UNIVERSITY OF SOUTH FLORIDA

COLLEGE OF NURSING
1 CHIEF COMPLAINT: Encephalopathy
3 HISTORY OF PRESENT ILLNESS: (Be sure to OLDCART the symptoms in addition to the hospital course)
A 40-year-old male ith a history o! don syndrome as admitted the Emer"ency Room on #$%&$%' a!ter losin"
consciousness and !allin" at his assisted li(in" !acility) The patient as somehat sedated upon admission and appeared to
ha(e a ri"ht temple a*rasion and possi*le su*dermal hematoma) +ultiple tests ere conducted includin" an +R, ith and
ithout contrast- an EE.- echocardio"ram and carotid doppler) All test results ere unremar/a*le) Due to the patients
altered mental status and e0tensi(e list o! medications includin" *en1odia1epines the pro(ider ordered that the patient
discontinue all medication until the source o! the !all and altered mental status is disco(ered) On #$%2$%' the patient
de(eloped episodes o! tachycardia o! un/non ori"in and cardiolo"y is *ein" consulted) As o! #$%3$%' the patient is on
dyspha"ia %- puree thin li4uid diet- his dru" therapy is *ein" reinitiated sloly and cardiolo"y is e(aluatin" the patient !or
ori"in o! tachycardia)
2 PAST MEDICAL HISTORY/PAST SURGICAL HISTORY ,nclude hospitali1ations !or any medical
illness or operation
Date Operati! r I""!e##
5ni(ersity o! 6outh 7lorida Colle"e o! 8ursin" 9 Re(ision Au"ust &0%'
6tudent: Alyssa Blumenthal
PATIENT ASSESSMENT TOOL $
Assi"nment Date: #$&4$%'
1 PATIENT INFORMATION
A"ency: 6t) ;osephs <ospital
=atient ,nitials: C)D A"e: 40 Admission Date: #$%&$%'
.ender: +ale +arital 6tatus: 6in"le =rimary +edical Dia"nosis ith ,CD-%0 code:
=rimary Lan"ua"e: En"lish
Le(el o! Education: <i"h 6chool Other +edical Dia"noses: (ne on this admission)
Occupation (i! retired- hat !rom>): 8ot or/in"
8um*er$a"es children$si*lin"s: Only child
6er(ed$?eteran: 8o Code 6tatus: 7ull code
Li(in" Arran"ements: Li(es in a "roup home Ad(anced Directi(es: 8o
,! no- do they ant to !ill them out> 8o
6ur"ery Date: ----- =rocedure: -----
Culture$ Ethnicity $8ationality: Caucasian
Reli"ion: =rotestant Type o! ,nsurance: +edicare +edicaid
%
2
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7ather

---
7ather is
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+other 3&
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6till li(in"
A A
Comments: =atient is an only child raised *y his mother)
1 IMMUNI%ATION HISTORY
(+ay state B5C !or un/non- e0cept !or Tetanus- 7lu- and =na) YES NO
Routine childhood (accinations A
Routine adult (accinations !or military or !ederal ser(ice A
Adult Diphtheria (%#-24) A
Adult Tetanus (#$%&$%') A
,n!luen1a (!lu) (#$%D$%') A
=neumococcal (pneumonia) (%#-24) A
<a(e you had any other (accines "i(en !or international tra(el or
occupational purposes> =lease List A
1 ALLERGIES
OR ADVERSE
REACTIONS
8A+E o!
Causati(e A"ent
Type o! Reaction (descri*e e0plicitly)
+edications
8o @non Aller"ies
Other (!ood- tape-
late0- dye- etc))
& PATHOPHYSIOLOGY: (include A=A re!erence and in te0t citations) (+echanics o! disease- ris/ !actors- ho to
dia"nose- ho to treat- pro"nosis- and include any "enetic !actors impactin" the dia"nosis- pro"nosis or
treatment)
Encephalopathy-
5ni(ersity o! 6outh 7lorida Colle"e o! 8ursin" 9 Re(ision Au"ust &0%' &
& MEDICATIONS: E,nclude *oth prescription and OTCF home (reconciliation)- routine- and =R8 medication) .i(e trade and
"eneric name)G
Na'e: C!(e!trati! )'*/'"+ D#a*e A',!t )'*+
R,te: Fre-,e!(.:
P/ar'a(e,ti(a" ("a##
H'e H#pita" r 0t/
I!1i(ati!
