Вы находитесь на странице: 1из 2

History Assessment Medications Other

RM# Allergies:

MOM G___T___P___A___L___
GBS________
Blood Group_______
Rh ____ RhoGAM ____
Physician/MW
BS/AC _______

SVD/Forceps/Vacuum/C/S
EBL:
IV:
History Assessment Other Discharge
RM # Mec ____________ JA/Bili ____________
BABY GA _______ Sex____ Void ____________ Mom orders _______
Date/Time of Birth Bath ____________ Baby orders________
APGARS ____/_______ PKU ______________
Feeding/Plan: Weight ____________
Birth Weight __________ Cord Clamp_________
%Weight Loss _________ Liaison Nurse _______
Purple Crying _______
Physician Erythromycin _______ Notes: Teaching __________
Vitamin K __________ ID record __________
Blue Card __________
HBIG ___ Hep B Vacc ___ Car Seat ___________
History Assessment Medications Other
RM# Allergies:

MOM G___T___P___A___L___
GBS________
Blood Group_______
Rh ____ RhoGAM ____
Physician/MW
BS/AC _______

SVD/Forceps/Vacuum/C/S
EBL:
IV:
History Assessment Other Discharge
RM # Mec ____________ JA/Bili ____________
BABY GA _______ Sex____ Void ____________ Mom orders _______
Date/Time of Birth Bath ____________ Baby orders________
APGARS ____/_______ PKU ______________
Feeding/Plan: Weight ____________
Birth Weight __________ Cord Clamp_________
%Weight Loss _________ Liaison Nurse _______
Physician Purple Crying _______
Erythromycin _______ Notes: Teaching __________
Vitamin K __________ ID record __________
Blue Card __________
HBIG ___ Hep B Vacc ___ Car Seat ___________

Вам также может понравиться