University of San Agustin
General Luna St., 5000 Iloilo City, Philippines
www.usa.edu.ph
COLLEGE OF HEALTH AND ALLIED MEDICAL PROFESSIONS - DEPARTMENT OF
NURSING
LABE, SHANE KYLE D.
BSN 1 – A
NCM 107a SL/RLE: Care of Mother, Child, and Adolescent (Well Clients)
Activity 2: OB History
INSTRUCTIONS: KINDLY BASE YOUR DATA/INFORMATION IN THE SAMPLE PHYSICIAN ORDERS BELOW IN
FILLING UP THE FORMS.
PHYSICIAN ORDER SHEET
Hospital No: 1234567
Patient name: DE LA CRUZ, JUANA__Age:25 y. o. Sex:_Female Civil Status: Married Ward: OB ward
DATE
TIME
PROGRESS
NOTES
5/22/2021
(+) fever
(+) foul
Smelling
lochia
2 days
postpartum
NSVD
G2P2
PHYSICIAN ORDER
C
Please admit patient at OB ward
under the
Service of Dr. Kwok, J.
TPR q 4h and record
Soft diet
Laboratories:
· CBC, PC, Blood typing
· Urinalysis, Chest X-ray PA view
· S. NA, K
· FBS, Lipid profile
Start IVF: D5LR 1L x 8 hours
Medications:
Ceftriaxone 500 mg IVTT OD
ANST
Paracetamol 300 mg IVTT q4H
PRN for Temp. > 37.8C
Special Orders:
· Vital signs q2 and record
· Monitor lochia and refer
· Refer laboratory results once in
· Refer PRN
Dr. Sharon Maquiran
OB-ROD
Lic No. 0123456
Email: cn@usa.edu.ph | Tel. No.: 0999-997-1485 | Fax No.: (033) 337-4403
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University of San Agustin
General Luna St., 5000 Iloilo City, Philippines
www.usa.edu.ph
COLLEGE OF HEALTH AND ALLIED MEDICAL PROFESSIONS - DEPARTMENT OF
NURSING
C-CARRIED OUT
A-ADMINISTERED
R-REQUESTED
E-ENDORSED
Email: cn@usa.edu.ph | Tel. No.: 0999-997-1485 | Fax No.: (033) 337-4403
D-DISCONTINUED