Si1e e22e(t#/N,r#i!* (!#i1erati!#
Na'e C!(e!trati! D#a*e A',!t
R,te Fre-,e!(.
P/ar'a(e,ti(a" ("a##
H'e H#pita" r 0t/
I!1i(ati!
Si1e e22e(t#/N,r#i!* (!#i1erati!#
Na'e C!(e!trati! D#a*e A',!t
R,te Fre-,e!(.
P/ar'a(e,ti(a" ("a##
H'e H#pita" r 0t/
I!1i(ati!
Si1e e22e(t#/N,r#i!* (!#i1erati!#
Na'e C!(e!trati! D#a*e A',!t
R,te Fre-,e!(.
P/ar'a(e,ti(a" ("a##
H'e H#pita" r 0t/
I!1i(ati!
Si1e e22e(t#/N,r#i!* (!#i1erati!#
Na'e C!(e!trati! D#a*e A',!t
R,te Fre-,e!(.
P/ar'a(e,ti(a" ("a##
H'e H#pita" r 0t/
I!1i(ati!
Si1e e22e(t#/N,r#i!* (!#i1erati!#
Na'e C!(e!trati! D#a*e A',!t
R,te Fre-,e!(.
P/ar'a(e,ti(a" ("a##
H'e H#pita" r 0t/
I!1i(ati!
Si1e e22e(t#/N,r#i!* (!#i1erati!#
Na'e C!(e!trati! D#a*e A',!t
R,te Fre-,e!(.
P/ar'a(e,ti(a" ("a##
H'e H#pita" r 0t/
I!1i(ati!
5ni(ersity o! 6outh 7lorida Colle"e o! 8ursin" 9 Re(ision Au"ust &0%' '
Si1e e22e(t#/N,r#i!* (!#i1erati!#
Na'e C!(e!trati! D#a*e A',!t
R,te Fre-,e!(.
P/ar'a(e,ti(a" ("a##
H'e H#pita" r 0t/
I!1i(ati!
Si1e e22e(t#/N,r#i!* (!#i1erati!#
Na'e C!(e!trati! D#a*e A',!t
R,te Fre-,e!(.
P/ar'a(e,ti(a" ("a##
H'e H#pita" r 0t/
I!1i(ati!
Si1e e22e(t#/N,r#i!* (!#i1erati!#
Na'e C!(e!trati! D#a*e A',!t
R,te Fre-,e!(.
P/ar'a(e,ti(a" ("a##
H'e H#pita" r 0t/
I!1i(ati!
Si1e e22e(t#/N,r#i!* (!#i1erati!#
Na'e C!(e!trati! D#a*e A',!t
R,te Fre-,e!(.
P/ar'a(e,ti(a" ("a##
H'e H#pita" r 0t/
I!1i(ati!
