Interview :

Script: Magandang araw po Mrs, kami po ay estudyante ng Our Lady of Fatima University
mula sa kursong Bachelor of Science in Nursing. Ang interview po natin sa araw na ito, ay
tumutukoy po sa kalagayan ng inyong pagbubuntis. Rest assured po na ang information na
makakalap po namin ay mananatiling confidential.

Q’s: demographic data

 Name: (No need to be specific) or mention depende sa client

 Date of Birth:

 Age:

 Address: (No need to be specific) // optional

 Marital Status: Kayo po ba ay may asawa o single parent?

 Religion:

 Allergies for Medication: and if meron, ano ang alternative since nagbubuntis sila as of
the moment

 Alcohol or Tobacco Use: ** Before and during pregnancy

 Medical Condition: **before pregnancy

 Treatment: Albularyo or Doctor

 Children:

 Need identified:

 Plan during delivery, who to involve, and where to deliver:

Gynecologic and Obstetric History (Before the pregnancy)

 Chief complaint History of illness (past medical history) ; May sakit ba sa puso si nanay?
May inherited diseases ba sa pamilya?

 Menstrual pattern Cycle (days) - irreg or regular

 Duration of flow - was it equaled or exceeded

 Amount of flow (based on pad's use if soaked or not) masyado bang malakas or tama
lang

 Associated pain

 Intermittent bleeding : Nung nagkaroon ng pagdudugo, ano po ang naging resulta ng

diagnosis ng doctor? Makakaapekto daw po ba ito sa inyong pagbubuntis?
 Age of menarche

 Contraception current method, satisfied with the method? Infections (during vaginal and
rectal exams)

 Any difficulty in conception current and previous: before mabuo si baby

 Description of each pregnancy and outcome : (** if hindi ito ang unang pagbubuntis)

 Describe any maternal, fetal, neonatal complications ; (** if hindi ito ang unang
pagbubuntis)

 Hospitalizations (when, where, what is the cause) : while pregnant

 Childhood diseases (what specific health problem)

 Surgical history Medication and allergies

 Over the counter medication : **if nagtetake while pregnant, sa interpretation na ito
maassess

 Herbal preparation

 Health maintenance Diet and nutritional status

 Exercise, elimination, sleep, hobbies: before and during pregnancy

Open-ended Q’s:

 Pang-ilang pagbubuntis niyo na po ito?

 Ano po ‘yong unang symptoms na napansin ninyo bago niyo naconfirm na buntis po kayo?

 May mga difficulties po ba kayong nakaharap habang nagbubuntis?

 Nakakaranas po ba kayo ng bleeding o pagdudugo habang nagbubuntis?

**Kung hindi naman ito ang unang pagbubuntis:

 Ano pong pinagkaiba ng unang pagbubuntis niyo sa pagbubuntis niyo ngayon? Alin po ang mas
nahirapan kayo?

 Bakit niyo po nasabi na mas nahirapan kayo (pertain to the answer of the client kung alin siya mas
nahirapan)

 Normal delivery po ba kayo sa unang pregnancy or cs?