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    Pci Forms

    Uploaded by

    Kim Salud
    The document contains attendance sheets, break sheets, assignment sheets, and monitoring sheets from a nursing clinical rotation. It details the attendance, assignments, and monitoring of 3 nursing students - Arabelo, Dela Torre, and Salud - over their rotation in Station 2B under instructor Mrs. Baluran for the AM shift on January 16, 2015.

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    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd

    Pci Forms

    Uploaded by

    Kim Salud
    253 views13 pages
    The document contains attendance sheets, break sheets, assignment sheets, and monitoring sheets from a nursing clinical rotation. It details the attendance, assignments, and monitoring of 3 nursing students - Arabelo, Dela Torre, and Salud - over their rotation in Station 2B under instructor Mrs. Baluran for the AM shift on January 16, 2015.

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    PCI FORMS

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    The document contains attendance sheets, break sheets, assignment sheets, and monitoring sheets from a nursing clinical rotation. It details the attendance, assignments, and monitoring of 3 nursing students - Arabelo, Dela Torre, and Salud - over their rotation in Station 2B under instructor Mrs. Baluran for the AM shift on January 16, 2015.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Download as docx, pdf, or txt
    253 views13 pages

    Pci Forms

    Uploaded by

    Kim Salud
    The document contains attendance sheets, break sheets, assignment sheets, and monitoring sheets from a nursing clinical rotation. It details the attendance, assignments, and monitoring of 3 nursing students - Arabelo, Dela Torre, and Salud - over their rotation in Station 2B under instructor Mrs. Baluran for the AM shift on January 16, 2015.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Download as docx, pdf, or txt
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    Xavier University- Ateneo de Cagayan

    College of Nursing
    A.Y. 2014-2015

    Area of Rotation: Practicing Clinical Instructor

    Date: _________________

    Shadowed Clinical Instructor: Mrs. Florence Baluran, RN, MAN

    Area of Rotation: Station 2B


    Shift: AM Shift

    ATTENDANCE SHEET

    Name

    Time in

    Signature

    1. Arabelo, Stephanie
    2. Dela Torre, Daniel
    Leandro
    3. Salud, Lovely Kim

    Absent:

    Late:

    STUDENTS ATTENDANCE SHEET


    Prepared by:
    Arabelo, Stephanie
    Dela Torre, Daniel
    Salud, Kim
    Jan. 16, 2015

    Xavier University- Ateneo de Cagayan


    College of Nursing
    A.Y. 2014-2015

    Area of Rotation: Practicing Clinical Instructor

    Date: _________________

    Shadowed Clinical Instructor: Mrs. Florence Baluran, RN, MAN

    Name

    Time in

    Absent:

    Area of Rotation: Station 2B


    Shift: AM Shift

    Signature

    Late:
    BREAK SHEET

    Prepared by:
    Arabelo, Stephanie
    Dela Torre, Daniel
    Salud, Kim
    Jan. 16, 2015

    Xavier University- Ateneo de Cagayan


    College of Nursing
    A.Y. 2014-2015

    Area of Rotation: Practicing Clinical Instructor

    Date: _________________

    Shadowed Clinical Instructor: Mrs. Florence Baluran, RN, MAN

    Name

    Tim
    e
    out

    Tim
    e in

    Endorsed to

    Area of Rotation: Station 2B


    Shift: AM Shift

    Signature

    1. Arabelo,
    Stephanie
    2. dela Torre,
    Daniel
    Leandro
    3. Salud,
    Lovely Kim

    STUDENTS BREAK SHEET

    Prepared by:
    Arabelo, Stephanie
    Dela Torre, Daniel
    Salud, Kim
    Jan. 16, 2015

    Xavier University- Ateneo de Cagayan


    College of Nursing
    A.Y. 2014-2015

    Area of Rotation: Practicing Clinical Instructor

    Date: _________________

    Area of Rotation: Station 2B

    Shadowed Clinical Instructor: Mrs. Florence Baluran, RN, MAN

    Name

    Time
    out

    Time
    in

    Shift: AM Shift

    Endorsed to

    Signature

    STUDENT ASSIGNMENT

    Prepared by:
    Arabelo, Stephanie
    Dela Torre, Daniel
    Salud, Kim
    Jan. 16, 2015

    Xavier University- Ateneo de Cagayan


    College of Nursing
    A.Y. 2014-2015

    Area of Rotation: Practicing Clinical Instructor

    Date: _________________

    Shadowed Clinical Instructor: Mrs. Florence Baluran, RN, MAN

    Name

    Area of Rotation: Station 2B


    Shift: AM Shift

    Assigned Students

    1. Arabelo, Stephanie

    2. Dela Torre, Daniel


    Leandro

    3. Salud, Lovely Kim

    PATIENT ASSIGNMENT

    Prepared by:
    Arabelo, Stephanie
    Dela Torre, Daniel
    Salud, Kim
    Jan. 16, 2015

    Xavier University- Ateneo de Cagayan


    College of Nursing
    A.Y. 2014-2015

    Area of Rotation: Practicing Clinical Instructor

    Date: _________________

    Shadowed Clinical Instructor: Mrs. Florence Baluran, RN, MAN

    Name of Student

    Area of Rotation: Station 2B


    Shift: AM Shift

    Name of Patient(s)

