"MedcinForm-V1.0"
"PALIVIZUMAB -- PEDS--NHB--RLE--22 August 2005","Navy","System"
0,0,0,830,535,0,1048576,"","",""
2,5,377,295,395,0,32," |||||||0|0||0|0|||0|||0|0|0|0|0||||","V=1:DF=0:PS=1:TP=0:MR=F:BS=0:TWS=0:PB=0:NB=1:ROS=0:PL=0:FB=0:EM=0:CB=0",":-2147483633:HPI/PMH/ROS|PE/Assessment/Plan"
1,20,350,250,370,120010,268445441," |||||||19|80|YCHN|0|0|||0|||0|0|0|0|0||||","|T=T|Y=2|L=","Illness Since Last Visit"
1,300,350,530,370,5,268445441," |||||||19|80|YCHN|0|0|||0|||0|0|0|0|0||||","|T=T|Y=2|L=","Fever"
1,580,350,810,370,120,268445441," |||||||19|80|YCHN|0|0|||0|||0|0|0|0|0||||","|T=T|Y=2|L=","Mucous Discharge From Eyes"
1,300,370,530,390,162,268445441," |||||||19|80|YCHN|0|0|||0|||0|0|0|0|0||||","|T=T|Y=2|L=","Nasal Discharge"
1,580,370,810,390,170,268445441," |||||||19|80|YCHN|0|0|||0|||0|0|0|0|0||||","|T=T|Y=2|L=","Nasal Passage Blockage"
1,20,370,250,390,148,268445441," |||||||19|80|YCHN|0|0|||0|||0|0|0|0|0||||","|T=T|Y=2|L=","Discharge From The Ears"
1,20,390,250,410,353,268445441," |||||||19|80|YCHN|0|0|||0|||0|0|0|0|0||||","|T=T|Y=2|L=","Difficulty Breathing (dyspnea)"
1,300,390,530,410,247,268445441," |||||||19|80|YCHN|0|0|||0|||0|0|0|0|0||||","|T=T|Y=2|L=","Cough"
1,580,390,810,410,273,268445441," |||||||19|80|YCHN|0|0|||0|||0|0|0|0|0||||","|T=T|Y=2|L=","Wheezing"
1,300,410,530,430,415,268445441," |||||||19|80|YCHN|0|0|||0|||0|0|0|0|0||||","|T=T|Y=2|L=","Vomiting"
1,580,410,810,430,475,268445441," |||||||19|80|YCHN|0|0|||0|||0|0|0|0|0||||","|T=T|Y=2|L=","Abdominal Pain"
1,300,430,530,450,2472,268445441," |||||||19|80|YCHN|0|0|||0|||0|0|0|0|0||||","|T=T|Y=2|L=","Abnormal Urinary Volume"
1,20,410,250,430,1412,268445441," |||||||19|80|YCHN|0|0|||0|||0|0|0|0|0||||","|T=T|Y=2|L=","Normal Appetite"
1,580,430,810,450,1733,268445441," |||||||19|80|YCHN|0|0|||0|||0|0|0|0|0||||","|T=T|Y=2|L=","Acting Fussy"
1,20,430,250,450,1493,268445441," |||||||19|80|YCHN|0|0|||0|||0|0|0|0|0||||","|T=T|Y=2|L=","Change in BM Frequency"
1,20,15,620,65,1718,4202753," |||||||19|80|YCN|0|0|||0|||0|0|0|0|0||||","|B=T|T=T|Y=2|L=","Chief Complaint:~High risk infant for Palivizumab vaccination"
1,580,80,810,100,120227,8961," |||||||19|80|YCN|0|0|||0|||0|0|0|0|0||||","|B=T|T=T|Y=2|L=","Medication History Reviewed~reviewed"
1,20,80,560,320,112342,4202753," |||||||19|80|YCN|0|0|||0|||0|0|0|0|0||||","|B=T|T=T|Y=2|L=","History of Present Illness:~No interval history which would impact receiving Palivizumab"
1,650,16,800,66,112379,4202753," |||||||19|80|YCN|0|0|||0|||0|0|0|0|0||||","|B=T|T=T|Y=2|L=","Reason For Visit~Deployment Related / NOT Deployment Related"
