt: Unit Dose st: Discontinued rt: SC fr: ASDIR ss: Y di: Ongoing xv: 36 xu: Hours pi: 4083275 hi: 10161 t0: [22:00:00 22/11/2018] tf: [19:00:00 23/11/2018] mn: Insulin pt: Unit Dose st: Discontinued rt: SC fr: HS ds: 22 dn: 1 di: Ongoing xv: 36 xu: Hours
pi: 4083866 hi: 10161 t0: [06:00:00 23/11/2018] tf: [10:00:00 26/11/2018] mn: Fentanyl Patch pt: Unit Dose st: Inactive (Due to a change order) rt: TP fr: Q72H dn: 0 di: Ongoing xv: 36 xu: Hours pi: 4083867 hi: 10161 t0: [06:00:00 23/11/2018] tf: [06:00:00 24/11/2018] mn: Morphine Sulfate IR pt: Unit Dose st: Expired rt: PO fr: Q6H:PRN dt: 4 di: Doses xv: 36 xu: Hours
pi: 4084570 hi: 10161 t0: [12:00:00 23/11/2018] tf: [22:00:00 26/11/2018] mn: Miconazole Powder 2% pt: Unit Dose st: Discontinued via patient discharge rt: TP fr: TID:PRN di: Ongoing xv: 36 xu: Hours pi: 4084571 hi: 10161 t0: [10:00:00 23/11/2018] tf: [22:00:00 26/11/2018] mn: Atorvastatin pt: Unit Dose st: Discontinued via patient discharge rt: PO fr: DAILY ds: 10 dn: 1 di: Ongoing xv: 36 xu: Hours
pi: 4086251 hi: 10161 t0: [20:00:00 23/11/2018] tf: [19:00:00 24/11/2018] mn: Hydromorphone pt: Unit Dose st: Expired rt: IV fr: ONCE ds: 20 dn: 1 dt: 1 di: Doses xv: 36 xu: Hours pi: 4086303 hi: 10161 t0: [20:00:00 23/11/2018] tf: [22:00:00 26/11/2018] mn: Insulin pt: Unit Dose st: Discontinued via patient discharge rt: SC fr: ASDIR ss: Y di: Ongoing xv: 36 xu: Hours pi: 4086304 hi: 10161 t0: [22:00:00 23/11/2018] tf: [22:00:00 26/11/2018] mn: Insulin pt: Unit Dose st: Discontinued via patient discharge rt: SC fr: HS ds: 22 dn: 1 di: Ongoing xv: 36 xu: Hours
pi: 4087825 hi: 10161 t0: [22:00:00 24/11/2018] tf: [22:00:00 26/11/2018] mn: Gabapentin pt: Unit Dose st: Discontinued via patient discharge rt: PO fr: HS ds: 22 dn: 1 di: Ongoing xv: 36 xu: Hours pi: 4087826 hi: 10161 t0: [20:00:00 24/11/2018] tf: [22:00:00 26/11/2018] mn: Gabapentin pt: Unit Dose st: Discontinued via patient discharge rt: PO fr: BID ds: 08, 20 dn: 2 di: Ongoing xv: 36 xu: Hours pi: 4087827 hi: 10161 t0: [22:00:00 24/11/2018] tf: [10:00:00 24/11/2018] mn: Citalopram Hydrobromide pt: Unit Dose st: Inactive (Due to a change order) rt: PO fr: HS ds: 22 dn: 1 di: Ongoing xv: 36 xu: Hours pi: 4087862 hi: 10161 t0: [10:00:00 24/11/2018] tf: [22:00:00 26/11/2018] mn: Warfarin pt: Unit Dose st: Discontinued via patient discharge rt: PO fr: DAILY ds: 10 dn: 1 di: Ongoing xv: 36 xu: Hours pi: 4087888 hi: 10161 t0: [22:00:00 24/11/2018] tf: [22:00:00 26/11/2018] mn: Citalopram Hydrobromide pt: Unit Dose st: Discontinued via patient discharge rt: PO fr: HS ds: 22 dn: 1 di: Ongoing xv: 36 xu: Hours