Si1e e22e(t#/N,r#i!* (!#i1erati!#
5ni(ersity o! 6outh 7lorida Colle"e o! 8ursin" 9 Re(ision Au"ust &0%' 4
& NUTRITION: ,nclude type o! diet- &4 <R a(era"e home diet- and your nutritional analysis ith recommendations)
Diet ordered in hospital> Dyspha"ia %- =uree thin li4uid
diet
Analysis o! home diet (Compare to B+y =lateC and
Diet pt !ollos at home> 6ame as hospital Consider co-mor*idities and cultural considerations):
&4 <R a(era"e home diet:
Brea/!ast: 4 ounces o! "rape Huice and I ounces chocolate
ensure
Lunch: %& ounces Bee! *roth- 4 ounces o! oran"e Hello- I
ounces o! ater
Dinner: I ounces stra*erry ensure- 4 ounces o! chocolate
puddin"- %2 ounces o! strin" (e"eta*le soup
1 COPING ASSESSMENT/SUPPORT SYSTEM: (these are prompts desi"ned to help "uide your discussion)
Jho helps you hen you are ill> The assisted li(in" !acility and the patientKs mother tend to him hen he is ill)
<o do you "enerally cope ith stress> or Jhat do you do hen you are upset> The patientKs mother states that durin"
times o! stress she is there !or him)
Recent di!!iculties (7eelin"s o! depression- an0iety- *ein" o(erhelmed- relationships- !riends- social li!e)
The patient has had recent *eha(ioral distur*ances in hich he ill *an" is head a"ainst the all) The patient is prescri*ed
a *en1odia1epine to ease his an0iety)
32 DOMESTIC VIOLENCE ASSESSMENT
Consider beginning with: Unfortunately many, children, as well as adult women and men have been or currently are
unsafe in their relationships in their homes. I am going to ask some questions that help me to make sure that you are
safe.
<a(e you e(er !elt unsa!e in a close relationship> 8o
<a(e you e(er *een tal/ed don to> 8o
<a(e you e(er *een hit punched or slapped> 8o
<a(e you *een emotionally or physically harmed in other ays *y a person in a close relationship ith you> 8o
,! yes- ha(e you sou"ht help !or this> ---
Are you currently in a sa!e relationship> Les
5ni(ersity o! 6outh 7lorida Colle"e o! 8ursin" 9 Re(ision Au"ust &0%' D
4 DEVELOPMENTAL CONSIDERATIONS:
Eri/sonKs sta"e o! psychosocial de(elopment: Trust (s) +istrust A Autonomy (s) A Dou*t M 6hame ,nitiati(e (s) .uilt ,ndustry
(s) ,n!eriority ,dentity (s) Role Con!usion$Di!!usion ,ntimacy (s) ,solation .enerati(ity (s) 6el! a*sorption$6ta"nation E"o ,nte"rity (s)
Despair
Descri*e the sta"e your patient is in and "i(e the characteristics that the patient e0hi*its that led you to your determination:
Because my patient has don syndrome he does not !all under the de(elopment period !or his a"e "roup accordin" to
Eric/sonKs sta"es o! de(elopment)
Accordin" to Eric/sonKs sta"es o! de(elopment a 40 year old should *e in .enerati(ity (s) 6ta"nation) ,n this sta"e the
patient ould *e parentin"- teachin"- or *ein" in(ol(ed in the community so the patient can lea(e somethin" *ehind !or
the ne0t "eneration) <oe(er- a patient ith don syndrome is limited to responsi*ilities and there!ore !alls under a
di!!erent cate"ory) +y patient !alls under Eri/sonKs sta"e o! autonomy (s shame and dou*t) This de(elopment period
states that a!ter "ainin" trust in their care"i(ers- indi(iduals *e"in to reali1e that their *eha(ior s their on) ,t is natural !or
indi(iduals to assess their independence and reali1e that they ha(e a mind o! their on) This is ho they "ain a sense o!
