KINGDOM OF SAUDI ARABIA ‫المملكة العربية السعودية وزارة‬

Ministry of Education ‫التعليم جامـعـة حـائل‬

University of Hail
College of Nursing
‫كلية التمريض‬

Clinical Log
Student Name
University Number
Instructor Name
Score /10 Divided by 2 = /5

Demographic Data (1 Mark)

Patient Room Ward
Age Gender

Health History (1 Mark)

Medical Diagnoses Present health history:

Reason for Admission/Operation

Standard precaution (if Applicable)
Vital Signs Nursing Procedures Performed Assisted Observed
(1 Mark) (1 Mark)
Temperature 1.
Pulse Rate 2.
Respiratory Rate 3.
Blood Pressure 4.
SPO2 5.
Pain Score if Applicable 6.

Physical Assessment (signs and symptoms) (1 Mark)

Nursing Diagnosis (At least 1)

1.
2.
Interventions (1 Mark)
 KINGDOM OF SAUDI ARABIA ‫المملكة العربية السعودية‬
Ministry of Education ‫وزارة التعليم‬
University of Hail
College of Nursing
‫جامـعـة حـائل‬
‫كلية التمريض‬

Medication Assessment (3 Marks)

Medication Name Drug Classification Dosage/Route/Frequency Reason for Use (Indication) Nursing
Generic &trade 0.5 marks 0.5 marks 0.5 marks Considerations/Interventions (1
name 0.5 marks mark)

1.

2.

3.

4.

5.