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Patient Medication and Treatment Record

This document appears to be a medication sheet or kardex for tracking a patient's medications and treatments during a hospital stay. It includes fields for the patient's name, age, sex, hospital information, attending physician, diagnosis, and dates of admission and surgery. The bulk of the document consists of tables to record medications ordered including dose, route, and dates and times of administration as well as signatures. There are also sections to note the patient's mental status, activities, diet, tubes or catheters, and any special instructions. Additional tables allow recording intravenous fluids, blood transfusions, medical treatments, lab tests and diagnostics ordered and performed.

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Cezanne Cruz
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486 views3 pages

Patient Medication and Treatment Record

This document appears to be a medication sheet or kardex for tracking a patient's medications and treatments during a hospital stay. It includes fields for the patient's name, age, sex, hospital information, attending physician, diagnosis, and dates of admission and surgery. The bulk of the document consists of tables to record medications ordered including dose, route, and dates and times of administration as well as signatures. There are also sections to note the patient's mental status, activities, diet, tubes or catheters, and any special instructions. Additional tables allow recording intravenous fluids, blood transfusions, medical treatments, lab tests and diagnostics ordered and performed.

Uploaded by

Cezanne Cruz
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
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NAME: Age: Sex: Date:

Ward/room no.: Attending Physician:


Date MEDICATION-DOSE- FREQUENCY TIM Date Date Date
ordered ROUTE E Sign sign sign
AM
PM
N
AM
PM
N
AM
PM
N

AM
PM
N

AM
PM
N

AM
PM
N

MEDICATION SHEET
KARDEX
NAME: ________________________________ AGE:____ SEX:_____ HOSPITAL NO._____________________

ADDRESS:_______________________________________ CLASSIFICATION:___________ WEIGHT:________

ADMITTING PHYSICIAN:__________________________ DATE/TIME ADMITTED:________BLOOD TYPE:_____

ATTENDING PHYSCIAN:_____________________________________________________________________

IMPRESSION DIAGNOSIS:____________________________________________________________________

SURGERY DONE:____________________________________________________DATE/TIME: SURGERY_____

MENTAL STATUS: Activities: Diet: Tubes: Special Info:


___Conscious ___ambulant ___NPO ___Foley Catheter ___Weigh Daily
___drowsy ___dangle and sit up ___DAT ___thoracic tube ___BP q shift
___stupor ___bedrest with BRP ___Soft ___NGT ___Neuro V/S
___unconscious ___CBR w/o BRP ___clear liquids ___CVP ___abdominal girth
___comatose Others:___________ ___ gen. liquids Others:__________ Others:__________
Others:_________

Date Medication Date IV FLUIDS/ BLOOD TRANSFUSION DATE AND


ordered Ordered TIME
DISCONTINUED

DATE Medical Treatment/ Date Done


ORDERED Laboratories/Diagnostics

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