Anaphylaxis/Severe Allergy IHP

Student's Name *
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DoB
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Address
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Treating Physician
Physician Phone Number
Physician Fax Number

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Nursing Diagnosis: Risk for Allergic Reaction
Nursing Diagnosis: Risk for ineffective airway clearance
Nursing Diagnosis: Risk for Shock
Nursing Diagnosis: Deficient Knowledge
Nursing Diagnosis: Student and Family
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IHP Developed By

Name
Date
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