ROW_ID string | SUBJECT_ID string | HADM_ID string | CHARTDATE string | CHARTTIME string | STORETIME string | CATEGORY string | DESCRIPTION string | CGID string | ISERROR string | TEXT string | MASK string | MASK_LABEL string | binary_label string | input_text string | Chunks string |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
2079183 | 32048 | 149152.0 | 2187-08-10 | 2187-08-10 14:30:00 | 2187-08-10 14:35:00 | Nursing/other | Report | 19836.0 | NPN 07a-07p
5 ID
RESP
RA, LS clear & equal with mild intec/subc. retractions.
RR30-50's. No spells or desats this shift thus far. Cont.
monitor resp. status.
I&D
48hr r/o done. BC negative thus far. Cont. monitor for s&s
of infection.
FEN
TF increased to 80cc/kg/day, PE/BM20, all PO this shift thus
far. No spits. Coo... | NPN 07a-07p
5 ID
RESP
RA, LS clear & equal with mild intec/subc. retractions.
RR30-50's. No spells or desats this shift thus far. Cont.
monitor resp. status.
I&D
48hr r/o done. BC negative thus far. Cont. monitor for s&s
of infection.
FEN
TF increased to 80cc/kg/day, PE/BM20, all PO this shift thus
far. No spits. Coo... | 00000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000... | NPN 07a-07p
5 ID
RESP
RA, LS clear & equal with mild intec/subc. retractions.
RR30-50's. No spells or desats this shift thus far. Cont.
monitor resp. status.
I&D
48hr r/o done. BC negative thus far. Cont. monitor for s&s
of infection.
FEN
TF increased to 80cc/kg/day, PE/BM20, all PO this shift thus
far. No spits. Coo... | ["NPN 07a-07p\n\n5 ID\n\nRESP\nRA, LS clear & equal with mild intec/subc. retractions.\nRR30-50's. No spells or desats this shift thus far. Cont.\nmonitor resp. status.\nI&D\n48hr r/o done. BC negative thus far. Cont. monitor for s&s\nof infection.\nFEN\nTF increased to 80cc/kg/day, PE/BM20, all PO this shift thus\nfar... | ||
2079184 | 32048 | 149152.0 | 2187-08-10 | 2187-08-10 17:31:00 | 2187-08-10 17:32:00 | Nursing/other | Report | 17593.0 | Family Meeting
Had family meeting with both parents, NNP [**Last Name (LF) 734**], [**Name8 (MD) 735**] RN to discuss status and plans as well as discharge criteria. Need help in choosing pediatrician. Answered questions.
| Family Meeting
Had family meeting with both parents, NNP <Name>Tejada</Name>, <Name>Aaron Wilson</Name> RN to discuss status and plans as well as discharge criteria. Need help in choosing pediatrician. Answered questions.
| 00000000000000000000000000000000000000000000000000000000001111110011111111111100000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000 | Family Meeting
Had family meeting with both parents, NNP Tejada, Aaron Wilson RN to discuss status and plans as well as discharge criteria. Need help in choosing pediatrician. Answered questions.
| ['Family Meeting\n\nHad family meeting with both parents, NNP Tejada, Aaron Wilson RN to discuss status and plans as well as discharge criteria. Need help in choosing pediatrician. Answered questions.\n\n'] | ||
2079661 | 32213 | 193976.0 | 2100-11-01 | 2100-11-01 13:18:00 | 2100-11-01 13:29:00 | Nursing/other | Report | 18929.0 | NPN
RESP- Infant remains stable in RA. LS clear and =. No
increased WOB noted. No spells noted thus far. Day 2 of 5.
Will continue to monitor and support.
FEN- TF min of 120cc/kg/d of E24=46ccs q4h. Infant taking
in above required volume all PO. Tolerating feeds well with
no spits thus far. Abd is benign with... | NPN
RESP- Infant remains stable in RA. LS clear and =. No
increased WOB noted. No spells noted thus far. Day 2 of 5.
Will continue to monitor and support.
FEN- TF min of 120cc/kg/d of E24=46ccs q4h. Infant taking
in above required volume all PO. Tolerating feeds well with
no spits thus far. Abd is benign with... | 00000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000... | NPN
RESP- Infant remains stable in RA. LS clear and =. No
increased WOB noted. No spells noted thus far. Day 2 of 5.
Will continue to monitor and support.
FEN- TF min of 120cc/kg/d of E24=46ccs q4h. Infant taking
in above required volume all PO. Tolerating feeds well with
no spits thus far. Abd is benign with... | ['NPN\n\n\nRESP- Infant remains stable in RA. LS clear and =. No\nincreased WOB noted. No spells noted thus far. Day 2 of 5.\n Will continue to monitor and support.\n\nFEN- TF min of 120cc/kg/d of E24=46ccs q4h. Infant taking\nin above required volume all PO. Tolerating feeds well with\nno spits thus far. Abd is ... | ||
2075366 | 31630 | 141993.0 | 2129-08-27 | 2129-08-27 20:21:00 | 2129-08-27 20:23:00 | Nursing/other | Report | 19157.0 | [** 63**] Physical Exam
Awake and [** 96**] in isolette. AFOF. BSC and equal on RA with mild retractions and comfortable resp effort. No audible murmur at this time, normal pulses, pink and well perfused. Thoracotomy dressing intact and removed, beneath the dressing was an intact incision with dermabond in place, no dr... | <Digit>27</Digit> Physical Exam
Awake and <Digit>50</Digit> in isolette. AFOF. BSC and equal on RA with mild retractions and comfortable resp effort. No audible murmur at this time, normal pulses, pink and well perfused. Thoracotomy dressing intact and removed, beneath the dressing was an intact incision with dermabond... | 11000000000000000000000000011000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000... | 27 Physical Exam
Awake and 50 in isolette. AFOF. BSC and equal on RA with mild retractions and comfortable resp effort. No audible murmur at this time, normal pulses, pink and well perfused. Thoracotomy dressing intact and removed, beneath the dressing was an intact incision with dermabond in place, no drainage and hea... | ['27 Physical Exam\nAwake and 50 in isolette. AFOF. BSC and equal on RA with mild retractions and comfortable resp effort. No audible murmur at this time, normal pulses, pink and well perfused. Thoracotomy dressing intact and removed, beneath the dressing was an intact incision with dermabond in place, no drainage and ... | ||
2075367 | 31630 | 141993.0 | 2129-08-28 | 2129-08-28 01:03:00 | 2129-08-28 01:05:00 | Nursing/other | Report | 19157.0 | [** 63**] Physical Exam
Awake andlaert in isolette, swaddled. AFOF. BSC and equal on RA with mild retractions and comfortable respirations. No audible murmur, well erfused and pink with normal pulses. Incision dry and intact under the dermabond. ABD soft and rounded with active BS, no masses.
| <Digit>48</Digit> Physical Exam
Awake andlaert in isolette, swaddled. AFOF. BSC and equal on RA with mild retractions and comfortable respirations. No audible murmur, well erfused and pink with normal pulses. Incision dry and intact under the dermabond. ABD soft and rounded with active BS, no masses.
| 11000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000 | 48 Physical Exam
Awake andlaert in isolette, swaddled. AFOF. BSC and equal on RA with mild retractions and comfortable respirations. No audible murmur, well erfused and pink with normal pulses. Incision dry and intact under the dermabond. ABD soft and rounded with active BS, no masses.
| ['48 Physical Exam\nAwake andlaert in isolette, swaddled. AFOF. BSC and equal on RA with mild retractions and comfortable respirations. No audible murmur, well erfused and pink with normal pulses. Incision dry and intact under the dermabond. ABD soft and rounded with active BS, no masses.\n'] | ||
2075368 | 31630 | 141993.0 | 2129-08-28 | 2129-08-28 01:49:00 | 2129-08-28 01:51:00 | Nursing/other | Report | 19812.0 | NPN 7p-7a
FEN: CW 2265 (up 50g). TF 150cc/k/d of PE28 = 55cc Q4hrs.
Abd. benign. Infant bottled 45cc @ 2200. Voiding, no
stool. No spits. Aspirate of 2.8cc. On Fe and Vit E.
Infant learning to PO, becoming more vigorous. Continue to
encourage PO's and supplement remainder.
DEV: Temp stable in off isolette. ... | NPN 7p-7a
FEN: CW 2265 (up 50g). TF 150cc/k/d of PE28 = 55cc Q4hrs.
Abd. benign. Infant bottled 45cc @ 2200. Voiding, no
stool. No spits. Aspirate of 2.8cc. On Fe and Vit E.
Infant learning to PO, becoming more vigorous. Continue to
encourage PO's and supplement remainder.
DEV: Temp stable in off isolette. ... | 00000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000... | NPN 7p-7a
FEN: CW 2265 (up 50g). TF 150cc/k/d of PE28 = 55cc Q4hrs.
Abd. benign. Infant bottled 45cc @ 2200. Voiding, no
stool. No spits. Aspirate of 2.8cc. On Fe and Vit E.
Infant learning to PO, becoming more vigorous. Continue to
encourage PO's and supplement remainder.
DEV: Temp stable in off isolette. ... | ["NPN 7p-7a\n\n\nFEN: CW 2265 (up 50g). TF 150cc/k/d of PE28 = 55cc Q4hrs.\nAbd. benign. Infant bottled 45cc @ 2200. Voiding, no\nstool. No spits. Aspirate of 2.8cc. On Fe and Vit E.\nInfant learning to PO, becoming more vigorous. Continue to\nencourage PO's and supplement remainder.\n\nDEV: Temp stable in off... | ||
2075369 | 31630 | 141993.0 | 2129-08-28 | 2129-08-28 15:44:00 | 2129-08-28 15:47:00 | Nursing/other | Report | 16433.0 | Nursing Progress Note:
#3 - FEN: TF at 150cc/kilo/day = 55cc's q 4 hours of PE28.
Bottled 50cc then 35cc's today thus far. Waking for some
feeds. Abdomin soft and round. +BS. Voiding and stooling.
One small spit noted. Max aspirate 2cc's. Remains on vit e
and iron.
#4 - G&D: In off isolette. [** **] and active with car... | Nursing Progress Note:
#3 - FEN: TF at 150cc/kilo/day = 55cc's q 4 hours of PE28.
Bottled 50cc then 35cc's today thus far. Waking for some
feeds. Abdomin soft and round. +BS. Voiding and stooling.
One small spit noted. Max aspirate 2cc's. Remains on vit e
and iron.
#4 - G&D: In off isolette. and active with cares.
Mov... | 00000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000... | Nursing Progress Note:
#3 - FEN: TF at 150cc/kilo/day = 55cc's q 4 hours of PE28.
Bottled 50cc then 35cc's today thus far. Waking for some
feeds. Abdomin soft and round. +BS. Voiding and stooling.
One small spit noted. Max aspirate 2cc's. Remains on vit e
and iron.
#4 - G&D: In off isolette. and active with cares.
Mov... | ["Nursing Progress Note:\n#3 - FEN: TF at 150cc/kilo/day = 55cc's q 4 hours of PE28.\nBottled 50cc then 35cc's today thus far. Waking for some\nfeeds. Abdomin soft and round. +BS. Voiding and stooling.\nOne small spit noted. Max aspirate 2cc's. Remains on vit e\nand iron.\n#4 - G&D: In off isolette. and active with ca... | ||
2076595 | 31736 | 144915.0 | 2121-12-06 | 2121-12-06 07:27:00 | 2121-12-06 07:28:00 | Nursing/other | Report | 15938.0 | [** 82**] Physical E xam
PE: pink, under phototherapy with eyes covered, AFOF, sutures override, orally intubated, breath sounds clear/equal, mild to moderate intercostal and subcostal retracting, no murmur, normal pulses and perfusion, abd soft, non distended, non tender, soft intermittent bowel sounds, PICC right arm... | <Digit>38</Digit> Physical E xam
PE: pink, under phototherapy with eyes covered, AFOF, sutures override, orally intubated, breath sounds clear/equal, mild to moderate intercostal and subcostal retracting, no murmur, normal pulses and perfusion, abd soft, non distended, non tender, soft intermittent bowel sounds, PICC r... | 11000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000... | 38 Physical E xam
PE: pink, under phototherapy with eyes covered, AFOF, sutures override, orally intubated, breath sounds clear/equal, mild to moderate intercostal and subcostal retracting, no murmur, normal pulses and perfusion, abd soft, non distended, non tender, soft intermittent bowel sounds, PICC right arm with i... | ['38 Physical E xam\nPE: pink, under phototherapy with eyes covered, AFOF, sutures override, orally intubated, breath sounds clear/equal, mild to moderate intercostal and subcostal retracting, no murmur, normal pulses and perfusion, abd soft, non distended, non tender, soft intermittent bowel sounds, PICC right arm wit... | ||
2076596 | 31736 | 144915.0 | 2121-12-06 | 2121-12-06 09:27:00 | 2121-12-06 09:41:00 | Nursing/other | Report | 14424.0 | NICU Attending Note
DOL # 4 = 27 2/7 weeks PMA with HMD, PDA, issues of fluid/nutrition, hyperbili. No new concerns.