    Prepared by:
    Arabelo, Stephanie
    Dela Torre, Daniel
    Salud, Kim
    Jan. 16, 2015

    Xavier University- Ateneo de Cagayan


    College of Nursing
    A.Y. 2014-2015

    Area of Rotation: Practicing Clinical Instructor

    Date: _________________

    Area of Rotation: Station 2B

    Shadowed Clinical Instructor: Mrs. Florence Baluran, RN, MAN

    Shift: AM Shift

    STUDENTS REQUIREMENT CHECKLIST

    WEEK ____
    NAMES

    DAY 1
    LRU

    GO

    SO

    DPA

    AX TOOL

    PATHO

    DAY 2
    NCP

    DS

    DP

    LFD

    LRU

    SO

    DPA

    LFD

    WE

    PCI E.

    Journal

    STUDENTS PARAPHERNALIA CHECKLIST


    Prepared by:
    Arabelo, Stephanie
    Dela Torre, Daniel
    Salud, Kim
    Jan. 16, 2015

    Xavier University- Ateneo de Cagayan


    College of Nursing
    A.Y. 2014-2015

    Area of Rotation: Practicing Clinical Instructor

    Date: _________________

    Shadowed Clinical Instructor: Mrs. Florence Baluran, RN, MAN


    WEEK: ___
    PARAPHERNALI
    A

    Area of Rotation: Station 2B


    Shift: AM Shift

    Day 1

    Day 2

    NAMES

    NAMES

    PATIENT CENSUS

    Prepared by:
    Arabelo, Stephanie
    Dela Torre, Daniel
    Salud, Kim
    Jan. 16, 2015

    Xavier University- Ateneo de Cagayan


    College of Nursing
    A.Y. 2014-2015

    Area of Rotation: Practicing Clinical Instructor

    Date: _________________

    Area of Rotation: Station 2B

    Shadowed Clinical Instructor: Mrs. Florence Baluran, RN, MAN

    Room
    No.

    Patients Name

    Age

    Gender

    Diagnosis

    Shift: AM Shift

    CC

    A.P.

    Date of
    Admission

    Prepared by:
    Arabelo, Stephanie
    Dela Torre, Daniel
    Salud, Kim
    Jan. 16, 2015

    Xavier University- Ateneo de Cagayan


    College of Nursing
    A.Y. 2014-2015

    Area of Rotation: Practicing Clinical Instructor

    Date: _________________

    Area of Rotation: Station 2B

    Shadowed Clinical Instructor: Mrs. Florence Baluran, RN, MAN

    Shift: AM Shift

    MONITORING SHEET
    Room
    No.

    Patients Name

    Diagnosis

    Diet

    IVF
    Time

    VS
    Level

    PR

    RP

    Intake
    BP

    O2
    Sat

    Parenteral

    Output
    Stool

    Time

    Level

    PR

    RP

    BP

    O2
    Sat

    Parenteral

    Output
    Stool

    Prepared by:
    Arabelo, Stephanie
    Dela Torre, Daniel
    Salud, Kim
    Jan. 16, 2015

    Xavier University- Ateneo de Cagayan


    College of Nursing
    A.Y. 2014-2015

    Area of Rotation: Practicing Clinical Instructor

    Date: _________________

    Shadowed Clinical Instructor: Mrs. Florence Baluran, RN, MAN

    Area of Rotation: Station 2B


    Shift: AM Shift

    MEDICATION SHEET

    Student
    Assigned

    Roo
    m
    No.

    Patients
    Name
    Name of Drugs

    Day 1: Monday
    Date: _______
    Timing
    Dosag
    e

    Route

    Note
    s

    Day 2: Tuesday
    Date: _______
    Name of Drugs Timin Dosag
    g
    e

    Rout
    e

    Prepared by:
    Arabelo, Stephanie
    Dela Torre, Daniel
    Salud, Kim
    Jan. 16, 2015

    Note
    s

    Xavier University- Ateneo de Cagayan


    College of Nursing
    A.Y. 2014-2015

    Area of Rotation: Practicing Clinical Instructor

    Date: _________________

    Shadowed Clinical Instructor: Mrs. Florence Baluran, RN, MAN

    Area of Rotation: Station 2B


    Shift: AM Shift

    TREATMENT SHEET

    Student
    Assigned

    Room No.

    Patients Name

    Treatment

    Prepared by:
    Arabelo, Stephanie
    Dela Torre, Daniel
    Salud, Kim
    Jan. 16, 2015

    Xavier University- Ateneo de Cagayan


    College of Nursing
    A.Y. 2014-2015

    Area of Rotation: Practicing Clinical Instructor


    Date: _________________
    Area of Rotation:
    Station 2B
    MAN

    Shadowed Clinical Instructor: Mrs. Florence Baluran, RN,


    Shift: AM Shift

    WALA NI LABOT

    Prepared

    Arabelo,

    Dela Torr

    Salud, Ki
    Jan. 16, 2

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