Maternity_Clinical_Log_1

Maternity_Clinical_Log_1 - Maternity Page 1 of 6 Clinical...

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Maternity Page 1 of 6 San Jose State University School of Nursing NURS 146B CLINICAL LOG PART A: Patient History List previous pregnancies and deliveries: Year Weeks gestation Vaginal/C-Section Sex Complications List medications taken during pregnancy : Delivery Information Summary: Allergies_______________ 5/04/2008 DG Clinical Date Student: Maternal Information Infant Information Initials: Age: Sex: DOB: Allergies: Weight: Time of birth: Language: Eng Span Other OFC: cm. Admission G P Post Delivery G P Apgars: 1min: 5 min: 10 min: Blood Type: Rh: Gestational Age: VDRL: HbsAg: B Strep: Admission Vital signs: Rubella: PPD: Chlamydia: Temp: P: R: GC: CXR: Recent vital signs: Ethnicity: Religion: Birthplace: Temp. P: R: Circle: NSVD VBAC VACUUM FORCEPS C-SECTION EBL: Reason for C-Section: FTP CPD FD RPT Other: INTACT EPISIOTOMY LACERATION 1 st 2 nd 3 rd 4 th degree ARMOM or SROM Date: Time: Clear? MECONIUM: (type): none thin mod thick Foul Smelling? Time elapsed between ROM
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This note was uploaded on 09/08/2010 for the course NURS 146B at San Jose State.

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Maternity_Clinical_Log_1 - Maternity Page 1 of 6 Clinical...

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