Department of Nursing Date ________________________
NURS 303L – Clinical Case Study Assignment
Client Age __________ M F Admit Date__________________ Allergies__________________________________
Admitting Diagnosis __Hypertension______________________________________________________________________________________________
Activity Level__________________________________ Diet____________________________________________________________
Past Medical / Surgical History_______________________________________________________________________________________________________ ____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
Treatments____________________________________________________________________________________________________________ _____________________________________________________________________________________________________________________
Procedures / Surgeries – this admission_____________________________________________________________________________________
__________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
IV Therapy: Site____________________________ Fluid___________________________________ Device__________________________ Rate___________________________________
Medications Medications