their on autonomy) ,! indi(iduals are restrained too much or punished too harshly a sense o! shame and dou*t occurs)
Eric/son- E) (%#ID)) !he "ife Cycle Completed. 8e Lor/: 8orton Company
Descri*e hat impact o! disease$condition or hospitali1ation has had on your patientKs de(elopmental sta"e o! li!e:
Due to my patient *ein" *orn ith don syndrome he has mental retardations that ha(e limited him in his de(elopment)
33 CULTURAL ASSESSMENT:
BJhat do you thin/ is the cause o! your illness>C =atients mother states B<e !ell at his AL7)C
Jhat does your illness mean to you> Jas not assessed)
33 SE5UALITY ASSESSMENT: )t/e 2""6i!* prompts 'a. /e"p t *,i1e .,r 1i#(,##i!+
<a(e you e(er *een se0ually acti(e> Jas not assessed)
Do you pre!er omen- men or *oth "enders> Jas not assessed)
Are you aare o! e(er ha(in" a se0ually transmitted in!ection> Jas not assessed)
<a(e you or a partner e(er had an a*normal pap smear> Jas not assessed)
<a(e you or your partner recei(ed the .ardasil (<=?) (accination> Jas not assessed)

Are you currently se0ually acti(e> Jas not assessed)
Jhen se0ually acti(e- hat measures do you ta/e to pre(ent ac4uirin" a se0ually transmitted disease or an unintended
pre"nancy> Jas not assessed)
<o lon" ha(e you *een ith your current partner> Jas not assessed)
<a(e any medical or sur"ical conditions chan"ed your a*ility to ha(e se0ual acti(ity> Jas not assessed)
Do you ha(e any concerns a*out se0ual health or ho to pre(ent se0ually transmitted disease or unintended pre"nancy>
Jas not assessed)
5ni(ersity o! 6outh 7lorida Colle"e o! 8ursin" 9 Re(ision Au"ust &0%' 2
71 SPIRITUALITY ASSESSMENT: (includin" *ut not limited to the !olloin" 4uestions)
Jhat importance does reli"ion or spirituality ha(e in your li!e>
=atients mother attends a protestant church and states- Bit helps me to ma/e sense o! my li!e)C
Do your reli"ious *elie!s in!luence your current condition>
=atients mother as una*le to (er*ali1e anser)
33 SMO8ING9 CHEMICAL USE9 OCCUPATIONAL/ENVIRONMENTAL E5POSURES:
%) Does the patient currently- or has he$she e(er smo/ed or used chein" to*acco> N
&) Does the patient drin/ alcohol or has he$she e(er dran/ alcohol> N
') <as the patient e(er used street dru"s such as mariHuana- cocaine- heroin- or other> N
4) <a(e you e(er- or are you currently e0posed to any occupational or en(ironmental <a1ards$Ris/s N
5ni(ersity o! 6outh 7lorida Colle"e o! 8ursin" 9 Re(ision Au"ust &0%' 3
1: REVIE; OF SYSTEMS
Ge!era" C!#tit,ti! Ga#tri!te#ti!a" I'',!"*i(
Recent ei"ht loss or "ain 8ausea- (omitin"- or diarrhea Chills ith se(ere sha/in"
I!te*,'e!tar. Constipation ,rrita*le Boel 8i"ht seats
Chan"es in appearance o! s/in .ERD Cholecystitis 7e(er
=ro*lems ith nails ,ndi"estion .astritis $ 5lcers <,? or A,D6
Dandru!! <emorrhoids Blood in the stool Lupus
=soriasis Lello Haundice <epatitis Rheumatoid Arthritis
<i(es or rashes =ancreatitis 6arcoidosis
6/in in!ections Colitis Tumor
5se o! sunscreen 6=7: Di(erticulitis Li!e threatenin" aller"ic reaction
Bathin" routine: Appendicitis Enlar"ed lymph nodes
Other: A*dominal A*scess Other:
Last colonoscopy>
HEENT Other: He'at"*i(/O!("*i(
Di!!iculty seein" Ge!it,ri!ar. Anemia
Cataracts or .laucoma nocturia Bleeds easily
Di!!iculty hearin" dysuria Bruises easily
Ear in!ections hematuria Cancer
6inus pain or in!ections polyuria Blood Trans!usions
8ose *leeds /idney stones Blood type i! /non:
=ost-nasal drip 8ormal !re4uency o! urination: 0$day Other:
Oral$pharyn"eal in!ection Bladder or /idney in!ections
Dental pro*lems Meta<"i(/E!1(ri!e
Routine *rushin" o! teeth 0$day Dia*etes Type:
Routine dentist (isits 0$year <ypothyroid $<yperthyroid
?ision screenin" ,ntolerance to hot or cold
Other: Osteoporosis
Other:
P,"'!ar.