1,580,190,810,240,3390,4202753," |||||||19|80|YCN|0|0|||0|||0|0|0|0|0||||","|B=T|T=T|Y=2|L=","Allergies"
1,140,330,210,350,112344,257," |||||||19|80|YC|0|0|||0|||0|0|0|0|0||||","|T=T|Y=2|L=","Negative~Negative"
1,580,170,810,190,3399,8449," |||||||19|80|YCN|0|0|||0|||0|0|0|0|0||||","|O=257|B=T|T=T|Y=2|L=","NKDA"
1,570,165,820,165,0,1," |||||||0|80||0|0|||0|||0|0|0|0|0||||","","0:0:1:1:"
1,10,325,820,325,0,1," |||||||0|80||0|0|||0|||0|0|0|0|0||||","","0:0:1:1:"
1,580,250,810,320,195089,4202753," |||||||19|80|YCN|0|0|||0|||0|0|0|0|0||||","|B=T|T=T|Y=2|L=","Immunizations~[   ] UTD by review~[   ] UTD by report~[   ] Not UTD"
1,570,245,820,245,0,1," |||||||0|80||0|0|||0|||0|0|0|0|0||||","","0:0:1:1:"
1,20,330,140,350,0,32769," |||||||0|80||0|0|||0|||0|0|0|0|0||||","|B=T|T=T","Review of Systems:"
1,580,100,810,160,3409,4203265," |||||||19|80|YCN|0|0|||0|||0|0|0|0|0||||","|B=T|T=T|Y=2|L=","Medications (N=None)"
1,10,10,820,10,0,1," |||||||0|0||0|0|||0|||0|0|0|0|0||||","","0:0:1:1:"
1,10,455,820,455,0,1," |||||||0|80||0|0|||0|||0|0|0|0|0||||","","0:0:1:1:"
1,10,525,820,525,0,1," |||||||0|80||0|0|||0|||0|0|0|0|0||||","","0:0:1:1:"
1,810,15,810,69,0,1," |||||||0|0||0|0|||0|||0|0|0|0|0||||","","0:0:1:1:"
1,640,15,810,15,0,1," |||||||0|0||0|0|||0|||0|0|0|0|0||||","","0:0:1:1:"
1,640,68,810,68,0,1," |||||||0|0||0|0|||0|||0|0|0|0|0||||","","0:0:1:1:"
1,640,15,640,69,0,1," |||||||0|0||0|0|||0|||0|0|0|0|0||||","","0:0:1:1:"
1,10,75,820,75,0,1," |||||||0|0||0|0|||0|||0|0|0|0|0||||","","0:0:1:1:"
1,20,460,810,520,5101,4202753," |||||||19|80|YCN|0|0|||0|||0|0|0|0|0||||","|B=T|T=T|Y=2|L=","Past Medical History:~See Problem Summary list"
1,820,10,820,525,0,1," |||||||0|0||0|0|||0|||0|0|0|0|0||||","","0:0:1:1:"
1,10,10,10,525,0,1," |||||||0|0||0|0|||0|||0|0|0|0|0||||","","0:0:1:1:"
1,570,75,570,325,0,1," |||||||0|0||0|0|||0|||0|0|0|0|0||||","","0:0:1:1:"
2,180,100,260,120,6001,8449," |||||||19|80|YCN|0|0|||0|||0|0|0|0|0||||","|T=T|Y=2|L=","N/A~N/A"
2,20,120,260,140,195992,8961," |||||||19|80|YCN|0|0|||0|||0|0|0|0|0||||","|T=T|Y=2|L=","Current Vital Signs Reviewed"
2,20,280,260,370,11454,4202753," |||||||19|80|YCN|0|0|||0|||0|0|0|0|0||||","|B=T|T=T|Y=2|L=","Barriers to Learning~BARRIERS TO LEARNING~[   ] NONE~[   ] PHYSICAL~[   ] EMOTIONAL~[   ] COGNITIVE"
2,10,10,820,10,0,1,"||||||breaths/min|0|80||0|0|||0|||0|0|0|0|0||||","","0:0:1:1:"
2,10,10,10,520,0,1,"||||||bpm|0|80||0|0|||0|||0|0|0|0|0||||","","0:0:1:1:"
2,20,380,410,470,35832,4202753," |||||||19|80|YCN|0|0|||0|||0|0|0|0|0||||","|B=T|U=T|T=T|Y=2|L=","Assessment~High Risk infant for Palivizumab vaccination~ ~The patient/caregiver acknowledges understanding of the presented information."