I agree with above [**Name6 (MD) 71**] [**Name8 (MD) 31**] [**First Name9 (NamePattern2) 82**] [**Location (un) **].
CVR/RESP: BP 72/45, RRR with no audible murmur, no palpable palmar pulses, slight r... | NICU Attending Note
DOL # 4 = 27 2/7 weeks PMA with HMD, PDA, issues of fluid/nutrition, hyperbili. No new concerns.
I agree with above <Name>Lissette Camargo</Name> <Name>Wayne Grier</Name> <Name>Shawn</Name> <Location>USS Ramos
FPO AA 25841</Location>.
CVR/RESP: BP 72/45, RRR with no audible murmur, no palpable pa... | 00000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000011111111111111110111111111110111110111111111111111111111100000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000... | NICU Attending Note
DOL # 4 = 27 2/7 weeks PMA with HMD, PDA, issues of fluid/nutrition, hyperbili. No new concerns.
I agree with above Lissette Camargo Wayne Grier Shawn USS Ramos
FPO AA 25841.
CVR/RESP: BP 72/45, RRR with no audible murmur, no palpable palmar pulses, slight retractions, BS diminished, clear. Compl... | ["NICU Attending Note\n\nDOL # 4 = 27 2/7 weeks PMA with HMD, PDA, issues of fluid/nutrition, hyperbili. No new concerns.\n\nI agree with above Lissette Camargo Wayne Grier Shawn USS Ramos\nFPO AA 25841.\n\nCVR/RESP: BP 72/45, RRR with no audible murmur, no palpable palmar pulses, slight retractions, BS diminished, cle... | ||
2076597 | 31736 | 144915.0 | 2121-12-06 | 2121-12-06 14:51:00 | 2121-12-06 15:13:00 | Nursing/other | Report | 21232.0 | NPN
#1 Rec'd on vent settings: 18/6 x 14, Fio2 21-25%. Settings
clinically decreased to 16/5. LS = and auscultated both
diminished and clear throughout day. RR usually 40-60's but
sometimes to 80's. Has baseline retractions but increased
WOB noted at times. Blood gas this AM: 7.19/48/37/19/-10 ->
NaHCo3 given. Blood ... | NPN
#1 Rec'd on vent settings: 18/6 x 14, Fio2 21-25%. Settings
clinically decreased to 16/5. LS = and auscultated both
diminished and clear throughout day. RR usually 40-60's but
sometimes to 80's. Has baseline retractions but increased
WOB noted at times. Blood gas this AM: 7.19/48/37/19/-10 ->
NaHCo3 given. Blood ... | 0000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000>000000000000000000000... | NPN
#1 Rec'd on vent settings: 18/6 x 14, Fio2 21-25%. Settings
clinically decreased to 16/5. LS = and auscultated both
diminished and clear throughout day. RR usually 40-60's but
sometimes to 80's. Has baseline retractions but increased
WOB noted at times. Blood gas this AM: 7.19/48/37/19/-10 ->
NaHCo3 given. Blood ... | ["NPN\n\n\n#1 Rec'd on vent settings: 18/6 x 14, Fio2 21-25%. Settings\nclinically decreased to 16/5. LS = and auscultated both\ndiminished and clear throughout day. RR usually 40-60's but\nsometimes to 80's. Has baseline retractions but increased\nWOB noted at times. Blood gas this AM: 7.19/48/37/19/-10 ->\nNaHCo3 giv... | ||
2077772 | 31878 | 193940.0 | 2108-12-24 | 2108-12-24 19:12:00 | 2108-12-24 19:22:00 | Nursing/other | Report | 15838.0 | NPN (1500-2300)
1. ID: Infant remains on AMp and Gent for R/O sepsis. BC
NG to date and with no overt S&S of infection. Will be 48
hours old at 0100. Will discuss continuing with Abx prior
to the next dose.
2. Resp: remains in RA, LS clear and equal, no A's or B's,
no sat drifts. Will continue to monitor for A... | NPN (1500-2300)
1. ID: Infant remains on AMp and Gent for R/O sepsis. BC
NG to date and with no overt S&S of infection. Will be 48
hours old at 0100. Will discuss continuing with Abx prior
to the next dose.
2. Resp: remains in RA, LS clear and equal, no A's or B's,
no sat drifts. Will continue to monitor for A... | 00000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000... | NPN (1500-2300)
1. ID: Infant remains on AMp and Gent for R/O sepsis. BC
NG to date and with no overt S&S of infection. Will be 48
hours old at 0100. Will discuss continuing with Abx prior
to the next dose.
2. Resp: remains in RA, LS clear and equal, no A's or B's,
no sat drifts. Will continue to monitor for A... | ["NPN (1500-2300)\n\n\n1. ID: Infant remains on AMp and Gent for R/O sepsis. BC\nNG to date and with no overt S&S of infection. Will be 48\nhours old at 0100. Will discuss continuing with Abx prior\nto the next dose.\n\n2. Resp: remains in RA, LS clear and equal, no A's or B's,\nno sat drifts. Will continue to mo... | ||
2077836 | 31884 | 139535.0 | 2111-11-23 | 2111-11-23 02:45:00 | 2111-11-23 02:56:00 | Nursing/other | Report | 20318.0 | NPN 1900- 0700
RESP
O: Infant remains in RA. RR 30-40's with sats stable. LS
clear and equal. No retractions noted. No a/b spells noted
thus far.
A: stable in RA
P: Cont to monitor
FEN
O: Wt 2580, up 5g. TF E20, ad-[** 145**] (=33cc) Q4H. Infant waking
about every 4 hours for cares. Taking 75cc with each feeding
thu... | NPN 1900- 0700
RESP
O: Infant remains in RA. RR 30-40's with sats stable. LS
clear and equal. No retractions noted. No a/b spells noted
thus far.
A: stable in RA
P: Cont to monitor
FEN
O: Wt 2580, up 5g. TF E20, ad-<Digit>659</Digit> (=33cc) Q4H. Infant waking
about every 4 hours for cares. Taking 75cc with each fee... | 00000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000111000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000... | NPN 1900- 0700
RESP
O: Infant remains in RA. RR 30-40's with sats stable. LS
clear and equal. No retractions noted. No a/b spells noted
thus far.
A: stable in RA
P: Cont to monitor
FEN
O: Wt 2580, up 5g. TF E20, ad-659 (=33cc) Q4H. Infant waking
about every 4 hours for cares. Taking 75cc with each feeding
thus far. ... | ["NPN 1900- 0700\n\n\nRESP\nO: Infant remains in RA. RR 30-40's with sats stable. LS\nclear and equal. No retractions noted. No a/b spells noted\nthus far.\nA: stable in RA\nP: Cont to monitor\n\nFEN\nO: Wt 2580, up 5g. TF E20, ad-659 (=33cc) Q4H. Infant waking\nabout every 4 hours for cares. Taking 75cc with each feed... | ||
2077837 | 31884 | 139535.0 | 2111-11-23 | 2111-11-23 12:59:00 | 2111-11-23 13:01:00 | Nursing/other | Report | 19211.0 | Neonatology
DOL #6, CGA 38 1/7 weeks.
CVR: Continues in RA, comfortable, no spells. Hemodynamically stable, no murmur. MAP 50s.
FEN: Wt 2580, up 5 grams. Ad [** 145**] feeding 80 cc/kg/day, took 125 cc/kg/day E20, all PO. Feeding well. Voiding/stooling.
GI: Rebound bili this am 7.4/0.5, down from 9.6.
DEV: Temp ... | Neonatology
DOL #6, CGA 38 1/7 weeks.
CVR: Continues in RA, comfortable, no spells. Hemodynamically stable, no murmur. MAP 50s.
FEN: Wt 2580, up 5 grams. Ad <Digit>610</Digit> feeding 80 cc/kg/day, took 125 cc/kg/day E20, all PO. Feeding well. Voiding/stooling.
GI: Rebound bili this am 7.4/0.5, down from 9.6.
DE... | 00000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000111000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000... | Neonatology
DOL #6, CGA 38 1/7 weeks.
CVR: Continues in RA, comfortable, no spells. Hemodynamically stable, no murmur. MAP 50s.
FEN: Wt 2580, up 5 grams. Ad 610 feeding 80 cc/kg/day, took 125 cc/kg/day E20, all PO. Feeding well. Voiding/stooling.
GI: Rebound bili this am 7.4/0.5, down from 9.6.
DEV: Temp stable ... | ['Neonatology\nDOL #6, CGA 38 1/7 weeks.\n\nCVR: Continues in RA, comfortable, no spells. Hemodynamically stable, no murmur. MAP 50s.\n\nFEN: Wt 2580, up 5 grams. Ad 610 feeding 80 cc/kg/day, took 125 cc/kg/day E20, all PO. Feeding well. Voiding/stooling.\n\nGI: Rebound bili this am 7.4/0.5, down from 9.6.\n\nDEV: T... | ||
2079529 | 32201 | 141948.0 | 2149-10-05 | 2149-10-05 05:49:00 | 2149-10-05 05:54:00 | Nursing/other | Report | 18785.0 | NPN 7p-7a
Resp: Infant remains in RA. Ls clr/=. RR 40-60's. Mild sc
retractions noted. 2 spells so far this shift. 3 in 24hrs.
Conts on caffeiene. Cont to monitor.
Fen: Wt. 1.490kg (0 change). Conts on tf 150cc/kg of bm
24/pe 24. Tol pg feeds well gavaged over 45". Abd soft.
Active bs. Yellow stool with each diaper ... | NPN 7p-7a
Resp: Infant remains in RA. Ls clr/=. RR 40-60's. Mild sc
retractions noted. 2 spells so far this shift. 3 in 24hrs.
Conts on caffeiene. Cont to monitor.
Fen: Wt. 1.490kg (0 change). Conts on tf 150cc/kg of bm
24/pe 24. Tol pg feeds well gavaged over 45". Abd soft.
Active bs. Yellow stool with each diaper ... | 00000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000... | NPN 7p-7a
Resp: Infant remains in RA. Ls clr/=. RR 40-60's. Mild sc
retractions noted. 2 spells so far this shift. 3 in 24hrs.
Conts on caffeiene. Cont to monitor.
Fen: Wt. 1.490kg (0 change). Conts on tf 150cc/kg of bm
24/pe 24. Tol pg feeds well gavaged over 45". Abd soft.
Active bs. Yellow stool with each diaper ... | ['NPN 7p-7a\n\n\nResp: Infant remains in RA. Ls clr/=. RR 40-60\'s. Mild sc\nretractions noted. 2 spells so far this shift. 3 in 24hrs.\nConts on caffeiene. Cont to monitor.\n\nFen: Wt. 1.490kg (0 change). Conts on tf 150cc/kg of bm\n24/pe 24. Tol pg feeds well gavaged over 45". Abd soft.\nActive bs. Yellow stool with ... | ||
2079530 | 32201 | 141948.0 | 2149-10-05 | 2149-10-05 12:54:00 | 2149-10-05 12:59:00 | Nursing/other | Report | 16865.0 | NPN 0700-1900
#1Resp: Pt. remains in RA, RR 40-60's, sats > 94%. Pt. had
2 spells d/t apnea w/ QSR. Lungs clear & equal w/ mild SCR.
P: cont to monitor resp status.
#2FEN: TF 150cc/kg/d of BM24/PE24 NG Q 4hrs. Tolerating
feeds well, no spits, min asp. Abd soft & round, +BS, no
loops. AG stable. Pt. voiding ... | NPN 0700-1900
#1Resp: Pt. remains in RA, RR 40-60's, sats > 94%. Pt. had
2 spells d/t apnea w/ QSR. Lungs clear & equal w/ mild SCR.
P: cont to monitor resp status.
#2FEN: TF 150cc/kg/d of BM24/PE24 NG Q 4hrs. Tolerating
feeds well, no spits, min asp. Abd soft & round, +BS, no
loops. AG stable. Pt. voiding ... | 0000000000000000000000000000000000000000000000000000000000000>000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000... | NPN 0700-1900
#1Resp: Pt. remains in RA, RR 40-60's, sats > 94%. Pt. had
2 spells d/t apnea w/ QSR. Lungs clear & equal w/ mild SCR.
P: cont to monitor resp status.