Di!!iculty Breathin" Ce!tra" Ner=,# S.#te'
Cou"h - dry or producti(e ;OMEN ONLY C?A
Asthma ,n!ection o! the !emale "enitalia Di11iness
Bronchitis +onthly sel! *reast e0am 6e(ere <eadaches
Emphysema 7re4uency o! pap$pel(ic e0am +i"raines
=neumonia Date o! last "yn e0am> 6ei1ures
Tu*erculosis menstrual cycle re"ular irre"ular Tic/s or Tremors
En(ironmental aller"ies menarche a"e> Encephalitis
last CAR> menopause a"e> +enin"itis
Other: Date o! last +ammo"ram MResult: Other:
Date o! DEAA Bone Density M Result:
Car1i=a#(,"ar MEN ONLY Me!ta" I""!e##
<ypertension ,n!ection o! male "enitalia$prostate> Depression
<yperlipidemia 7re4uency o! prostate e0am> 6chi1ophrenia
Chest pain $ An"ina Date o! last prostate e0am> An0iety
+yocardial ,n!arction B=< Bipolar
CAD$=?D 5rinary Retention Other:
C<7 M,#(,"#>e"eta"
+urmur ,nHuries or 7ractures C/i"1/1 Di#ea#e#
Throm*us Jea/ness +easles
Rheumatic 7e(er =ain +umps
+yocarditis .out =olio
Arrhythmias Osteomyelitis 6carlet 7e(er
Last E@. screenin"- hen> Arthritis Chic/en =o0
Other: Other: Other:
5ni(ersity o! 6outh 7lorida Colle"e o! 8ursin" 9 Re(ision Au"ust &0%' I
,s there any pro*lem that is not mentioned that your patient sou"ht medical attention !or ith anyone> 8o
Any other 4uestions or comments that your patient ould li/e you to /no> 8o
5ni(ersity o! 6outh 7lorida Colle"e o! 8ursin" 9 Re(ision Au"ust &0%' #
71: PHYSICAL E5AMINATION:(Descri*e a*normal assessment *elo non chec/ed *o0es)
.eneral 6ur(ey: <ei"ht: Jei"ht: B+,: =ain: (include ratin" M location)
=ulse: Blood
=ressure:
(include location)
Temperature: (route ta/en>) Respirations:
6pO& ,s the patient on Room Air or O&:
O(erall Appearance: EDress$"roomin"$physical handicaps$eye contactG
clean- hair com*ed- dress appropriate !or settin" and temperature- maintains eye contact- no o*(ious handicaps
O(erall Beha(ior: Ee)"): appropriate$restless$odd mannerisms$a"itated$lethar"ic$otherG
aa/e- calm- rela0ed- interacts ell ith others- Hud"ment intact
6peech: Ee)"): clear$mum*les $rapid $slurred$silent$otherG
clear- crisp diction
+ood and A!!ect: pleasant cooperati(e cheer!ul tal/ati(e 4uiet *oisterous !lat
apathetic *i1arre a"itated an0ious tear!ul ithdran a""ressi(e hostile loud
Other:
I!te*,'e!tar.
6/in is arm- dry- and intact
6/in tur"or elastic
8o rashes- lesions- or de!ormities
8ails ithout clu**in"
Capillary re!ill N ' seconds
<air e(enly distri*uted- clean- ithout (ermin
=eripheral ,? site Type: Location: Date inserted:
no redness- edema- or dischar"e
7luids in!usin"> no yes - hat>
=eripheral ,? site Type: Location: Date inserted:
no redness- edema- or dischar"e
7luids in!usin"> no yes - hat>
Central access de(ice Type: Location: Date inserted:
7luids in!usin"> no yes - hat>
HEENT: 7acial !eatures symmetric 8o pain in sinus re"ion 8o pain- clic/in" o! T+; Trachea midline
Thyroid not enlar"ed 8o palpa*le lymph nodes sclera hite and conHuncti(a clearF ithout dischar"e
Eye*ros- eyelids- or*ital area- eyelashes- and lacrimal "lands symmetric ithout edema or tenderness
