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University of Cebu-Banilad

College of Nursing
Cebu City

INTRAVENOUS FLUID STUDY

Name of Patient: _________________________________________________ Age:_________ Hospital #: ______________________ Room#___________________


Impression/Diagnose: _____________________________________________________________ Attending Pysician : ______________________________________
Allergies : ________________________________________________________

Type of Solution Classification Contents Indication Contraindication How Supplied? Dosage and Nursing
Frequency Responsibilities
_____________________________________________ __________________________________________________
Name and Signature of Clinical Instuctor Name and Signature of Student

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