#2FEN: TF 150cc/kg/d of BM24/PE24 NG Q 4hrs. Tolerating
feeds well, no spits, min asp. Abd soft & round, +BS, no
loops. AG stable. Pt. voiding ... | ["NPN 0700-1900\n\n\n#1Resp: Pt. remains in RA, RR 40-60's, sats > 94%. Pt. had\n2 spells d/t apnea w/ QSR. Lungs clear & equal w/ mild SCR.\n P: cont to monitor resp status.\n\n#2FEN: TF 150cc/kg/d of BM24/PE24 NG Q 4hrs. Tolerating\nfeeds well, no spits, min asp. Abd soft & round, +BS, no\nloops. AG stable. P... | ||
2079531 | 32201 | 141948.0 | 2149-10-05 | 2149-10-05 13:43:00 | 2149-10-05 13:46:00 | Nursing/other | Report | 15638.0 | Neonatology Attending
Day 9 PMA 33 [**5-17**] wks
Remains in RA. RR 40-60s. Sats >98%. Had two bradycardia episodes over last 24 hours. No murmur. HR 130-160s. BP mean 61. Weight 1490g (unchanged). TF at 150 ml/kg/d- BM/PE 24- by gavage. Put to breast last night. On iron. Stable temperature in off incubat... | Neonatology Attending
Day 9 PMA 33 <Date>2-20</Date> wks
Remains in RA. RR 40-60s. Sats >98%. Had two bradycardia episodes over last 24 hours. No murmur. HR 130-160s. BP mean 61. Weight 1490g (unchanged). TF at 150 ml/kg/d- BM/PE 24- by gavage. Put to breast last night. On iron. Stable temperature in off ... | 00000000000000000000000000000000000001111000000000000000000000000000000000000000>00000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000... | Neonatology Attending
Day 9 PMA 33 2-20 wks
Remains in RA. RR 40-60s. Sats >98%. Had two bradycardia episodes over last 24 hours. No murmur. HR 130-160s. BP mean 61. Weight 1490g (unchanged). TF at 150 ml/kg/d- BM/PE 24- by gavage. Put to breast last night. On iron. Stable temperature in off incubator. A... | ['Neonatology Attending\n\nDay 9 PMA 33 2-20 wks\n\nRemains in RA. RR 40-60s. Sats >98%. Had two bradycardia episodes over last 24 hours. No murmur. HR 130-160s. BP mean 61. Weight 1490g (unchanged). TF at 150 ml/kg/d- BM/PE 24- by gavage. Put to breast last night. On iron. Stable temperature in off incubat... | ||
2079532 | 32201 | 141948.0 | 2149-10-06 | 2149-10-06 06:06:00 | 2149-10-06 06:11:00 | Nursing/other | Report | 18785.0 | NPN 7p-7a
Resp: Infant remains in RA. ls clr/=. RR 30-60's. Mild sc
retractions noted. 3 spells so far this shift. 6 in 24hrs.
Cont to monitor.
Fen: Wt. 1.525kg (+35gms). Conts on tf 150cc/kg of bm 26
with bp. Tol pg feeds well gavaged over 45". Abd soft.
Active bs. No spits. Minimal aspirates. Voiding and stooling... | NPN 7p-7a
Resp: Infant remains in RA. ls clr/=. RR 30-60's. Mild sc
retractions noted. 3 spells so far this shift. 6 in 24hrs.
Cont to monitor.
Fen: Wt. 1.525kg (+35gms). Conts on tf 150cc/kg of bm 26
with bp. Tol pg feeds well gavaged over 45". Abd soft.
Active bs. No spits. Minimal aspirates. Voiding and stooling... | 00000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000... | NPN 7p-7a
Resp: Infant remains in RA. ls clr/=. RR 30-60's. Mild sc
retractions noted. 3 spells so far this shift. 6 in 24hrs.
Cont to monitor.
Fen: Wt. 1.525kg (+35gms). Conts on tf 150cc/kg of bm 26
with bp. Tol pg feeds well gavaged over 45". Abd soft.
Active bs. No spits. Minimal aspirates. Voiding and stooling... | ['NPN 7p-7a\n\n\nResp: Infant remains in RA. ls clr/=. RR 30-60\'s. Mild sc\nretractions noted. 3 spells so far this shift. 6 in 24hrs.\nCont to monitor.\n\nFen: Wt. 1.525kg (+35gms). Conts on tf 150cc/kg of bm 26\nwith bp. Tol pg feeds well gavaged over 45". Abd soft.\nActive bs. No spits. Minimal aspirates. Voiding ... | ||
2075524 | 31668 | 134163.0 | 2122-07-07 | 2122-07-07 02:36:00 | 2122-07-07 02:46:00 | Nursing/other | Report | 14927.0 | Nursing Progress Note:
#1 Resp: O: Infant continues on prong CPAP of 6, 35-45%
FiO2. Lung sounds cl/=. Mild IC/SC retractions noted.
Continues on caffeine. No spells thus far this shift. A:
Infant breathing comfortably w/ resp. support. P: Continue
to support infant's resp. needs.
#2 FEN: O: Current weight = 1.260kg... | Nursing Progress Note:
#1 Resp: O: Infant continues on prong CPAP of 6, 35-45%
FiO2. Lung sounds cl/=. Mild IC/SC retractions noted.
Continues on caffeine. No spells thus far this shift. A:
Infant breathing comfortably w/ resp. support. P: Continue
to support infant's resp. needs.
#2 FEN: O: Current weight = 1.260kg... | 00000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000... | Nursing Progress Note:
#1 Resp: O: Infant continues on prong CPAP of 6, 35-45%
FiO2. Lung sounds cl/=. Mild IC/SC retractions noted.
Continues on caffeine. No spells thus far this shift. A:
Infant breathing comfortably w/ resp. support. P: Continue
to support infant's resp. needs.
#2 FEN: O: Current weight = 1.260kg... | ["Nursing Progress Note:\n\n\n#1 Resp: O: Infant continues on prong CPAP of 6, 35-45%\nFiO2. Lung sounds cl/=. Mild IC/SC retractions noted.\nContinues on caffeine. No spells thus far this shift. A:\nInfant breathing comfortably w/ resp. support. P: Continue\nto support infant's resp. needs.\n\n#2 FEN: O: Current weigh... | ||
2075525 | 31668 | 134163.0 | 2122-07-07 | 2122-07-07 10:06:00 | 2122-07-07 10:11:00 | Nursing/other | Report | 16929.0 | Neonatology Attending Progress Note
Now day of life 10, CA [**43**] 5/7 weeks.
On CPAP of 6 and in 35-45% FIO2
RR 40-80s
On caffeine.
HR 160-180s BP 55/40 45
Wt. 1260 up 50gm on 150ml/kg/d of TF - feedings 30ml/kg/d of MM, PN/IL for remainder of fluids.
UO 3.1ml/kg/hr no stool
Lytes 135 4.3 94 30 TG 58 Mg 1.9
Bili ... | Neonatology Attending Progress Note
Now day of life 10, CA <Digit>32</Digit> 5/7 weeks.
On CPAP of 6 and in 35-45% FIO2
RR 40-80s
On caffeine.
HR 160-180s BP 55/40 45
Wt. 1260 up 50gm on 150ml/kg/d of TF - feedings 30ml/kg/d of MM, PN/IL for remainder of fluids.
UO 3.1ml/kg/hr no stool
Lytes 135 4.3 94 30 TG 58 Mg 1... | 00000000000000000000000000000000000000000000000000000000000110000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000... | Neonatology Attending Progress Note
Now day of life 10, CA 32 5/7 weeks.
On CPAP of 6 and in 35-45% FIO2
RR 40-80s
On caffeine.
HR 160-180s BP 55/40 45
Wt. 1260 up 50gm on 150ml/kg/d of TF - feedings 30ml/kg/d of MM, PN/IL for remainder of fluids.
UO 3.1ml/kg/hr no stool
Lytes 135 4.3 94 30 TG 58 Mg 1.9
Bili 6.0/0.... | ['Neonatology Attending Progress Note\nNow day of life 10, CA 32 5/7 weeks.\nOn CPAP of 6 and in 35-45% FIO2\nRR 40-80s\nOn caffeine.\nHR 160-180s BP 55/40 45\n\nWt. 1260 up 50gm on 150ml/kg/d of TF - feedings 30ml/kg/d of MM, PN/IL for remainder of fluids.\nUO 3.1ml/kg/hr no stool\n\nLytes 135 4.3 94 30 TG 58 Mg 1.9\... | ||
2075526 | 31668 | 134163.0 | 2122-07-07 | 2122-07-07 13:29:00 | 2122-07-07 13:36:00 | Nursing/other | Report | 20522.0 | Nursing Progress Note
1. RESP Received infant in CPAP. Infant remains in prong
CPAP 6. FIO2 35-46%. LS CL=. Mild IC/SCR noted. On
caffeine as ordered. No bradys noted thus far. Cont to
assess RESP needs.
2. FEN TF=150cc/kg/day. IVF currently at 110cc/kg/day
PND10 running at 4.8cc/hr, IL running at 0.8cc/hr... | Nursing Progress Note
1. RESP Received infant in CPAP. Infant remains in prong
CPAP 6. FIO2 35-46%. LS CL=. Mild IC/SCR noted. On
caffeine as ordered. No bradys noted thus far. Cont to
assess RESP needs.
2. FEN TF=150cc/kg/day. IVF currently at 110cc/kg/day
PND10 running at 4.8cc/hr, IL running at 0.8cc/hr... | 00000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000... | Nursing Progress Note
1. RESP Received infant in CPAP. Infant remains in prong
CPAP 6. FIO2 35-46%. LS CL=. Mild IC/SCR noted. On
caffeine as ordered. No bradys noted thus far. Cont to
assess RESP needs.
2. FEN TF=150cc/kg/day. IVF currently at 110cc/kg/day
PND10 running at 4.8cc/hr, IL running at 0.8cc/hr... | ['Nursing Progress Note\n\n\n1. RESP Received infant in CPAP. Infant remains in prong\nCPAP 6. FIO2 35-46%. LS CL=. Mild IC/SCR noted. On\ncaffeine as ordered. No bradys noted thus far. Cont to\nassess RESP needs.\n\n2. FEN TF=150cc/kg/day. IVF currently at 110cc/kg/day\nPND10 running at 4.8cc/hr, IL running ... | ||
2075527 | 31668 | 134163.0 | 2122-07-07 | 2122-07-07 16:44:00 | 2122-07-07 16:45:00 | Nursing/other | Report | 19412.0 | Respiratory Care
Pt cont on prong CPAP. fio2 .38-.48. bs clear, rr 60-80 with mild retractions. On caffeine. No spells noted. Plan to support as needed. Will follow.
| Respiratory Care
Pt cont on prong CPAP. fio2 .38-.48. bs clear, rr 60-80 with mild retractions. On caffeine. No spells noted. Plan to support as needed. Will follow.
| 0000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000 | Respiratory Care
Pt cont on prong CPAP. fio2 .38-.48. bs clear, rr 60-80 with mild retractions. On caffeine. No spells noted. Plan to support as needed. Will follow.
| ['Respiratory Care\nPt cont on prong CPAP. fio2 .38-.48. bs clear, rr 60-80 with mild retractions. On caffeine. No spells noted. Plan to support as needed. Will follow.\n'] | ||
2076824 | 31738 | 149818.0 | 2136-02-25 | 2136-02-25 14:23:00 | 2136-02-25 14:32:00 | Nursing/other | Report | 19371.0 | NPN 0700-1900
#1 RESP: Pt. remains in RA breathing in the 30-70s iwht
mild IC/Subcostal retractions. Lung sounds cl+=
bilaterally. SATs 93-97% so far this shift. Pt. has had 2
spells so far this shift, see flowsheet for details. Pt.
continues on caffeine as ordered. P: Continue to monitor
respiratory status.
#... | NPN 0700-1900
#1 RESP: Pt. remains in RA breathing in the 30-70s iwht
mild IC/Subcostal retractions. Lung sounds cl+=
bilaterally. SATs 93-97% so far this shift. Pt. has had 2
spells so far this shift, see flowsheet for details. Pt.
continues on caffeine as ordered. P: Continue to monitor
respiratory status.
#... | 00000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000... | NPN 0700-1900
#1 RESP: Pt. remains in RA breathing in the 30-70s iwht
mild IC/Subcostal retractions. Lung sounds cl+=
bilaterally. SATs 93-97% so far this shift. Pt. has had 2
spells so far this shift, see flowsheet for details. Pt.
continues on caffeine as ordered. P: Continue to monitor
respiratory status.
#... | ['NPN 0700-1900\n\n\n#1 RESP: Pt. remains in RA breathing in the 30-70s iwht\nmild IC/Subcostal retractions. Lung sounds cl+=\nbilaterally. SATs 93-97% so far this shift. Pt. has had 2\nspells so far this shift, see flowsheet for details. Pt.\ncontinues on caffeine as ordered. P: Continue to monitor\nrespiratory ... | ||
2076881 | 31739 | 123012.0 | 2195-08-12 | 2195-08-12 14:03:00 | 2195-08-12 14:10:00 | Nursing/other | Report | 19271.0 | Nursing PRogress Note
#1 O: ad [** 145**] demand feeds [**Doctor Last Name 146**] 20, waking q2-4hours, taking
35-45cc. abd soft, active bowel sounds, vdg and stooling.
circ site clean, no bleeding, liberal vaseline applied. no
tylenol needed this shift. A: doing well w/feeds P: present
care.
