Documenti di Didattica
Documenti di Professioni
Documenti di Cultura
I.
Patient
No.
Name of Patient
Age
Date
Time
Kind of Infusion
Site
Type of
Cannula
Malones, Eugenia S.
54 years old
10/19/14
4:30 P.M.
23 years old
10/22/14
7:25 A.M.
Oredina, Carlito T.
61 years old
10/22/14
7:40 A.M.
II.
Gauge 22
(Insyte)
Gauge 20
(Venflon)
Gauge 20
(Venflon)
Dose
Rate
125 cc/hr
31 gtts/min
100 cc/hr
25 mgtts/min
125 cc/hr
31 gtts/min
License
No./Expiry
Date
AN-002202/
03/30/2015
AN-002202/
03/30/2015
AN-002202/
03/30/2015
License
No./Expiry
Date
Patient
No.
Name of Patient
Age
Date
Time
Drugs Incorporated
Dose
Diagnosis
Dideles, Angelo E.
73 years old
10/20/14
1:45 P.M.
De Leon, Virgilio G.
73 years old
10/20/14
2: 00 P.M.
Trigeminal Neuralgia
2:15 P.M.
III.
15 years old
10/20/14
AN-002202/
03/30/2015
AN-002202/
03/30/2015
AN-002202/
03/30/2015
License
No./Expiry
Date
Patient
No.
1
Name of Patient
Lizardo, Samuel Maric
P.
Age
23 years old
Date
10/24/14
Time
I.V. Insertion
Type of
Cannula
Diagnosis
11: 50 A.M.
Gauge 20
(Venflon)
AN-002202/
03/30/2015
Chona David, R.N.
This is to certify that I had successfully performed the above requirements as countersigned by my witnesses.
Received by: _______________________________________________
ANSAP
Submitted by:
Approved by: