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    Antenatal Assessment Chart

    Uploaded by

    Arun Ramanan
    This document contains an antenatal assessment chart for collecting a pregnant patient's medical history and examination findings. It includes sections to document the patient's identifying information, chief complaints, obstetric history, medical history, drug history, family history, lifestyle factors, psychological history, pain history, and the results of a physical examination including vital signs, abdominal and breast exams, and functional tests. The assessment gathers comprehensive information to evaluate the patient's health and pregnancy.

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    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd

    Antenatal Assessment Chart

    Uploaded by

    Arun Ramanan
    65 views5 pages
    This document contains an antenatal assessment chart for collecting a pregnant patient's medical history and examination findings. It includes sections to document the patient's identifying information, chief complaints, obstetric history, medical history, drug history, family history, lifestyle factors, psychological history, pain history, and the results of a physical examination including vital signs, abdominal and breast exams, and functional tests. The assessment gathers comprehensive information to evaluate the patient's health and pregnancy.

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    Ante Natal Assessment

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    This document contains an antenatal assessment chart for collecting a pregnant patient's medical history and examination findings. It includes sections to document the patient's identifying information, chief complaints, obstetric history, medical history, drug history, family history, lifestyle factors, psychological history, pain history, and the results of a physical examination including vital signs, abdominal and breast exams, and functional tests. The assessment gathers comprehensive information to evaluate the patient's health and pregnancy.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    65 views5 pages

    Antenatal Assessment Chart

    Uploaded by

    Arun Ramanan
    This document contains an antenatal assessment chart for collecting a pregnant patient's medical history and examination findings. It includes sections to document the patient's identifying information, chief complaints, obstetric history, medical history, drug history, family history, lifestyle factors, psychological history, pain history, and the results of a physical examination including vital signs, abdominal and breast exams, and functional tests. The assessment gathers comprehensive information to evaluate the patient's health and pregnancy.

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    ANTENATAL ASSESSMENT CHART

    NAME

    AGE

    OCCUPATION

    MARITAL STATUS

    HEIGHT WEIGHT

    BMI

    ADDRESS

    CHIEF COMPLAINTS OF THE PATIENT


    PERIOD OF AMENOEEHOEA

    NAUSEA, VOMITTING

    MUSCULOSKELETAL PROBLEMS

    CRAMPS

    FREQUENCY OF MICTURATION

    HEADACHE, EPIGASTRIC PAIN

    SWELLING

    MALAISE

    PRESENT HISTORY

    GPAL
    HISTORY OF GASTROINTESTINAL SYSTEM

    LOSS OF APPETITE

    LOSS OF WEIGHT

    HEART BURN

    CONSTIPATION
    HISTORY OF GENITOURINARY SYSTEM

    INCONTINENCE

    PROLAPSE

    POLYURIA

    BURNING MICTURITION

    PAST HISTORY
    ANY HISTORY OF T.B

    SEIZURES

    BLOOD PRESSURE

    ANAEMIA

    PREVIOUS HISTORY OF MUSCULOSKELETAL PROBLEMS

    Rh INCOMPATIBILITY

    OBSTERIC HISTORY
    ST ND
    S.NO NO OF MODE OF ANY 1 STAGE 2 STAGE BABY SEX BABY
    DELIVERIES DELIVERY COMPLICATIONS OF OF WEIGHT
    LABOUR LABOUR

    MEDICAL HISTORY
    CARDIAC PROBLEMS

    HYPER OR HYPOTHYROIDISM

    AUTO IMMUNE DISORDERS

    BRONCHIAL ASTHMA
    DRUG HISTORY

    SURGICAL HISTORY
    FAMILY HISTORY
    TWINS

    CONGENITAL DEFECTS

    DIABETES MELLITUS

    PERSONAL HISTORY
    SMOKING, ALCOHOLISM

    SLEEPING HABITS

    SOCIO ECONOMIC HISTORY


    OCCUPATION

    FAMILY MEMBERS

    ECONOMIC OUTCOME

    LIFESTYLE

    PSYCHOLOGICAL HISTORY
    EMOTIONAL DISTURBANCES

    ANXIETY/DEPRESSION

    PAIN HISTORY
    ONSET

    DURATION

    TYPE OF PAIN

    LOCATION

    AGGRAVATING FACTORS

    RELIEVING FACTORS
    NIGHT PAIN

    IRRITABILITY LEVEL

    VAS SCORE

    ON OBSERVATION
    GENERAL CONDITION- ECTOMORPH, ENDOMORPH,MESOMORPH

    EDEMA

    TROPHIC CHANGES

    CHOLASMA

    LINEA NIGRA

    STRAIE GRAVIDUM

    NAIL BED

    CONJUCTIVA AND TONGUE

    POSTURE

    ANTERIOR VIEW

    POSTERIOR VIEW

    LATERAL VIEW

    GAIT

    ON PALPATION
    TENDERNESS

    TEMPERATURE VARIATION IN SKIN

    SWELLING

    ON EXAMINATION
    1. VITAL SIGNS

    BP

    PULSE
    RESPIRATORY RATE

    2. ABDOMINAL GIRTH
    3. FUNDAL HEIGHT
    4. LIE/PRESENTATION
    5. RANGE OF MOTION
    6. EDEMA ASSESSMENT

    GIRTH

    VOLUMETRIC

    7. MANUAL MUSCLE TESTING


    8. DTR
    9. DIASTASIS RECTI ASSESSMENT
    10. BREAST EXAMINATION

    SIZE

    NIPPLE

    AREOLA

    11. VARICOSE VEIN/DVT


    12. INCONTINENCE ASSESSMENT
    13. EXERCISE TOLERENCE TESTING

    6 MINUTE WALK TEST

    3 STEP TEST

    14. SPECIAL TEST


    15. FUNSTIONAL ASSESSMENT

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