=ERRLA pupil si1e $ mm =eripheral (ision intact EO+ intact throu"h 2 cardinal !ields ithout nysta"mus
Ears symmetric ithout lesions or dischar"e Jhisper test heard: ri"ht ear- inches M le!t ear- inches
8ose ithout lesions or dischar"e Lips- *uccal mucosa- !loor o! mouth- M ton"ue pin/ M moist ithout lesions
Dentition:
Comments:
5ni(ersity o! 6outh 7lorida Colle"e o! 8ursin" 9 Re(ision Au"ust &0%' %0
P,"'!ar./T/ra?: Respirations re"ular and unla*ored Trans(erse to A= ratio &:% Chest e0pansion symmetric
Lun"s clear to auscultation in all !ields ithout ad(entitious sounds
CL 9 Clear
=ercussion resonant throu"hout all lun" !ields- dull toards posterior *ases
J< 9 Jhee1es
6putum production: thic/ thin Amount: scant small moderate lar"e
CR - Crac/les
Color: hite pale yello yello dar/ yello "reen "ray li"ht tan *ron red
R< 9 Rhonchi

D 9 Diminished
6 9 6tridor
A* - A*sent
Car1i=a#(,"ar: 8o li!ts- hea(es- or thrills =+, !elt at:
<eart sounds: 6% 6& Re"ular ,rre"ular 8o murmurs- clic/s- or ad(entitious heart sounds 8o ;?D
Rhythm (!or patients ith EC. tracin" 9 tape 2 second strip *elo and analy1e)
Cal! pain *ilaterally ne"ati(e =ulses *ilaterally e4ual Eratin" scale: 0-a*sent- %-*arely palpa*le- &-ea/- '-normal- 4-*oundin"G
Apical pulse: Carotid: Brachial: Radial: 7emoral: =opliteal: D=: =T:
8o temporal or carotid *ruits Edema: Eratin" scale: 0-none- O% (%-&mm)- O& ('-4mm)- O' (D-2mm)- O4(3-Imm) G
Location o! edema: pittin" non-pittin"
E0tremities arm ith capillary re!ill less than ' seconds
GI/GU: Boel sounds acti(e 0 4 4uadrantsF no *ruits auscultated 8o or"anome"aly
=ercussion dull o(er li(er and spleen and tympanic o(er stomach and intestine A*domen non-tender to palpation
5rine output: Clear Cloudy Color: =re(ious &4 hour output: mLs 8$A
7oley Catheter 5rinal or Bedpan Bathroom =ri(ile"es ithout assistance or ith assistance
C?A punch ithout re*ound tenderness
Last B+: (date $ $ ) 7ormed 6emi-!ormed 5n!ormed 6o!t <ard Li4uid Jatery
Color: Li"ht *ron +edium Bron Dar/ Bron Lello .reen Jhite Co!!ee .round +aroon Bri"ht Red
<emoccult positi(e $ ne"ati(e (lea(e *lan/ i! not done)
.enitalia: Clean- moist- ithout dischar"e- lesions or odor 8ot assessed- patient alert- oriented- denies pro*lems
Other 9 Descri*e:
M,#(,"#>e"eta": 7ull RO+ intact in all e0tremities ithout crepitus
6tren"th *ilaterally e4ual at PPPPPPP R5E PPPPPPP L5E PPPPPPP RLE M PPPPPPP in LLE
Eratin" scale: 0-a*sent- %-trace- &-not a"ainst "ra(ity- '-a"ainst "ra(ity *ut not a"ainst resistance- 4-a"ainst some resistance- D-a"ainst !ull resistanceG
(erte*ral column ithout /yphosis or scoliosis
8euro(ascular status intact: peripheral pulses palpa*le- no pain- pallor- paralysis or parathesias
Ne,r"*i(a": =atient aa/e- alert- oriented to person- place- time- and date Con!usedF i! con!used attach mini mental e0am
C8 &-%& "rossly intact 6ensation intact to touch- pain- and (i*ration Rom*er"Ks 8e"ati(e