#2 O: temp stable, alert... | Nursing PRogress Note
#1 O: ad <Digit>662</Digit> demand feeds <Doctor Name>Dr.Taylor</Doctor Name> 20, waking q2-4hours, taking
35-45cc. abd soft, active bowel sounds, vdg and stooling.
circ site clean, no bleeding, liberal vaseline applied. no
tylenol needed this shift. A: doing well w/feeds P: present
care.
#2 O: ... | 00000000000000000000000000000000011100000000000000111111111000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000... | Nursing PRogress Note
#1 O: ad 662 demand feeds Dr.Taylor 20, waking q2-4hours, taking
35-45cc. abd soft, active bowel sounds, vdg and stooling.
circ site clean, no bleeding, liberal vaseline applied. no
tylenol needed this shift. A: doing well w/feeds P: present
care.
#2 O: temp stable, alert/sl. irritable when awak... | ['Nursing PRogress Note\n\n\n#1 O: ad 662 demand feeds Dr.Taylor 20, waking q2-4hours, taking\n35-45cc. abd soft, active bowel sounds, vdg and stooling.\ncirc site clean, no bleeding, liberal vaseline applied. no\ntylenol needed this shift. A: doing well w/feeds P: present\ncare.\n#2 O: temp stable, alert/sl. irritable... | ||
2076882 | 31739 | 123012.0 | 2195-08-12 | 2195-08-12 18:21:00 | 2195-08-12 18:22:00 | Nursing/other | Report | 19591.0 | NP NOTE
PE: well appearing term infant supine in open crib. Pale pink, well perfused in RA. AFOF, sutures approximated, eyes clear, nares patent,MMMP
Chest is clear, equal bs
CV; RRR, no murmur, pulses+2=
Abd: soft with active bs
GU: circ healing,testes in scrotum
| NP NOTE
PE: well appearing term infant supine in open crib. Pale pink, well perfused in RA. AFOF, sutures approximated, eyes clear, nares patent,MMMP
Chest is clear, equal bs
CV; RRR, no murmur, pulses+2=
Abd: soft with active bs
GU: circ healing,testes in scrotum
| 0000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000 | NP NOTE
PE: well appearing term infant supine in open crib. Pale pink, well perfused in RA. AFOF, sutures approximated, eyes clear, nares patent,MMMP
Chest is clear, equal bs
CV; RRR, no murmur, pulses+2=
Abd: soft with active bs
GU: circ healing,testes in scrotum
| ['NP NOTE\nPE: well appearing term infant supine in open crib. Pale pink, well perfused in RA. AFOF, sutures approximated, eyes clear, nares patent,MMMP\nChest is clear, equal bs\nCV; RRR, no murmur, pulses+2=\nAbd: soft with active bs\nGU: circ healing,testes in scrotum\n'] | ||
2076883 | 31739 | 123012.0 | 2195-08-13 | 2195-08-13 03:17:00 | 2195-08-13 05:47:00 | Nursing/other | Report | 17217.0 | PCA 7pm-7am
I have examined infant and agree with above note/assessment from [**Initials (NamePattern4) **] [**Last Name (NamePattern4) **] PCA.
HepB vaccine given. [**Last Name (NamePattern4) 5**] in and updated by this RN at [**Last Name (NamePattern4) 165**]. Independant with cares.
| PCA 7pm-7am
I have examined infant and agree with above note/assessment from <Initial>KY</Initial> <Name>Ceja</Name> PCA.
HepB vaccine given. <Name>Pegram</Name> in and updated by this RN at <Name>Hasan</Name>. Independant with cares.
| 000000000000000000000000000000000000000000000000000000000000000000000000000001101111000000000000000000000000001111110000000000000000000000000000001111100000000000000000000000000 | PCA 7pm-7am
I have examined infant and agree with above note/assessment from KY Ceja PCA.
HepB vaccine given. Pegram in and updated by this RN at Hasan. Independant with cares.
| ['PCA 7pm-7am\nI have examined infant and agree with above note/assessment from KY Ceja PCA.\nHepB vaccine given. Pegram in and updated by this RN at Hasan. Independant with cares.\n'] | ||
2078037 | 31892 | 163351.0 | 2154-02-14 | 2154-02-14 17:12:00 | 2154-02-14 17:27:00 | Nursing/other | Report | 17603.0 | NPN DAYS
ALT IN RESP:REMAINS INTUBATED ON HIFI. RECEIVED BABY ON MAP
11, DELTA P 20. DECREASED MAP TO 10 THIS MORNING. CAP GAS AT
1530 7.26/76/43/36/3. INCREASED DELTA P 3 TO 23. 02
REQUIREMENT 30-57%. LUNGS CLEAR, WITH MILD
INTERCOASTAL/SUBCOASTAL RETRACTIONS. SUCTION TWICE FOR SMALL
TO MOD AMT OF CLOUDY SECRETIONS ... | NPN DAYS
ALT IN RESP:REMAINS INTUBATED ON HIFI. RECEIVED BABY ON MAP
11, DELTA P 20. DECREASED MAP TO 10 THIS MORNING. CAP GAS AT
1530 7.26/76/43/36/3. INCREASED DELTA P 3 TO 23. 02
REQUIREMENT 30-57%. LUNGS CLEAR, WITH MILD
INTERCOASTAL/SUBCOASTAL RETRACTIONS. SUCTION TWICE FOR SMALL
TO MOD AMT OF CLOUDY SECRETIONS ... | 00000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000... | NPN DAYS
ALT IN RESP:REMAINS INTUBATED ON HIFI. RECEIVED BABY ON MAP
11, DELTA P 20. DECREASED MAP TO 10 THIS MORNING. CAP GAS AT
1530 7.26/76/43/36/3. INCREASED DELTA P 3 TO 23. 02
REQUIREMENT 30-57%. LUNGS CLEAR, WITH MILD
INTERCOASTAL/SUBCOASTAL RETRACTIONS. SUCTION TWICE FOR SMALL
TO MOD AMT OF CLOUDY SECRETIONS ... | ["NPN DAYS\n\n\nALT IN RESP:REMAINS INTUBATED ON HIFI. RECEIVED BABY ON MAP\n11, DELTA P 20. DECREASED MAP TO 10 THIS MORNING. CAP GAS AT\n1530 7.26/76/43/36/3. INCREASED DELTA P 3 TO 23. 02\nREQUIREMENT 30-57%. LUNGS CLEAR, WITH MILD\nINTERCOASTAL/SUBCOASTAL RETRACTIONS. SUCTION TWICE FOR SMALL\nTO MOD AMT OF CLOUDY S... | ||
2078038 | 31892 | 163351.0 | 2154-02-15 | 2154-02-15 05:37:00 | 2154-02-15 05:51:00 | Nursing/other | Report | 14815.0 | Respiratory Care
Baby continues on HFOV with MAP 10, amp 23, 15 Hz with 02 req 32-44% at rest this shift. Repositioned @ 2130. Bagged with PIP 20-22. ETT [** 453**] for sm amt cldy secretions. OP x2 [** 453**] for copious thick cldy secretions. ETT retaped without incident. CBG: 7.30/70/36/36/5; no changes made @ this ... | Respiratory Care
Baby continues on HFOV with MAP 10, amp 23, 15 Hz with 02 req 32-44% at rest this shift. Repositioned @ 2130. Bagged with PIP 20-22. ETT <Digit>799</Digit> for sm amt cldy secretions. OP x2 <Digit>799</Digit> for copious thick cldy secretions. ETT retaped without incident. CBG: 7.30/70/36/36/5; no chan... | 00000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000001110000000000000000000000000000000000011100000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000... | Respiratory Care
Baby continues on HFOV with MAP 10, amp 23, 15 Hz with 02 req 32-44% at rest this shift. Repositioned @ 2130. Bagged with PIP 20-22. ETT 799 for sm amt cldy secretions. OP x2 799 for copious thick cldy secretions. ETT retaped without incident. CBG: 7.30/70/36/36/5; no changes made @ this time. On caffe... | ['Respiratory Care\nBaby continues on HFOV with MAP 10, amp 23, 15 Hz with 02 req 32-44% at rest this shift. Repositioned @ 2130. Bagged with PIP 20-22. ETT 799 for sm amt cldy secretions. OP x2 799 for copious thick cldy secretions. ETT retaped without incident. CBG: 7.30/70/36/36/5; no changes made @ this time. On ca... | ||
2079729 | 32242 | 163974.0 | 2121-11-12 | 2121-11-12 16:22:00 | 2121-11-12 16:59:00 | Nursing/other | Report | 16024.0 | NPN 0700-1900
1. Sepsis: Today is day #[**3-1**] ampi and gent. Bld cx
remains neg to date. Plan to do LP tomorrow.
2. Resp: Infant remains on prong CPAP 6. FiO2 = 21=26%.
LS clear. Suctioned orally for small smount thin cloudy
secretions. RR=RR=30-60's. Mild SCR/ICR. No spells or
desats. On caffeine an... | NPN 0700-1900
1. Sepsis: Today is day #<Date>9-29</Date> ampi and gent. Bld cx
remains neg to date. Plan to do LP tomorrow.
2. Resp: Infant remains on prong CPAP 6. FiO2 = 21=26%.
LS clear. Suctioned orally for small smount thin cloudy
secretions. RR=RR=30-60's. Mild SCR/ICR. No spells or
desats. On caf... | 00000000000000000000000000000000000000000000111100000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000... | NPN 0700-1900
1. Sepsis: Today is day #9-29 ampi and gent. Bld cx
remains neg to date. Plan to do LP tomorrow.
2. Resp: Infant remains on prong CPAP 6. FiO2 = 21=26%.
LS clear. Suctioned orally for small smount thin cloudy
secretions. RR=RR=30-60's. Mild SCR/ICR. No spells or
desats. On caffeine and Vit... | ["NPN 0700-1900\n\n\n1. Sepsis: Today is day #9-29 ampi and gent. Bld cx\nremains neg to date. Plan to do LP tomorrow.\n\n2. Resp: Infant remains on prong CPAP 6. FiO2 = 21=26%.\nLS clear. Suctioned orally for small smount thin cloudy\nsecretions. RR=RR=30-60's. Mild SCR/ICR. No spells or\ndesats. On caffe... | ||
2079730 | 32242 | 163974.0 | 2121-11-12 | 2121-11-12 17:12:00 | 2121-11-12 17:18:00 | Nursing/other | Report | 14948.0 | Respiratory Care Note
ECHO done today. Results pending.
| Respiratory Care Note
ECHO done today. Results pending.
| 00000000000000000000000000000000000000000000000000000000 | Respiratory Care Note
ECHO done today. Results pending.
| ['Respiratory Care Note\nECHO done today. Results pending.\n'] | ||
2079731 | 32242 | 163974.0 | 2121-11-12 | 2121-11-12 17:12:00 | 2121-11-12 17:16:00 | Nursing/other | Report | 14948.0 | Respiratory Care Note
Baby [**Name (NI) 25**] [**Known lastname 856**] remains on +6 prong CPAP, FiO2 ,21 this shift.. BS clear. RR 30's-60's. On caffeine. No bradys noted. Plan ABG this pm.
| Respiratory Care Note
Baby <Name>Guadalupe Martin</Name> <Name>Kuykendall</Name> remains on +6 prong CPAP, FiO2 ,21 this shift.. BS clear. RR 30's-60's. On caffeine. No bradys noted. Plan ABG this pm.
| 00000000000000000000000000011111111111111110111111111100000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000 | Respiratory Care Note
Baby Guadalupe Martin Kuykendall remains on +6 prong CPAP, FiO2 ,21 this shift.. BS clear. RR 30's-60's. On caffeine. No bradys noted. Plan ABG this pm.
