Labor & Delivery | NursingWorksheets.com

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Date: ___________Shift: ___________Nurse: ___________

NursingWorksheets.comLabor & Delivery

PATIENT 1

Name:

Rm: ____

Age: ____

Allergies:

Code: ____

MD:

Dx:

VITALS

	0700	0800	0900	1000	1100	1200	1300	1400	1500	1600	1700	1800
HR
BP
RR
Temp
SpO2
Pain

FETAL MONITORING

FHR Baseline:

Variability:

Accels:

Decels:

Category (I/II/III):

CONTRACTIONS

Frequency: ____

Duration: ____

Intensity: ____

Resting Tone: ____

CERVICAL STATUS

Dilation (cm): ____

Effacement (%): ____

Station: ____

Position: ____

GBS / ANTIBIOTICS

GBS Status:

Abx / Time:

MEDICATIONS

Drug / Dose / Route	Time	Given	Notes

LABS

Na:

K:

BUN:

Cr:

Glu:

WBC:

Hgb:

Plt:

Other:

IV ACCESS

Site/Gauge:

Fluid/Rate:

Date:

I&O

INTAKE

PO:

IV:

Blood:

Other:

Total:

OUTPUT

Urine:

Drain:

Emesis:

Other:

Total:

ASSESSMENT

PLAN / TASKS

NOTES