6tereo"nosis- "raphesthesia- and proprioception intact .ait smooth- re"ular ith symmetric len"th o! the stride
DTR: Eratin" scale: 0-a*sent- O% slu""ish$diminished- O& acti(e$e0pected- O' sli"htly hyperacti(e- O4 <yperacti(e- ith intermittent or transient clonusG
Triceps: Biceps: Brachioradial: =atellar: Achilles: An/le clonus: positi(e ne"ati(e Ba*ins/i: positi(e ne"ati(e
71: PERTINENT LA0 VALUES AND DIAGNOSTIC TEST RESULTS (include pertinent normals as ell as
a*normals- include rationale and analysis) List dates ith all la*s and dia"nostic tests):
=ertinent includes la*s that are chec/ed hen on certain medications- monitored !or the disease process- need
prior to and a!ter sur"ery- and pertinent to hospitali1ation) Do not !or"et to include dia"nostic tests- such as
5ltrasounds- A-rays- CT- +R,- <,DA- etc) ,! a la* or test is not in the chart (such as one that is done preop) then
include hy you e0pect it to *e done and hat results you e0pect to see)
La< Date# Tre!1 A!a".#i#
32 CURRENT HEALTHCARE TREATMENTS AND PROCEDURES: (Diet- (itals- acti(ity- scheduled
dia"nostic tests- consults- accu chec/s- etc) Also pro(ide rationale and !re4uency i! applica*le))
@ NURSING DIAGNOSES (actual and potential - listed in order o! priority)
%)
&)
')
4)
D)
7 1& CARE PLAN
N,r#i!* Dia*!#i#: (Jhich nursin" dia"nosis you are doin" your care plan on "oes here))
Patie!t Ga"#/O,t('e# N,r#i!* I!ter=e!ti!# t A(/ie=e
Ga"
Rati!a"e 2r I!ter=e!ti!#
Pr=i1e Re2ere!(e#
E=a",ati! 2 Ga" ! Da. (are i#
Pr=i1e1
72 DISCHARGE PLANNING: (put a Q in !ront o! any pt education in a*o(e care plan that you ould include !or dischar"e teachin")
C!#i1er t/e 2""6i!* !ee1#:
R66 Consult
RDietary Consult
R=T$ OT
R=astoral Care
RDura*le +edical 8eeds
R7$5 appts
R+ed ,nstruction$=rescription
R are any o! the patientKs medications a(aila*le at a discount pharmacy> RLes R 8o
RReha*$ <<
R=alliati(e Care
7 1& CARE PLAN
N,r#i!* Dia*!#i#:
Patie!t Ga"#/O,t('e# N,r#i!* I!ter=e!ti!# t A(/ie=e
Ga"
Rati!a"e 2r I!ter=e!ti!#
Pr=i1e Re2ere!(e#
E=a",ati! 2 I!ter=e!ti!# !
Da. (are i# Pr=i1e1
7 DISCHARGE PLANNING: (put a Q in !ront o! any pt education in a*o(e care plan that you ould include !or dischar"e teachin")
C!#i1er t/e 2""6i!* !ee1#:
R66 Consult
RDietary Consult
R=T$ OT
R=astoral Care
RDura*le +edical 8eeds
R7$5 appts
R+ed ,nstruction$=rescription
R are any o! the patientKs medications a(aila*le at a discount pharmacy> RLes R 8o
RReha*$ <<
R=alliati(e Care
7 1& CARE PLAN
N,r#i!* Dia*!#i#:
Patie!t Ga"#/O,t('e# N,r#i!* I!ter=e!ti!# t A(/ie=e
Ga"
Rati!a"e 2r I!ter=e!ti!#
Pr=i1e Re2ere!(e#
E=a",ati! 2 I!ter=e!ti!# !
Da. (are i# Pr=i1e1
7 DISCHARGE PLANNING: (put a Q in !ront o! any pt education in a*o(e care plan that you ould include !or dischar"e teachin")
C!#i1er t/e 2""6i!* !ee1#:
R66 Consult
RDietary Consult
R=T$ OT
R=astoral Care
RDura*le +edical 8eeds
R7$5 appts
R+ed ,nstruction$=rescription
R are any o! the patientKs medications a(aila*le at a discount pharmacy> RLes R 8o
RReha*$ <<
R=alliati(e Care
Re!erences