Get Obstetric History And Physical Template 2014-2025

This guide provides a clear and user-friendly approach to completing the Obstetric History and Physical Template online. By following these steps, users will be able to efficiently fill out the required sections of the form with ease.

Follow the steps to complete the Obstetric History and Physical Template online:

1. Press the ‘Get Form’ button to access the Obstetric History and Physical Template and open it in your preferred editor.
2. Begin by entering the age, G, P (Gravida, Para), gestational age (GA), last menstrual period (LMP) date, and estimated due date (EDD) along with the confirming provider.
3. In the gynecological history section, document the age of menarche, any abnormal Pap smear results, regularity of menses, and any history of STDs.
4. State the chief complaint (CC) clearly in the designated area.
5. Fill out the obstetric history (OB Hx) section by noting prior pregnancies with relevant details such as year, estimated gestational age (EGA), whether the delivery was vaginal or cesarean, and any specific problems.
6. Provide the history of present illness (HPI) using the space provided; use additional pages if necessary.
7. Note the onset of labor, contraction frequency, and whether there has been rupture of membranes (ROM). Include answers to questions regarding bleeding and fetal kick counts (FKC).
8. Record details of prenatal care including visits to obstetricians or family practice providers, and total number of prenatal care visits.
9. In the review of systems (ROS) section, indicate any relevant observations across specified areas such as HEENT, lungs, cardiovascular, and abdomen.
10. Enter vital signs and physical examination details including temperature, heart rate, blood pressure, respiratory rate, height, weight, and body mass index (BMI).
11. Detail any ultrasounds performed and their findings in the ultrasound section.
12. Complete the pregnancy labs section by filling out the required tests such as ABO/Rh group, and other relevant laboratory values.
13. Document medications, allergies, past medical and surgical histories, and whether blood products are acceptable.
14. Record fetal heart tones (FHT), uterine contractions (UCs), and any findings from fetal monitoring.
15. Concisely state the assessment of the patient including maternal and fetal evaluations.
16. Outline plans for care, including pain management and any necessary follow-up.
17. Complete sections for family history, social history regarding support and living situation, and mental health history.
18. Finally, sign and date the template to confirm its accuracy and completion. Users can now save changes, download, print, or share the filled form as needed.

Start completing your Obstetric History and Physical Template online today!