Documentos de Académico
Documentos de Profesional
Documentos de Cultura
_____Born an alive baby girl or boy via normal spontaneous delivery attended by Dr. __________________
Name tag verified and completed and placed on right ankle by _____________________
Placed prone position on mothers chest for skin to skin contact.
Trans-out to PR-RR with mother by maintaining skin to skin contact.
Rooting reflex noted, assisted mother and initiated breastfeeding, baby with good or poor sucking reflex and breastfeeding
sustained.
Health teaching were given to mothers as follows.
Breastfeed baby per demand and to burp after every feeding.
Keep cord stump clean and dry always.
Never leave the baby unattended.
Emphasized importance of newborn screening.
Advised to perform hand hygiene and hand washing before and after handling the baby.
Keep diaper area clean and dry always.
Avoid using oil, ointment, powder and lotion on babys skin.
Avoid putting binder on cord stump.
Report to NICU staff immediately any untoward observation such as cyanosis, poor suck, fast breathing, and irritability.
Mother acknowledged above health teachings.
Weight __________
HC___________Abd C ___________
Length __________
CC ___________
Arm C ___________
RR __________
CR __________
DR SAMPLE CHARTING
________Received for LR/ER, ambulatory or per wheelchair or per stretcher with an ongoing IVF of __________+__________U
ocyticin x________gtts/min at _______cc level, infusing on right or left hand; accompanied by ____________________________.
________Delivered an alive baby girl or boy via normal spontaneous vaginal delivery by Dr./Intern/Clerk ______________________.
________Cord clamping and cutting done by Dr./Intern/Clerk____________________, after cessation of cord pulsation.
________Placenta out by Shultz or Duncan presentation by Dr./Intern/Clerk_____________________________________.
of vicryl rapide.
Perineal care and betadine swab done
Placed adult diaper and secured.
________Brought to RR per stretcher accompanied by _____________________ with ongoing IVF of _______+______u oxytocin
x_____gtts/min at _____cc level infusing well on right or left hand.
________Trans-out to ward per wheelchair with ongoing IVF of _______+______u oxytocin x_____gtts/min at _____cc level
infusing well on right or left hand, cuddling baby girl or boy; accompanied by______________________________.
SLU BSN II
D and C Notes
________Received for LR/ER, ambulatory or per wheelchair or per stretcher or ambulatory, accompanied by ________________ with
an ongoing IVF of __________+__________U ocyticin x________hrs at _______cc level, infusing on right or left hand.
________Operation ended.
________ Trans-out to ward per wheelchair with ongoing IVF of _______+______u oxytocin x_____gtts/min at _____cc level
infusing well on right or left hand, cuddling baby girl or boy; accompanied by______________________________.
SLU BSN II