pi: 4088200 hi: 10161 t0: [14:00:00 24/11/2018] tf: [14:00:00 24/11/2018] mn: Morphine Sulfate IR pt: Unit Dose st: Discontinued rt: PO fr: Q4-6H:PRN di: Ongoing xv: 36 xu: Hours
pi: 4088375 hi: 10161 t0: [15:00:00 24/11/2018] tf: [22:00:00 26/11/2018] mn: Morphine Sulfate (Oral Soln.) pt: Unit Dose st: Discontinued via patient discharge rt: PO fr: Q4-6H:PRN di: Ongoing xv: 36 xu: Hours
pi: 4090257 hi: 10161 t0: [20:00:00 25/11/2018] tf: [22:00:00 26/11/2018] mn: Furosemide pt: Unit Dose st: Discontinued via patient discharge rt: PO fr: BID ds: 08, 20 dn: 2 di: Ongoing xv: 36 xu: Hours pi: 4090258 hi: 10161 t0: [12:00:00 25/11/2018] tf: [10:00:00 26/11/2018] mn: Hydromorphone pt: Unit Dose st: Discontinued rt: IV fr: Q4-6H:PRN di: Ongoing xv: 36 xu: Hours pi: 4090259 hi: 10161 t0: [10:00:00 25/11/2018] tf: [22:00:00 26/11/2018] mn: Metoprolol XL pt: Unit Dose st: Discontinued via patient discharge rt: PO fr: DAILY ds: 10 dn: 1 di: Ongoing xv: 36 xu: Hours
pi: 4091217 hi: 10161 t0: [20:00:00 25/11/2018] tf: [19:00:00 26/11/2018] mn: Potassium Chloride pt: Unit Dose st: Expired rt: PO fr: ONCE ds: 20 dn: 1 dt: 1 di: Doses xv: 36 xu: Hours
pi: 4091584 hi: 10161 t0: [23:00:00 25/11/2018] tf: [22:00:00 26/11/2018] mn: Lorazepam pt: Unit Dose st: Discontinued via patient discharge rt: PO fr: HS:PRN di: Ongoing xv: 36 xu: Hours
pi: 4091585 hi: 10161 t0: [23:00:00 25/11/2018] tf: [22:00:00 26/11/2018] mn: Lorazepam pt: Unit Dose st: Discontinued via patient discharge rt: PO fr: HS:PRN di: Ongoing xv: 36 xu: Hours
pi: 4092665 hi: 10161 t0: [10:00:00 26/11/2018] tf: [22:00:00 26/11/2018] mn: Lisinopril pt: Unit Dose st: Discontinued via patient discharge rt: PO fr: DAILY ds: 10 dn: 1 di: Ongoing xv: 36 xu: Hours pi: 4092720 hi: 10161 t0: [11:00:00 26/11/2018] tf: [22:00:00 26/11/2018] mn: Milk of Magnesia pt: Unit Dose st: Discontinued via patient discharge rt: PO fr: Q6H:PRN di: Ongoing xv: 36 xu: Hours pi: 4092721 hi: 10161 t0: [11:00:00 26/11/2018] tf: [22:00:00 26/11/2018] mn: Fentanyl Patch pt: Unit Dose st: Discontinued via patient discharge rt: TP fr: Q72H dn: 0 di: Ongoing xv: 36 xu: Hours pi: 4092722 hi: 10161 t0: [20:00:00 26/11/2018] tf: [22:00:00 26/11/2018] mn: Docusate Sodium pt: Unit Dose st: Discontinued via patient discharge rt: PO fr: BID ds: 08, 20 dn: 2 di: Ongoing xv: 36 xu: Hours pi: 4092723 hi: 10161 t0: [11:00:00 26/11/2018] tf: [22:00:00 26/11/2018] mn: Senna pt: Unit Dose st: Discontinued via patient discharge rt: PO fr: BID:PRN di: Ongoing xv: 36 xu: Hours
pi: 4093240 hi: 10161 t0: [13:00:00 26/11/2018] tf: [22:00:00 26/11/2018] mn: Hydromorphone pt: Unit Dose st: Discontinued via patient discharge rt: IVPCA fr: ASDIR di: Ongoing xv: 36 xu: Hours