| ["Respiratory Care Note\nBaby Guadalupe Martin Kuykendall remains on +6 prong CPAP, FiO2 ,21 this shift.. BS clear. RR 30's-60's. On caffeine. No bradys noted. Plan ABG this pm.\n\n"] | ||
2079732 | 32242 | 163974.0 | 2121-11-13 | 2121-11-13 00:55:00 | 2121-11-13 00:57:00 | Nursing/other | Report | 19157.0 | NNP Physical Exam
Awake and lactive on open warmer. [** 404**] with secure eye shields and mild cephal molding. BSC and equal on CPAP with good transmission, mild retractions, with comfortable respirations. No audible murmur, pink and well perfused with normal pulses. ABD soft and slightly loopy in upper quadrants, OG ... | NNP Physical Exam
Awake and lactive on open warmer. <Digit>632</Digit> with secure eye shields and mild cephal molding. BSC and equal on CPAP with good transmission, mild retractions, with comfortable respirations. No audible murmur, pink and well perfused with normal pulses. ABD soft and slightly loopy in upper quadra... | 00000000000000000000000000000000000000000000000000001110000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000... | NNP Physical Exam
Awake and lactive on open warmer. 632 with secure eye shields and mild cephal molding. BSC and equal on CPAP with good transmission, mild retractions, with comfortable respirations. No audible murmur, pink and well perfused with normal pulses. ABD soft and slightly loopy in upper quadrants, OG placed ... | ['NNP Physical Exam\nAwake and lactive on open warmer. 632 with secure eye shields and mild cephal molding. BSC and equal on CPAP with good transmission, mild retractions, with comfortable respirations. No audible murmur, pink and well perfused with normal pulses. ABD soft and slightly loopy in upper quadrants, OG plac... | ||
2079733 | 32242 | 163974.0 | 2121-11-13 | 2121-11-13 02:06:00 | 2121-11-13 02:10:00 | Nursing/other | Report | 19157.0 | Procedure Note: LP
Indication: R/O memingitis
Consent obtained
Time out observed
Premedicated with Sweat-ease pacifier
Prepped and draped in sterile fashion. 22 Gague spinal needle inserted into L4-L5 intervetebral space and clear/slightly champeign colored CSF flowed easily. total of 1 cm collected in 3 tubes. Sent fo... | Procedure Note: LP
Indication: R/O memingitis
Consent obtained
Time out observed
Premedicated with Sweat-ease pacifier
Prepped and draped in sterile fashion. 22 Gague spinal needle inserted into L4-L5 intervetebral space and clear/slightly champeign colored CSF flowed easily. total of 1 cm collected in 3 tubes. Sent fo... | 00000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000... | Procedure Note: LP
Indication: R/O memingitis
Consent obtained
Time out observed
Premedicated with Sweat-ease pacifier
Prepped and draped in sterile fashion. 22 Gague spinal needle inserted into L4-L5 intervetebral space and clear/slightly champeign colored CSF flowed easily. total of 1 cm collected in 3 tubes. Sent fo... | ['Procedure Note: LP\nIndication: R/O memingitis\nConsent obtained\nTime out observed\nPremedicated with Sweat-ease pacifier\nPrepped and draped in sterile fashion. 22 Gague spinal needle inserted into L4-L5 intervetebral space and clear/slightly champeign colored CSF flowed easily. total of 1 cm collected in 3 tubes. ... | ||
2079734 | 32242 | 163974.0 | 2121-11-13 | 2121-11-13 05:10:00 | 2121-11-13 05:12:00 | Nursing/other | Report | 14815.0 | Respiratory Care
Baby continues on prong CPAP 6 with 02 req 21-31% this shift. BS clear. RR 30's-50's with mild IC/SCR. No spells noted. On caffeine, vit A. Will cont CPAP, monitor closely.
| Respiratory Care
Baby continues on prong CPAP 6 with 02 req 21-31% this shift. BS clear. RR 30's-50's with mild IC/SCR. No spells noted. On caffeine, vit A. Will cont CPAP, monitor closely.
| 00000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000 | Respiratory Care
Baby continues on prong CPAP 6 with 02 req 21-31% this shift. BS clear. RR 30's-50's with mild IC/SCR. No spells noted. On caffeine, vit A. Will cont CPAP, monitor closely.
| ["Respiratory Care\nBaby continues on prong CPAP 6 with 02 req 21-31% this shift. BS clear. RR 30's-50's with mild IC/SCR. No spells noted. On caffeine, vit A. Will cont CPAP, monitor closely.\n"] | ||
2075803 | 31668 | 134163.0 | 2122-08-25 | 2122-08-25 11:47:00 | 2122-08-25 11:51:00 | Nursing/other | Report | 17593.0 | Neonatology Attending
DOL 59 PMA 36 5/7 weeks
Stable in NCO2 100% 100 ml (transitioned well). Sats 90-98%, occ drift to high 80s. R 50s-80s. No A/B.
Soft murmur. BP 75/44 mean 54
On 130 ml/kg/d BM 26 po/pg. 2 partial pos overnight. Mother has stopped pumping. Voiding. Stooling. Wt 2725 grams (up 40).
Mot... | Neonatology Attending
DOL 59 PMA 36 5/7 weeks
Stable in NCO2 100% 100 ml (transitioned well). Sats 90-98%, occ drift to high 80s. R 50s-80s. No A/B.
Soft murmur. BP 75/44 mean 54
On 130 ml/kg/d BM 26 po/pg. 2 partial pos overnight. Mother has stopped pumping. Voiding. Stooling. Wt 2725 grams (up 40).
Mot... | 00000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000... | Neonatology Attending
DOL 59 PMA 36 5/7 weeks
Stable in NCO2 100% 100 ml (transitioned well). Sats 90-98%, occ drift to high 80s. R 50s-80s. No A/B.
Soft murmur. BP 75/44 mean 54
On 130 ml/kg/d BM 26 po/pg. 2 partial pos overnight. Mother has stopped pumping. Voiding. Stooling. Wt 2725 grams (up 40).
Mot... | ['Neonatology Attending\n\nDOL 59 PMA 36 5/7 weeks\n\nStable in NCO2 100% 100 ml (transitioned well). Sats 90-98%, occ drift to high 80s. R 50s-80s. No A/B.\n\nSoft murmur. BP 75/44 mean 54\n\nOn 130 ml/kg/d BM 26 po/pg. 2 partial pos overnight. Mother has stopped pumping. Voiding. Stooling. Wt 2725 grams (up... | ||
2075804 | 31668 | 134163.0 | 2122-08-25 | 2122-08-25 14:00:00 | 2122-08-25 14:06:00 | Nursing/other | Report | 14927.0 | Nursing Progress Note:
#2 FEN: O: Total fluids remain @ 130cc/kg/day, BM26. Q 4hr
feedings, PO/PG as tolerated. PO intake = 43cc x1 this AM.
Infant's abdomen is soft, +BS, no loops. Infant voiding
well, trace stool x2. Minimal aspirates, no spits. Continues
on iron and vit. E. A: Infant tolerating feedings well. P:
C... | Nursing Progress Note:
#2 FEN: O: Total fluids remain @ 130cc/kg/day, BM26. Q 4hr
feedings, PO/PG as tolerated. PO intake = 43cc x1 this AM.
Infant's abdomen is soft, +BS, no loops. Infant voiding
well, trace stool x2. Minimal aspirates, no spits. Continues
on iron and vit. E. A: Infant tolerating feedings well. P:
C... | 00000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000... | Nursing Progress Note:
#2 FEN: O: Total fluids remain @ 130cc/kg/day, BM26. Q 4hr
feedings, PO/PG as tolerated. PO intake = 43cc x1 this AM.
Infant's abdomen is soft, +BS, no loops. Infant voiding
well, trace stool x2. Minimal aspirates, no spits. Continues
on iron and vit. E. A: Infant tolerating feedings well. P:
C... | ["Nursing Progress Note:\n\n\n#2 FEN: O: Total fluids remain @ 130cc/kg/day, BM26. Q 4hr\nfeedings, PO/PG as tolerated. PO intake = 43cc x1 this AM.\nInfant's abdomen is soft, +BS, no loops. Infant voiding\nwell, trace stool x2. Minimal aspirates, no spits. Continues\non iron and vit. E. A: Infant tolerating feedings w... | ||
2075805 | 31668 | 134163.0 | 2122-08-25 | 2122-08-25 15:46:00 | 2122-08-25 15:51:00 | Nursing/other | Report | 15318.0 | Clinical Nutrition
O:
~36 [**12-2**] wk CGA BB on DOL 59.
WT: 2725 g (+40)(~50th %Ile); birthwt: 1220 g. Average wt gain over past wk ~40 g/day
HC: 33.5 cm (~50th to 75th %Ile); last: 31 cm
LN: 45.5 cm (~25th %Ile); last: 42.5 cm
Meds include Fe and Vit E
[**Month/Day (2) 107**] not needed
Nutrition: 130 cc/kg/... | Clinical Nutrition
O:
~36 <Date>11-4</Date> wk CGA BB on DOL 59.
WT: 2725 g (+40)(~50th %Ile); birthwt: 1220 g. Average wt gain over past wk ~40 g/day
HC: 33.5 cm (~50th to 75th %Ile); last: 31 cm
LN: 45.5 cm (~25th %Ile); last: 42.5 cm
Meds include Fe and Vit E
<Month>March</Month> not needed
Nutrition: 130 cc... | 00000000000000000000000000111100000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000111110000000000000000000000000000000000000000000000000000000000... | Clinical Nutrition
O:
~36 11-4 wk CGA BB on DOL 59.
WT: 2725 g (+40)(~50th %Ile); birthwt: 1220 g. Average wt gain over past wk ~40 g/day
HC: 33.5 cm (~50th to 75th %Ile); last: 31 cm
LN: 45.5 cm (~25th %Ile); last: 42.5 cm
Meds include Fe and Vit E
March not needed
Nutrition: 130 cc/kg/day BM 26, po/pg over 60... | ['Clinical Nutrition\nO:\n~36 11-4 wk CGA BB on DOL 59.\nWT: 2725 g (+40)(~50th %Ile); birthwt: 1220 g. Average wt gain over past wk ~40 g/day\nHC: 33.5 cm (~50th to 75th %Ile); last: 31 cm\nLN: 45.5 cm (~25th %Ile); last: 42.5 cm\nMeds include Fe and Vit E\nMarch not needed\nNutrition: 130 cc/kg/day BM 26, po/... | ||
2075806 | 31668 | 134163.0 | 2122-08-25 | 2122-08-25 16:19:00 | 2122-08-25 16:20:00 | Nursing/other | Report | 15938.0 | [** 63**] PHysical Exam
Pe: pink, AFOF, nasal cannula in place, breath sounds clear/equal, moderate subcostal retracting, comfortable, soft murmur, abd soft, tiny umbilical hernia, active, good tone.
| <Digit>72</Digit> PHysical Exam
Pe: pink, AFOF, nasal cannula in place, breath sounds clear/equal, moderate subcostal retracting, comfortable, soft murmur, abd soft, tiny umbilical hernia, active, good tone.
| 1100000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000 | 72 PHysical Exam
Pe: pink, AFOF, nasal cannula in place, breath sounds clear/equal, moderate subcostal retracting, comfortable, soft murmur, abd soft, tiny umbilical hernia, active, good tone.
| ['72 PHysical Exam\nPe: pink, AFOF, nasal cannula in place, breath sounds clear/equal, moderate subcostal retracting, comfortable, soft murmur, abd soft, tiny umbilical hernia, active, good tone.\n'] | ||
2077037 | 31761 | 177551.0 | 2193-07-15 | 2193-07-15 11:35:00 | 2193-07-15 12:18:00 | Nursing/other | Report | 21222.0 | Attending Note
antibody negative, RPR NR, Rubella I, Hep B negative and GBS unknown. Mom has a history of headache treated with Firocet. This infant was born by repeat C-section with Apgar scoreEKG-preliminary [**Location (un) 211**] WNL will fax to TCH for offical reads 8 (1 min) 9 (5 min). She was transferred to the... | Attending Note
antibody negative, RPR NR, Rubella I, Hep B negative and GBS unknown. Mom has a history of headache treated with Firocet. This infant was born by repeat C-section with Apgar scoreEKG-preliminary <Location>951 Corey Isle
Lake Gabrielle, MO 31536</Location> WNL will fax to TCH for offical reads 8 (1 min) ... | 00000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000001111111111111111111111111111111111111110000000000000000000000000000000000000000000000000000000000000000000000... | Attending Note
antibody negative, RPR NR, Rubella I, Hep B negative and GBS unknown. Mom has a history of headache treated with Firocet. This infant was born by repeat C-section with Apgar scoreEKG-preliminary 951 Corey Isle
Lake Gabrielle, MO 31536 WNL will fax to TCH for offical reads 8 (1 min) 9 (5 min). She was tr... | ['Attending Note\nantibody negative, RPR NR, Rubella I, Hep B negative and GBS unknown. Mom has a history of headache treated with Firocet. This infant was born by repeat C-section with Apgar scoreEKG-preliminary 951 Corey Isle\nLake Gabrielle, MO 31536 WNL will fax to TCH for offical reads 8 (1 min) 9 (5 min). She wa... | ||
2077038 | 31761 | 177551.0 | 2193-07-15 | 2193-07-15 12:35:00 | 2193-07-15 12:39:00 | Nursing/other | Report | 16914.0 | NPN
Infant placed on radiant warmer with cvr monitor. Stable in
room air. lung sounds are clear/=. Soft murmur auscultated.
4 extremity Blood pressures done, CXray done, EKG done [**Name8 (MD) 31**]
MD [**Last Name (Titles) 21**]. See flowsheet/MD note for details.
transfer to NBN as ordered.
| NPN
Infant placed on radiant warmer with cvr monitor. Stable in
room air. lung sounds are clear/=. Soft murmur auscultated.
4 extremity Blood pressures done, CXray done, EKG done <Name>Johnathon Ivory</Name>
MD <Name>Edward</Name>. See flowsheet/MD note for details.
transfer to NBN as ordered.
| 0000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000111111111111111000011111100000000000000000000000000000000000000000000000000000000000000000000 | NPN
Infant placed on radiant warmer with cvr monitor. Stable in
room air. lung sounds are clear/=. Soft murmur auscultated.
