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ABC Report
Please enter your Caregiver ID
*
Please enter your Patient's Admission ID
*
Patient Name
*
Clinical ABC
Does your patient have any ABC changes?
*
-----SELECT-------
Yes
No
My Patient is:
A
Acting differently
Newly confused, agitated, sleepy
Fever or chills
B
Breathing differently, or coughing
Short of breath or more short of breath than usual
New or worsening cough
C
Change in circulation or skin
Increase in swelling of arms, legs, face or belly
Change in skin?
D
Diet changes, not eating or drinking as usual
E
Elimination or bathroom changes
More or less urine, dark, blood, mucus or foul smelling
Any diarrhea, or no bowel movement for 3 days?
F
Fall or feeling pain
Fallen or has more difficulty standing or walking
Feeling new or worse pain
G
Go take your medications
My patient took all of their medications from the end of your last shift until the end of this shift
I checked the medication box
Activity
Did your patient do Active Range of Motion today?
*
Yes
No
Tiptoe
Marching
Reach
Leg lifts
Tap dance
Core balance
Chair rise
Did you do pleasurable activities with your patient today?
*
Yes
No
Outdoor activities
Beauty/pampering
Crafts/hobbies/games
Socializing
Other pleasurable activities
Patient Info
What is your patients highest spirometry reading?
*
Please enter a number from
000
to
9999
.
Spirometry
Spirometry not taken
What is your patient's Weight?
*
Please enter a number from
10
to
999
.
Weight
Patient not weighed
What is your patients monthly TUG
Please enter a number from
1
to
999
.
Enter either 1,2, or 3 digits, the first one for minutes and the last 2 for seconds. For example, 1 minute and 30 seconds would be entered as 130
TUG
TUG not needed
Δ