Transcription of SAMPLE NOTES/COMMON ABBREVIATIONS
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SAMPLE NOTES/COMMON ABBREVIATIONS
Rev 5/1/2017 SAMPLE NOTES/COMMON ABBREVIATIONS Tools for the OB/GYN clerkship, contained in this document: obstetrics admission delivery operative postpartum section gynecologic history & physical (H & P) labor rounding lessonrev 5/1/2017 Admission to Labor and Delivery NoteDate & time Identification (includes age, gravidity, parity, estimated gestational age, and reason for admission): 26yoG3P1A1 @ 38W5D EGA presents with painful contractions since noon. Pt reports good fetal movement, and denies rupture of membranes or vaginal bleeding.
Tools for the OB/GYN clerkship, contained in this document: 1. Sample obstetrics admission note. 2. Sample delivery note 3. Sample operative note 4. Sample postpartum note a. Vaginal delivery b. Cesarean section orders/note 5. Sample gynecologic history & physical (H & P) 6. Sample labor rounding note 7. Admission orders 8. Commonly-used ...
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