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  • Prenatal Assessment Tool

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    Vic Intia Paa
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    Ana Dela Cruz, a 22-year-old married woman, is 12 weeks pregnant based on her last menstrual period of September 20, 2020. This is her first pregnancy. She experiences headaches and frequent urination as discomforts. Her vital signs and weight are normal during her initial prenatal assessment. She will return for her next prenatal visit as scheduled.

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    Prenatal assessment tool

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    Ana Dela Cruz, a 22-year-old married woman, is 12 weeks pregnant based on her last menstrual period of September 20, 2020. This is her first pregnancy. She experiences headaches and frequent urination as discomforts. Her vital signs and weight are normal during her initial prenatal assessment. She will return for her next prenatal visit as scheduled.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Flag for inappropriate content
    Download as pdf or txt
    97 views2 pages

    Prenatal Assessment Tool

    Uploaded by

    Vic Intia Paa
    Ana Dela Cruz, a 22-year-old married woman, is 12 weeks pregnant based on her last menstrual period of September 20, 2020. This is her first pregnancy. She experiences headaches and frequent urination as discomforts. Her vital signs and weight are normal during her initial prenatal assessment. She will return for her next prenatal visit as scheduled.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Flag for inappropriate content
    Download as pdf or txt
    of 2

    Universidad de Sta.

    Isabel- Barangay Health Center

    Naga City, Camarines Sur

    Prenatal Assessment

    Family Name: Dela Cruz First Name: Ana Middle Name: Bonifacio
    Address: Lerma Naga City Civil Status: Married
    Age: 22 y/o Gender: F Religion: Roman Catholic Date: December 8, 2020

    Gynecologic History:
    Menarche: 12 y/o Length of Cycle: 28 days’ Duration of Flow: 5 days with moderate Flow
    cycle

    ✔
    Family Planning Method: Natural: Artificial:

    Obstetrical Data:
    G1 P 0 (T0P0A0L0M0)
    LMP: September 20, 2020 EDD: June 27, 2021

    1st Trimester
    1st Visit 2nd Visit 3rd Visit 4th Visit 5th Visit 6th Visit
    Date
    Vital Signs T- 36.8 T- T- T- T- T-
    PR- 65 BPM PR- PR- PR- PR- PR-
    RR- 20 BPM RR- RR- RR- RR- RR-
    BP- 120/80 BP- BP- BP- BP- BP-
    Weight
    130 Pounds
    AOG
    12 Weeks
    Fundal
    Height
    FHT
    Discomforts
    (Please check the discomforts felt by the mother)
    Headache
    ✔
    Nausea

    Vomiting

    Nasal
    Stuffiness
    Difficulty
    of
    Breathing
    Fatigue

    Varicose
    Veins
    Edema
    Leg Cramps

    Constipation

    Hemorrhoid

    Other
    discomforts Frequent
    Urination
    Next Visit

    Prepared by: MCN Team AY 2020-2021


    Prepared by: MCN Team AY 2020-2021

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