4 extremity Blood pressures done, CXray done, EKG done Johnathon Ivory
MD Edward. See flowsheet/MD note for details.
transfer to NBN as ordered.
| ['NPN\n\n\nInfant placed on radiant warmer with cvr monitor. Stable in\nroom air. lung sounds are clear/=. Soft murmur auscultated.\n4 extremity Blood pressures done, CXray done, EKG done Johnathon Ivory\nMD Edward. See flowsheet/MD note for details.\n\ntransfer to NBN as ordered.\n\n\n'] | ||
2077039 | 31762 | 133669.0 | 2159-09-12 | 2159-09-12 23:30:00 | 2159-09-12 23:39:00 | Nursing/other | Report | 21222.0 | Admission Note
Ob-Aktins
Delivering Ob-Croopnik
Pedi-undecided by parents at this time
Baby boy [**Known lastname 215**] is the 2210 grams product of a 34 [**2-4**] week gestation (EDC [**2159-10-23**]) born to a 22 yo G1 P0 mom with PNS blood type O positive, antibody negative, RPR NR, Rubella Immune, Hep B negative,... | Admission Note
Ob-Aktins
Delivering Ob-Croopnik
Pedi-undecided by parents at this time
Baby boy <Name>Recinos</Name> is the 2210 grams product of a 34 <Date>8-28</Date> week gestation (EDC <Date>1911-1-27</Date>) born to a 22 yo G1 P0 mom with PNS blood type O positive, antibody negative, RPR NR, Rubella Immune, Hep B... | 00000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000001111111000000000000000000000000000000000001111000000000000000000000111111111000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000... | Admission Note
Ob-Aktins
Delivering Ob-Croopnik
Pedi-undecided by parents at this time
Baby boy Recinos is the 2210 grams product of a 34 8-28 week gestation (EDC 1911-1-27) born to a 22 yo G1 P0 mom with PNS blood type O positive, antibody negative, RPR NR, Rubella Immune, Hep B negative, and GBS unknown mom. ROM wa... | ['Admission Note\nOb-Aktins\nDelivering Ob-Croopnik\nPedi-undecided by parents at this time\n\nBaby boy Recinos is the 2210 grams product of a 34 8-28 week gestation (EDC 1911-1-27) born to a 22 yo G1 P0 mom with PNS blood type O positive, antibody negative, RPR NR, Rubella Immune, Hep B negative, and GBS unknown mom. ... | ||
2070650 | 31097 | 115637.0 | 2132-01-19 | 2132-01-19 17:27:00 | 2132-01-19 17:40:00 | Nursing/other | Report | 17681.0 | NURSING PROGRESS NOTE
1 - RESP - PT AT RA. BSC/=, MILD SC/IC RETRACTIONS. NO
A/BS NOTED, NO DESATS.
2 - FEN - TF=100CC/K, INCREASED TODAY. BREAST FEEDING W/
EVERY FEED - VIGOROUS, LATCHING .15MIN. TAKING 7CC PO LAST
FEED. SM SPIT X1. GAVAGING WHOLE FEED W/ BREAST FEEDING.
ABD SOFT, +BS, NO LOOPS. AG-22 CM. ... | NURSING PROGRESS NOTE
1 - RESP - PT AT RA. BSC/=, MILD SC/IC RETRACTIONS. NO
A/BS NOTED, NO DESATS.
2 - FEN - TF=100CC/K, INCREASED TODAY. BREAST FEEDING W/
EVERY FEED - VIGOROUS, LATCHING .15MIN. TAKING 7CC PO LAST
FEED. SM SPIT X1. GAVAGING WHOLE FEED W/ BREAST FEEDING.
ABD SOFT, +BS, NO LOOPS. AG-22 CM. ... | 00000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000... | NURSING PROGRESS NOTE
1 - RESP - PT AT RA. BSC/=, MILD SC/IC RETRACTIONS. NO
A/BS NOTED, NO DESATS.
2 - FEN - TF=100CC/K, INCREASED TODAY. BREAST FEEDING W/
EVERY FEED - VIGOROUS, LATCHING .15MIN. TAKING 7CC PO LAST
FEED. SM SPIT X1. GAVAGING WHOLE FEED W/ BREAST FEEDING.
ABD SOFT, +BS, NO LOOPS. AG-22 CM. ... | ['NURSING PROGRESS NOTE\n\n\n1 - RESP - PT AT RA. BSC/=, MILD SC/IC RETRACTIONS. NO\nA/BS NOTED, NO DESATS.\n\n2 - FEN - TF=100CC/K, INCREASED TODAY. BREAST FEEDING W/\nEVERY FEED - VIGOROUS, LATCHING .15MIN. TAKING 7CC PO LAST\nFEED. SM SPIT X1. GAVAGING WHOLE FEED W/ BREAST FEEDING.\nABD SOFT, +BS, NO LOOPS. A... | ||
2070651 | 31097 | 115637.0 | 2132-01-19 | 2132-01-19 18:57:00 | 2132-01-19 19:02:00 | Nursing/other | Report | 18714.0 | Neonatology Attending
DOL 3 / CGA 35 3/7 weeks
[**Known lastname 2243**] remains in RA, sats >90%, no spells.
No murmur, BP 59/36(45).
wt 1730, down 50g
TF 80, PE/BM 20, full feeds PO/PG + BF
bili 9.4/0.3
temp stable in servo isolette
Assessment: former 35 [**3-21**] week male twin #2 with feeding and thermoregul... | Neonatology Attending
DOL 3 / CGA 35 3/7 weeks
<Name>Merino</Name> remains in RA, sats >90%, no spells.
No murmur, BP 59/36(45).
wt 1730, down 50g
TF 80, PE/BM 20, full feeds PO/PG + BF
bili 9.4/0.3
temp stable in servo isolette
Assessment: former 35 <Date>8-4</Date> week male twin #2 with feeding and thermoregul... | 000000000000000000000000000000000000000000000000111111000000000000000000000>0000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000001110000000000000000000000000000000000000000000000000000000000000000000000000... | Neonatology Attending
DOL 3 / CGA 35 3/7 weeks
Merino remains in RA, sats >90%, no spells.
No murmur, BP 59/36(45).
wt 1730, down 50g
TF 80, PE/BM 20, full feeds PO/PG + BF
bili 9.4/0.3
temp stable in servo isolette
Assessment: former 35 8-4 week male twin #2 with feeding and thermoregulatory immaturity and hyper... | ['Neonatology Attending\nDOL 3 / CGA 35 3/7 weeks\n\nMerino remains in RA, sats >90%, no spells.\n\nNo murmur, BP 59/36(45).\n\nwt 1730, down 50g\nTF 80, PE/BM 20, full feeds PO/PG + BF\n\nbili 9.4/0.3\n\ntemp stable in servo isolette\n\nAssessment: former 35 8-4 week male twin #2 with feeding and thermoregulatory imma... | ||
2070652 | 31097 | 115637.0 | 2132-01-20 | 2132-01-20 02:39:00 | 2132-01-20 02:54:00 | Nursing/other | Report | 17581.0 | NPN
#1 Infant remains in RA with sats >95%. RR 30-40's. BS
clear and equal. Mild ICR/SCR. No spells.
#2 TF 100cc/k/d of PE20/BM20=31cc Q4hrs. Abd soft, +BS, no
loops. AG 21.5cm. At 9pm Mom BF on and off x10 min then
infant was gavaged full volume. At 1am infant bottled 35cc.
Voiding and [** 21**]. DS 74. ... | NPN
#1 Infant remains in RA with sats >95%. RR 30-40's. BS
clear and equal. Mild ICR/SCR. No spells.
#2 TF 100cc/k/d of PE20/BM20=31cc Q4hrs. Abd soft, +BS, no
loops. AG 21.5cm. At 9pm Mom BF on and off x10 min then
infant was gavaged full volume. At 1am infant bottled 35cc.
Voiding and <Digit>67</Digit>. ... | 00000000000000000000000000000000000000000>00000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000001100000000000000000... | NPN
#1 Infant remains in RA with sats >95%. RR 30-40's. BS
clear and equal. Mild ICR/SCR. No spells.
#2 TF 100cc/k/d of PE20/BM20=31cc Q4hrs. Abd soft, +BS, no
loops. AG 21.5cm. At 9pm Mom BF on and off x10 min then
infant was gavaged full volume. At 1am infant bottled 35cc.
Voiding and 67. DS 74. Wt 173... | ["NPN\n\n\n#1 Infant remains in RA with sats >95%. RR 30-40's. BS\nclear and equal. Mild ICR/SCR. No spells.\n\n#2 TF 100cc/k/d of PE20/BM20=31cc Q4hrs. Abd soft, +BS, no\nloops. AG 21.5cm. At 9pm Mom BF on and off x10 min then\ninfant was gavaged full volume. At 1am infant bottled 35cc.\nVoiding and 67. DS ... | ||
2070653 | 31097 | 115637.0 | 2132-01-20 | 2132-01-20 02:39:00 | 2132-01-20 05:47:00 | Nursing/other | Report | 17581.0 | NPN
#5 Infant remains under single phototherapy with eye shields in place. Bili this am 7.7/.3/7.4.
| NPN
#5 Infant remains under single phototherapy with eye shields in place. Bili this am 7.7/.3/7.4.
| 000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000 | NPN
#5 Infant remains under single phototherapy with eye shields in place. Bili this am 7.7/.3/7.4.
| ['NPN\n#5 Infant remains under single phototherapy with eye shields in place. Bili this am 7.7/.3/7.4.\n'] | ||
2070654 | 31097 | 115637.0 | 2132-01-20 | 2132-01-20 03:55:00 | 2132-01-20 03:57:00 | Nursing/other | Report | 20104.0 | NNP ON-Call
Physical Exam
General: infant in isolette, room air; under phototherapy
Skin: warm and dry; color pink
HEENT; anterior fontanel open, level; saggital suture overriding
Chest: breath sounds clear/=; easy respirations
CV: RRR, no murmur; normal S1 S2; pulses +2
Abd:soft; no masses; active bowel sounds; cord o... | NNP ON-Call
Physical Exam
General: infant in isolette, room air; under phototherapy
Skin: warm and dry; color pink
HEENT; anterior fontanel open, level; saggital suture overriding
Chest: breath sounds clear/=; easy respirations
CV: RRR, no murmur; normal S1 S2; pulses +2
Abd:soft; no masses; active bowel sounds; cord o... | 00000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000... | NNP ON-Call
Physical Exam
General: infant in isolette, room air; under phototherapy
Skin: warm and dry; color pink
HEENT; anterior fontanel open, level; saggital suture overriding
Chest: breath sounds clear/=; easy respirations
CV: RRR, no murmur; normal S1 S2; pulses +2
Abd:soft; no masses; active bowel sounds; cord o... | ['NNP ON-Call\nPhysical Exam\nGeneral: infant in isolette, room air; under phototherapy\nSkin: warm and dry; color pink\nHEENT; anterior fontanel open, level; saggital suture overriding\nChest: breath sounds clear/=; easy respirations\nCV: RRR, no murmur; normal S1 S2; pulses +2\nAbd:soft; no masses; active bowel sound... | ||
2070655 | 31097 | 115637.0 | 2132-01-20 | 2132-01-20 10:40:00 | 2132-01-20 10:44:00 | Nursing/other | Report | 20700.0 | NICU Attending Note
DOL 4 CGA 35 [**5-19**] wks
On RA, RR 30-40's, no spells, sating >94%
No murmur, HR 120-150's, MBP 52
Bili this am 7.7 (down from 9.4)
Wt 1730 no change, on TF 100 cc/kg/d full feeds, BM/PE20, po/pg, on small spit, abd benign, voiding, [**Month/Day (4) 21**].
in isolette, temps stable
A/P: 4 d... | NICU Attending Note
DOL 4 CGA 35 <Date>7-29</Date> wks
On RA, RR 30-40's, no spells, sating >94%
No murmur, HR 120-150's, MBP 52
Bili this am 7.7 (down from 9.4)
Wt 1730 no change, on TF 100 cc/kg/d full feeds, BM/PE20, po/pg, on small spit, abd benign, voiding, <Month>September</Month>.
in isolette, temps stable
... | 00000000000000000000000000000000011110000000000000000000000000000000000000000000>00000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000111111111000000000000000000000000000000000000000000000000000000000... | NICU Attending Note
DOL 4 CGA 35 7-29 wks
On RA, RR 30-40's, no spells, sating >94%
No murmur, HR 120-150's, MBP 52
Bili this am 7.7 (down from 9.4)
Wt 1730 no change, on TF 100 cc/kg/d full feeds, BM/PE20, po/pg, on small spit, abd benign, voiding, September.
in isolette, temps stable
A/P: 4 do 35 wker on RA, HD... | ["NICU Attending Note\nDOL 4 CGA 35 7-29 wks\n\nOn RA, RR 30-40's, no spells, sating >94%\n\nNo murmur, HR 120-150's, MBP 52\n\nBili this am 7.7 (down from 9.4)\n\nWt 1730 no change, on TF 100 cc/kg/d full feeds, BM/PE20, po/pg, on small spit, abd benign, voiding, September.\n\nin isolette, temps stable\n\nA/P: 4 do 35... | ||
2075921 | 31675 | 119394.0 | 2118-09-25 | 2118-09-25 00:50:00 | 2118-09-25 00:58:00 | Nursing/other | Report | 18706.0 | Umbilical Line Placement
Neonatology NNP procedure note for umbilical line placement for parenternal nutrition
Time out observed. Infant positioned to maintained sterility. Umbilicus prepped with betadine and sterile drapes applied. #3.5 Fr double lumen catheter easily inserted through umbilical vein and sutured in ... | Umbilical Line Placement
Neonatology NNP procedure note for umbilical line placement for parenternal nutrition
Time out observed. Infant positioned to maintained sterility. Umbilicus prepped with betadine and sterile drapes applied. #3.5 Fr double lumen catheter easily inserted through umbilical vein and sutured in ... | 00000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000... | Umbilical Line Placement
Neonatology NNP procedure note for umbilical line placement for parenternal nutrition
Time out observed. Infant positioned to maintained sterility. Umbilicus prepped with betadine and sterile drapes applied. #3.5 Fr double lumen catheter easily inserted through umbilical vein and sutured in ... | ['Umbilical Line Placement\nNeonatology NNP procedure note for umbilical line placement for parenternal nutrition\n\nTime out observed. Infant positioned to maintained sterility. Umbilicus prepped with betadine and sterile drapes applied. #3.5 Fr double lumen catheter easily inserted through umbilical vein and suture... | ||
2075922 | 31675 | 119394.0 | 2118-09-25 | 2118-09-25 00:58:00 | 2118-09-25 01:04:00 | Nursing/other | Report | 18706.0 | Neonatology NNP on-call note
PE:
NEURO: infant nested on open warmer, active on exam, AFOS, aga tone
RESP: infant on CPAP, breath sounds = clear with mild subcostal retractions.
