ST. ANTHONY COLLEGE OF ROXAS CITY, INC. College of Nursing Roxas City IMMEDIATE NEWBORN CARE SCRUB FORM eee Name; MNERisTis Ute 8 Maren Cord Care #:_& ‘atient’s Name: aly Gil Clinical AOG: 98 weeks Sex: _Famale Pediatrician: Dr. tA. s Case w_o% Name of Mother: km. 8. Age: 28 ylo_ Civil Status: _M__ Date and Time of Delivery: _Mv.20, 202) § 1:10 am Type of Delivery: /__NSVD cs Presentation: / Cephalic Breech: Footling Frank Shoulder Tronsverse Anthropometric Measurements: ‘Weight: 77 kg - Head Circumference: 34 can Chest Circumference: 82 om Abdominal Circumference: __¢ en Length: Hem APGAR Score: e/F Medications and Treatments: Phytradioné (vitamin K)_Imq +1ec_ IM @_left-_ankrolateal thigh (vastus tateealis) yitin ih after bili; Recmbivax (Hepahihs BY vacuae (Re Comlinont)) 0-Se ne pt ccmatateal ag. [race lateralis) wiHm ah agter larth (rer dove), vital signs en Shite i of ewees if Imwor ” oonnchvel Respiratory Rate: 10 bpm Cardiac Rate: 730 Temperature: He Distinguishing Marks: istinguisnip sence of Veenit Casroin a white cheese Ike _gubstance Corer fhe shin onthe head and osm. Myke. MENG SN, SACRI d Signature of Student