2,20,250,260,270,208832,76033," |||||||19|80|YCVUN|0|0|||0|10|0|0|0|0|0|0||||","|B=T|T=T|Y=2|L=",":0:10:1:Pain Level ___"
2,10,245,270,245,0,1,"|||||||0|0||0|0|||0|||0|0|0|0|0||||","","0:0:1:1:"
2,20,220,260,240,105598,11009," ||||||%|19|80|YCVN|0|0|||0|||0|0|0|0|0||||","|T=T|Y=2|L=","Pulse Ox (N=Normal)"
2,20,100,90,120,0,32769," |||||||0|0||0|0|||0|||0|0|0|0|0||||","|B=T|T=T","Vital Signs:"
2,20,20,260,70,209275,4203265," |||||||19|80|YCN|0|0|||0|||0|0|0|0|0||||","|B=T|T=T|Y=2|L=","Growth Parameters Abnormal"
2,20,479,400,499,43338,33562881," |||||||19|295|YCN|0|0|||0|||0|0|0|0|0||||","|B=T|T=T|Y=2|L=","Follow-up:~Monthly and as needed."
2,20,140,260,160,6002,11009," ||||||F|19|80|YCVN|0|0|||0|||0|0|0|0|0||||","|T=T|Y=2|L=","Temperature (N=Normal)"
2,20,160,260,180,6021,11009," |||||||19|80|YCVN|0|0|||0|||0|0|0|0|0||||","|T=T|Y=2|L=","RR (N=Normal)"
2,20,180,260,200,6034,11009," |||||||19|80|YCVN|0|0|||0|||0|0|0|0|0||||","|T=T|Y=2|L=","Pulse Rate (N=Normal)"
2,20,200,260,220,6045,11009," |||||||19|80|YCVN|0|0|||0|||0|0|0|0|0||||","|T=T|Y=2|L=","BP (N=Normal)"
2,420,380,810,500,19467,4202753," |||||||19|80|YCN|0|0|||0|||0|0|0|0|0||||","|B=T|U=T|T=T|Y=2|L=","Plan~~ ~  __________mg IM now"
2,270,10,270,375,0,1,"|||||||0|80||0|0|||0|||0|0|0|0|0||||","","0:0:1:1:"
2,820,10,820,520,0,1,"|||||||0|0||0|0|||0|||0|0|0|0|0||||","","0:0:1:1:"
2,10,520,820,520,0,1,"|||||||0|0||0|0|||0|||0|0|0|0|0||||","","0:0:1:1:"
2,415,375,415,520,0,1,"|||||||0|0||0|0|||0|||0|0|0|0|0||||","","0:0:1:1:"
2,10,95,270,95,0,1,"|||||||0|0||0|0|||0|||0|0|0|0|0||||","","0:0:1:1:"
2,20,73,260,93,6063,76033," ||||||kg|19|80|YCVUN|0|0|||0|||0|0|0|0|0||||","|T=T|Y=2|L=",":0:0:0:Weight"
2,10,275,270,275,0,1,"|||||||0|0||0|0|||0|||0|0|0|0|0||||","","0:0:1:1:"
2,10,375,820,375,0,1,"|||||||0|0||0|0|||0|||0|0|0|0|0||||","","0:0:1:1:"
2,280,20,810,370,208847,4202753," |||||||19|80|YCN|0|0|||0|||0|0|0|0|0||||","|B=T|U=T|T=T|Y=2|L=","PHYSICAL EXAMINATION~[   ] Not Performed~ ~Dose calculation:~ ~Wt(kg) ______ x 15mg/kg = ______ mg"
2,10,10,270,375,0,8,"","C=12632256|K=12632256|O=12632256|E=12632256|R=20|W=1",""