CARDIAC: color pink/pale, no audible murmur on exam, cap refill ~4 secs, pulses palpable =, mucous membranes pink and moist.
GI: abd soft ... | Neonatology NNP on-call note
PE:
NEURO: infant nested on open warmer, active on exam, AFOS, aga tone
RESP: infant on CPAP, breath sounds = clear with mild subcostal retractions.
CARDIAC: color pink/pale, no audible murmur on exam, cap refill ~4 secs, pulses palpable =, mucous membranes pink and moist.
GI: abd soft ... | 00000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000... | Neonatology NNP on-call note
PE:
NEURO: infant nested on open warmer, active on exam, AFOS, aga tone
RESP: infant on CPAP, breath sounds = clear with mild subcostal retractions.
CARDIAC: color pink/pale, no audible murmur on exam, cap refill ~4 secs, pulses palpable =, mucous membranes pink and moist.
GI: abd soft ... | ['Neonatology NNP on-call note\nPE:\n\nNEURO: infant nested on open warmer, active on exam, AFOS, aga tone\n\nRESP: infant on CPAP, breath sounds = clear with mild subcostal retractions.\n\nCARDIAC: color pink/pale, no audible murmur on exam, cap refill ~4 secs, pulses palpable =, mucous membranes pink and moist.\n\nGI... | ||
2075983 | 31675 | 119394.0 | 2118-10-07 | 2118-10-07 10:59:00 | 2118-10-07 11:03:00 | Nursing/other | Report | 19812.0 | NPN 7a-7p
RESP: Infant remains in RA; satting 95-100%. RR 40-80's.
LS cl/= with mild IC/SC retxns. No spells this shift. On
caffeine. Infant stable in RA, comfortable. Continue to
assess respiratory status.
FEN: TF 150cc/k/d of BM26 = 37cc Q4hrs; gavaged over 45.
Abd. benign. Girth 23.5cm. No spits, no aspi... | NPN 7a-7p
RESP: Infant remains in RA; satting 95-100%. RR 40-80's.
LS cl/= with mild IC/SC retxns. No spells this shift. On
caffeine. Infant stable in RA, comfortable. Continue to
assess respiratory status.
FEN: TF 150cc/k/d of BM26 = 37cc Q4hrs; gavaged over 45.
Abd. benign. Girth 23.5cm. No spits, no aspi... | 00000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000... | NPN 7a-7p
RESP: Infant remains in RA; satting 95-100%. RR 40-80's.
LS cl/= with mild IC/SC retxns. No spells this shift. On
caffeine. Infant stable in RA, comfortable. Continue to
assess respiratory status.
FEN: TF 150cc/k/d of BM26 = 37cc Q4hrs; gavaged over 45.
Abd. benign. Girth 23.5cm. No spits, no aspi... | ["NPN 7a-7p\n\n\nRESP: Infant remains in RA; satting 95-100%. RR 40-80's.\nLS cl/= with mild IC/SC retxns. No spells this shift. On\ncaffeine. Infant stable in RA, comfortable. Continue to\nassess respiratory status.\n\nFEN: TF 150cc/k/d of BM26 = 37cc Q4hrs; gavaged over 45.\nAbd. benign. Girth 23.5cm. No spi... | ||
2075984 | 31675 | 119394.0 | 2118-10-07 | 2118-10-07 13:00:00 | 2118-10-07 13:03:00 | Nursing/other | Report | 15318.0 | Clinical Nutrition
O:
~33 [**2-15**] wk CGA BG on DOL 13.
WT: 1480 g (+30)(~10th %Ile); birthwt: 1445 g. Average wt gain over past wk ~13 g/kg/day.
HC: 28.5 cm (~10th to 25th %Ile); last: 28.5 cm
LN: 39.5 cm (~10th to 25th %Ile); last: 39.5 cm
Meds include Fe and Vit E
[**Month/Day (2) 107**] not due yet
Nutritio... | Clinical Nutrition
O:
~33 <Date>8-26</Date> wk CGA BG on DOL 13.
WT: 1480 g (+30)(~10th %Ile); birthwt: 1445 g. Average wt gain over past wk ~13 g/kg/day.
HC: 28.5 cm (~10th to 25th %Ile); last: 28.5 cm
LN: 39.5 cm (~10th to 25th %Ile); last: 39.5 cm
Meds include Fe and Vit E
<Month>August</Month> not due yet
Nut... | 00000000000000000000000000111100000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000011111100000000000000000000000000000000000000000000... | Clinical Nutrition
O:
~33 8-26 wk CGA BG on DOL 13.
WT: 1480 g (+30)(~10th %Ile); birthwt: 1445 g. Average wt gain over past wk ~13 g/kg/day.
HC: 28.5 cm (~10th to 25th %Ile); last: 28.5 cm
LN: 39.5 cm (~10th to 25th %Ile); last: 39.5 cm
Meds include Fe and Vit E
August not due yet
Nutrition: 150 cc/kg/day BM 26... | ['Clinical Nutrition\nO:\n~33 8-26 wk CGA BG on DOL 13.\nWT: 1480 g (+30)(~10th %Ile); birthwt: 1445 g. Average wt gain over past wk ~13 g/kg/day.\nHC: 28.5 cm (~10th to 25th %Ile); last: 28.5 cm\nLN: 39.5 cm (~10th to 25th %Ile); last: 39.5 cm\nMeds include Fe and Vit E\nAugust not due yet\nNutrition: 150 cc/kg... | ||
2077078 | 31762 | 133669.0 | 2159-09-21 | 2159-09-21 01:35:00 | 2159-09-21 03:05:00 | Nursing/other | Report | 17604.0 | PCA Progress Note
Addendum to above: I have examined this infant and agree with the above note and assessment by [**First Name8 (NamePattern2) **] [**Last Name (NamePattern1) 73**]. No contact with family tonight , will continue per current plan of care and continue to support / update family.
| PCA Progress Note
Addendum to above: I have examined this infant and agree with the above note and assessment by <Name>Dennis</Name> <Name>Young</Name>. No contact with family tonight , will continue per current plan of care and continue to support / update family.
| 00000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000011111101111100000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000 | PCA Progress Note
Addendum to above: I have examined this infant and agree with the above note and assessment by Dennis Young. No contact with family tonight , will continue per current plan of care and continue to support / update family.
| ['PCA Progress Note\nAddendum to above: I have examined this infant and agree with the above note and assessment by Dennis Young. No contact with family tonight , will continue per current plan of care and continue to support / update family.\n'] | ||
2077079 | 31762 | 133669.0 | 2159-09-21 | 2159-09-21 01:35:00 | 2159-09-21 01:35:00 | Nursing/other | Report | 17066.0 | PCA Progress Note
2 fen
birth weight 2210gms, current weight 2180gms (+25). tf @
150cc/kg/day, 55cc q4hrs, BM24; PO/PG. bottling per cues.
infant has bottled 30cc so far this shift. 1 sm spit,
otherwise tolerating feeds well. minimal aspirates. belly
benign, soft, no loops. AG 24cm. voiding and stooling
(heme-. cont... | PCA Progress Note
2 fen
birth weight 2210gms, current weight 2180gms (+25). tf @
150cc/kg/day, 55cc q4hrs, BM24; PO/PG. bottling per cues.
infant has bottled 30cc so far this shift. 1 sm spit,
otherwise tolerating feeds well. minimal aspirates. belly
benign, soft, no loops. AG 24cm. voiding and stooling
(heme-. cont... | 00000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000... | PCA Progress Note
2 fen
birth weight 2210gms, current weight 2180gms (+25). tf @
150cc/kg/day, 55cc q4hrs, BM24; PO/PG. bottling per cues.
infant has bottled 30cc so far this shift. 1 sm spit,
otherwise tolerating feeds well. minimal aspirates. belly
benign, soft, no loops. AG 24cm. voiding and stooling
(heme-. cont... | ["PCA Progress Note\n\n\n2 fen\n birth weight 2210gms, current weight 2180gms (+25). tf @\n150cc/kg/day, 55cc q4hrs, BM24; PO/PG. bottling per cues.\ninfant has bottled 30cc so far this shift. 1 sm spit,\notherwise tolerating feeds well. minimal aspirates. belly\nbenign, soft, no loops. AG 24cm. voiding and stooling\n(... | ||
2077080 | 31762 | 133669.0 | 2159-09-21 | 2159-09-21 14:58:00 | 2159-09-21 15:08:00 | Nursing/other | Report | 21232.0 | NPN 7A-7P
#2,4 TF at 150cc/k/g of BM24. Attempting oral feeds
according to cues (every feed today!), and infant
bottling/to breast well. Mom in and was updated, did infant
care and put [**Known lastname 225**] to breast. He was vigorous and
latched/sucked and feed was gavaged simultaneously. Mom
pleased with his acti... | NPN 7A-7P
#2,4 TF at 150cc/k/g of BM24. Attempting oral feeds
according to cues (every feed today!), and infant
bottling/to breast well. Mom in and was updated, did infant
care and put <Name>Pegram</Name> to breast. He was vigorous and
latched/sucked and feed was gavaged simultaneously. Mom
pleased with his activity.... | 00000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000001111110000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000... | NPN 7A-7P
#2,4 TF at 150cc/k/g of BM24. Attempting oral feeds
according to cues (every feed today!), and infant
bottling/to breast well. Mom in and was updated, did infant
care and put Pegram to breast. He was vigorous and
latched/sucked and feed was gavaged simultaneously. Mom
pleased with his activity. Will con't t... | ["NPN 7A-7P\n\n\n#2,4 TF at 150cc/k/g of BM24. Attempting oral feeds\naccording to cues (every feed today!), and infant\nbottling/to breast well. Mom in and was updated, did infant\ncare and put Pegram to breast. He was vigorous and\nlatched/sucked and feed was gavaged simultaneously. Mom\npleased with his activity. Wi... | ||
2077081 | 31762 | 133669.0 | 2159-09-22 | 2159-09-22 02:32:00 | 2159-09-22 02:40:00 | Nursing/other | Report | 18249.0 | NICU NPN 1900-0700
Fluid and Nutrition
Infant's wt. 2200gms(+20). Total fluids 150cc/k/day; infant
remains on 24cal/oz feeds. Bottle-fed 30cc at 9pm,
gavage-fed at 1am as infant was not interested in bottling.
Abdomen soft, B.S.(+), no loops, girth stable, no spits, no
aspirates, voiding and stooling q.s. Stool guiac... | NICU NPN 1900-0700
Fluid and Nutrition
Infant's wt. 2200gms(+20). Total fluids 150cc/k/day; infant
remains on 24cal/oz feeds. Bottle-fed 30cc at 9pm,
gavage-fed at 1am as infant was not interested in bottling.
Abdomen soft, B.S.(+), no loops, girth stable, no spits, no
aspirates, voiding and stooling q.s. Stool guiac... | 00000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000... | NICU NPN 1900-0700
Fluid and Nutrition
Infant's wt. 2200gms(+20). Total fluids 150cc/k/day; infant
remains on 24cal/oz feeds. Bottle-fed 30cc at 9pm,
gavage-fed at 1am as infant was not interested in bottling.
