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LOCUS OF CONTROL ORIENTATION AND LEVEL - Drake University

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Nursing<br />

Epidural<br />

Flow Sheet Il<br />

CODtS FOP ASSWSMOW<br />

SENSORY DERMATONE <strong>LEVEL</strong>:<br />

Cubnwur Landma& Segments Level<br />

Llitle finger. ..................................... C8<br />

Innei as~d of arm and btwrm .................. 11<br />

Nlpple Ilne..<br />

....................................<br />

l4<br />

Tlpc4 rlphold ................................... n<br />

~mblficua ..................................... T9O<br />

inguinal ligament ............................... H2<br />

MOKlP BLOCUOC g#)MAQO SCU<br />

DEXEtPI(0N <strong>OF</strong> @LOCK:<br />

0 Full llerton af knm and I%& porsrbla I0% block1<br />

1 Jusi able lo flex knees Sllli full Rerlon d bid potubla m% wodl<br />

2 Unnhla ,--.- tn .- flex . -- knees Sllll tltiXlOil Ot +mi. (66% blQCkl<br />

J ~name to move I ~ or S -1. (COmPlde black1<br />

SITE CHECK:<br />

+ , txthatec ~nlocc. drerrlng dW<br />

-<br />

- , Dressing wet, drolnage noted<br />

I - r = Alert. o&ke<br />

(comment requlredl<br />

3 2 = Occaslonolly drm* WJW to arouse<br />

3 = mtnargic<br />

PAIN: palent 10 rate pain on a scale d 0 to 40 4%- MAR'<br />

4 ~i Sornnolenl. d~Hlcult lo arouse -<br />

I<br />

TIME:<br />

COMMENIS<br />

EPIDURAL CAWEYER REMOVAL TIME.<br />

DESCRIPTION <strong>OF</strong> nP<br />

OESCRlPllON <strong>OF</strong> SlE<br />

INITIALS<br />

1

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