Date: ___________Shift: ___________Nurse: ___________
NursingWorksheets.com — Labor & Delivery
Vital signs monitoring grid | 0700 | 0800 | 0900 | 1000 | 1100 | 1200 | 1300 | 1400 | 1500 | 1600 | 1700 | 1800 |
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| HR | | | | | | | | | | | | |
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| BP | | | | | | | | | | | | |
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| RR | | | | | | | | | | | | |
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| Temp | | | | | | | | | | | | |
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| SpO2 | | | | | | | | | | | | |
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| Pain | | | | | | | | | | | | |
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FHR Baseline:
Variability:
Accels:
Decels:
Category (I/II/III):
Frequency: ____
Duration: ____
Intensity: ____
Resting Tone: ____
Dilation (cm): ____
Effacement (%): ____
Station: ____
Position: ____
Medication administration record| Drug / Dose / Route | Time | Given | Notes |
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Na:
K:
BUN:
Cr:
Glu:
WBC:
Hgb:
Plt:
Other:
Site/Gauge:
Fluid/Rate:
Date:
INTAKE
PO:
IV:
Blood:
Other:
Total:
OUTPUT
Urine:
Drain:
Emesis:
Other:
Total:
For educational use only. Always verify with clinical judgment and facility protocols.