Abdomen soft, B.S.(+), no loops, girth stable, no spits, no
aspirates, voiding and stooling q.s. Stool guiac... | ["NICU NPN 1900-0700\n\nFluid and Nutrition\nInfant's wt. 2200gms(+20). Total fluids 150cc/k/day; infant\nremains on 24cal/oz feeds. Bottle-fed 30cc at 9pm,\ngavage-fed at 1am as infant was not interested in bottling.\nAbdomen soft, B.S.(+), no loops, girth stable, no spits, no\naspirates, voiding and stooling q.s. St... | ||
2077082 | 31762 | 133669.0 | 2159-09-22 | 2159-09-22 12:48:00 | 2159-09-22 12:51:00 | Nursing/other | Report | 18056.0 | Neonatology Attending Note
DOL# 10, CGA 35 [**5-5**] wk
In RA, RR 30-50s
Clear BS
No spells
P 130-150s
MBP 56
Wt 2200 (up 20 gm)
TF 150 cc/kg BM 24
Some gavage
Voiding and stooling
In air isolette
A/P:
Premature infant with feeding immaturity
RESP: Stable on RA. Continue to monitor.
CV: Stable BPs.
FEN: Conti... | Neonatology Attending Note
DOL# 10, CGA 35 <Date>5-28</Date> wk
In RA, RR 30-50s
Clear BS
No spells
P 130-150s
MBP 56
Wt 2200 (up 20 gm)
TF 150 cc/kg BM 24
Some gavage
Voiding and stooling
In air isolette
A/P:
Premature infant with feeding immaturity
RESP: Stable on RA. Continue to monitor.
CV: Stable BPs.
FEN... | 00000000000000000000000000000000000000000001111000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000... | Neonatology Attending Note
DOL# 10, CGA 35 5-28 wk
In RA, RR 30-50s
Clear BS
No spells
P 130-150s
MBP 56
Wt 2200 (up 20 gm)
TF 150 cc/kg BM 24
Some gavage
Voiding and stooling
In air isolette
A/P:
Premature infant with feeding immaturity
RESP: Stable on RA. Continue to monitor.
CV: Stable BPs.
FEN: Continue t... | ['Neonatology Attending Note\nDOL# 10, CGA 35 5-28 wk\n\nIn RA, RR 30-50s\nClear BS\nNo spells\n\nP 130-150s\nMBP 56\n\nWt 2200 (up 20 gm)\nTF 150 cc/kg BM 24\nSome gavage\n\nVoiding and stooling\n\nIn air isolette\n\nA/P:\nPremature infant with feeding immaturity\nRESP: Stable on RA. Continue to monitor.\nCV: Stabl... | ||
2077083 | 31762 | 133669.0 | 2159-09-22 | 2159-09-22 14:28:00 | 2159-09-22 14:29:00 | Nursing/other | Report | 18255.0 | Neonatology-NNP Progress Note
PE: [**Known lastname 225**] remains in his isolette, swaddled, in room air, bbs cl=, rrr s1s 2no murmur, abd soft, nontender, V7S, afso, gavage in place
See attending note for plan
| Neonatology-NNP Progress Note
PE: <Name>Sakkas</Name> remains in his isolette, swaddled, in room air, bbs cl=, rrr s1s 2no murmur, abd soft, nontender, V7S, afso, gavage in place
See attending note for plan
| 000000000000000000000000000000000011111100000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000 | Neonatology-NNP Progress Note
PE: Sakkas remains in his isolette, swaddled, in room air, bbs cl=, rrr s1s 2no murmur, abd soft, nontender, V7S, afso, gavage in place
See attending note for plan
| ['Neonatology-NNP Progress Note\nPE: Sakkas remains in his isolette, swaddled, in room air, bbs cl=, rrr s1s 2no murmur, abd soft, nontender, V7S, afso, gavage in place\n\nSee attending note for plan\n'] | ||
2078226 | 31927 | 143719.0 | 2104-12-18 | 2104-12-18 10:58:00 | 2104-12-18 11:03:00 | Nursing/other | Report | 19211.0 | Neonatology
DOL #1, CGA 32 3/7 weeks.
CVR: Currently on CPAP 5 cm, FiO2 21-28%, breath sounds clear. RR 60-70s, mild retractions. CBG 7.32/50. Hemodynamically stable, HR 140-160s, MAP 41. CXR consistent with mild RDS w/ component of TTN.
FEN: BW 1715 gm. TF 80 cc/kg/day, UVC in place. Dstiks 173, 143. Abdomen b... | Neonatology
DOL #1, CGA 32 3/7 weeks.
CVR: Currently on CPAP 5 cm, FiO2 21-28%, breath sounds clear. RR 60-70s, mild retractions. CBG 7.32/50. Hemodynamically stable, HR 140-160s, MAP 41. CXR consistent with mild RDS w/ component of TTN.
FEN: BW 1715 gm. TF 80 cc/kg/day, UVC in place. Dstiks 173, 143. Abdomen b... | 00000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000... | Neonatology
DOL #1, CGA 32 3/7 weeks.
CVR: Currently on CPAP 5 cm, FiO2 21-28%, breath sounds clear. RR 60-70s, mild retractions. CBG 7.32/50. Hemodynamically stable, HR 140-160s, MAP 41. CXR consistent with mild RDS w/ component of TTN.
FEN: BW 1715 gm. TF 80 cc/kg/day, UVC in place. Dstiks 173, 143. Abdomen b... | ['Neonatology\nDOL #1, CGA 32 3/7 weeks.\n\nCVR: Currently on CPAP 5 cm, FiO2 21-28%, breath sounds clear. RR 60-70s, mild retractions. CBG 7.32/50. Hemodynamically stable, HR 140-160s, MAP 41. CXR consistent with mild RDS w/ component of TTN.\n\nFEN: BW 1715 gm. TF 80 cc/kg/day, UVC in place. Dstiks 173, 143. Ab... | ||
2078227 | 31927 | 143719.0 | 2104-12-18 | 2104-12-18 14:04:00 | 2104-12-18 14:20:00 | Nursing/other | Report | 19371.0 | NPN 0700-1900
#1 RESP: Recieved pt on CPAP 6, pt then changed to CPAP of
5 @ 0800. FIO2= 24-31% Pt. is breathing mainly in the
40-70s but has been noted to be tachypneic and have rates in
the 90's. Team aware. Pt. has had 1 desat to 65%, no
bradycardia, during a feeding, mild stim and increased O2 to
resolve. P... | NPN 0700-1900
#1 RESP: Recieved pt on CPAP 6, pt then changed to CPAP of
5 @ 0800. FIO2= 24-31% Pt. is breathing mainly in the
40-70s but has been noted to be tachypneic and have rates in
the 90's. Team aware. Pt. has had 1 desat to 65%, no
bradycardia, during a feeding, mild stim and increased O2 to
resolve. P... | 00000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000... | NPN 0700-1900
#1 RESP: Recieved pt on CPAP 6, pt then changed to CPAP of
5 @ 0800. FIO2= 24-31% Pt. is breathing mainly in the
40-70s but has been noted to be tachypneic and have rates in
the 90's. Team aware. Pt. has had 1 desat to 65%, no
bradycardia, during a feeding, mild stim and increased O2 to
resolve. P... | ["NPN 0700-1900\n\n\n#1 RESP: Recieved pt on CPAP 6, pt then changed to CPAP of\n5 @ 0800. FIO2= 24-31% Pt. is breathing mainly in the\n40-70s but has been noted to be tachypneic and have rates in\nthe 90's. Team aware. Pt. has had 1 desat to 65%, no\nbradycardia, during a feeding, mild stim and increased O2 to\nr... | ||
2078293 | 31940 | 169563.0 | 2121-06-29 | 2121-06-29 15:39:00 | 2121-06-29 15:41:00 | Nursing/other | Report | 20104.0 | NNP On-Call
Please see Dr.[**Name (NI) 194**] note for overall summary and plan.
Physical Exam
General: alert infant in crib, nasal cannula O2
Skin: warm and dry; color pink, mild jaundice
HEENT: anterior fontanel open, level; sutures opposed; eyes clear
Chest: breath sounds clear/=; easy respirations
CV: RRR, no murm... | NNP On-Call
Please see Dr.<Name>Frank Poff</Name> note for overall summary and plan.
Physical Exam
General: alert infant in crib, nasal cannula O2
Skin: warm and dry; color pink, mild jaundice
HEENT: anterior fontanel open, level; sutures opposed; eyes clear
Chest: breath sounds clear/=; easy respirations
CV: RRR, no ... | 00000000000000000000000000111111111100000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000... | NNP On-Call
Please see Dr.Frank Poff note for overall summary and plan.
Physical Exam
General: alert infant in crib, nasal cannula O2
Skin: warm and dry; color pink, mild jaundice
HEENT: anterior fontanel open, level; sutures opposed; eyes clear
Chest: breath sounds clear/=; easy respirations
CV: RRR, no murmur; norma... | ['NNP On-Call\nPlease see Dr.Frank Poff note for overall summary and plan.\n\nPhysical Exam\nGeneral: alert infant in crib, nasal cannula O2\nSkin: warm and dry; color pink, mild jaundice\nHEENT: anterior fontanel open, level; sutures opposed; eyes clear\nChest: breath sounds clear/=; easy respirations\nCV: RRR, no mur... | ||
2079895 | 32242 | 163974.0 | 2121-12-09 | 2121-12-09 00:49:00 | 2121-12-09 00:50:00 | Nursing/other | Report | 19157.0 | [** 82**] Physical Exam
Awake and [** 136**] in isolette. [** 404**] with mild cephal molding. BSC and equal on NC with mild retractions and comfortable respirations. No audible murmur, pink and well perfused with normal pulses. Normal GU for gestational age.
| <Digit>52</Digit> Physical Exam
Awake and <Digit>106</Digit> in isolette. <Digit>182</Digit> with mild cephal molding. BSC and equal on NC with mild retractions and comfortable respirations. No audible murmur, pink and well perfused with normal pulses. Normal GU for gestational age.
| 11000000000000000000000000011100000000000000111000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000 | 52 Physical Exam
Awake and 106 in isolette. 182 with mild cephal molding. BSC and equal on NC with mild retractions and comfortable respirations. No audible murmur, pink and well perfused with normal pulses. Normal GU for gestational age.
| ['52 Physical Exam\nAwake and 106 in isolette. 182 with mild cephal molding. BSC and equal on NC with mild retractions and comfortable respirations. No audible murmur, pink and well perfused with normal pulses. Normal GU for gestational age.\n'] | ||
2079896 | 32242 | 163974.0 | 2121-12-09 | 2121-12-09 01:53:00 | 2121-12-09 01:54:00 | Nursing/other | Report | 14437.0 | Respiratory care
[** **] [**Known lastname 856**] remains on HFNC 500 cc fio2 36-38%.BS clear throughout.RR 30-60's.No spells documented thus far this shift,he is on caffeine.
| Respiratory care
<Name>Lewis</Name> remains on HFNC 500 cc fio2 36-38%.BS clear throughout.RR 30-60's.No spells documented thus far this shift,he is on caffeine.
| 000000000000000000111110000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000 | Respiratory care
Lewis remains on HFNC 500 cc fio2 36-38%.BS clear throughout.RR 30-60's.No spells documented thus far this shift,he is on caffeine.
| ["Respiratory care\n Lewis remains on HFNC 500 cc fio2 36-38%.BS clear throughout.RR 30-60's.No spells documented thus far this shift,he is on caffeine.\n"] | ||
2079902 | 32242 | 163974.0 | 2121-12-10 | 2121-12-10 01:47:00 | 2121-12-10 01:48:00 | Nursing/other | Report | 14437.0 | Respiratory Care
[** **] [**Known lastname 856**] remains on 500 cc HFNC,fio2 25-27%.No spells documented thus far this shift,he is on caffeine.
| Respiratory Care
<Name>Archie</Name> remains on 500 cc HFNC,fio2 25-27%.No spells documented thus far this shift,he is on caffeine.
| 000000000000000000111111000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000 | Respiratory Care
Archie remains on 500 cc HFNC,fio2 25-27%.No spells documented thus far this shift,he is on caffeine.
| ['Respiratory Care\n Archie remains on 500 cc HFNC,fio2 25-27%.No spells documented thus far this shift,he is on caffeine.\n'] | ||
2079903 | 32242 | 163974.0 | 2121-12-10 | 2121-12-10 03:22:00 | 2121-12-10 03:26:00 | Nursing/other | Report | 16914.0 | NPN
#2RESP: Infant remains on NC 500cc at 25-27% fio2. Lung
sounds are clear/=. IC/SC retractions noted. No spells thus
far this shift. A:NC P:Continue to monitor for spells
#3FEN: Weight 1005g, up 39g. TF's remain at 150cc/kg/d of
BM30 with BP/ PE30. 25cc q 4 hours gavaged over 1 hour.
abdomen is soft and round, +b... | NPN
#2RESP: Infant remains on NC 500cc at 25-27% fio2. Lung
sounds are clear/=. IC/SC retractions noted. No spells thus
far this shift. A:NC P:Continue to monitor for spells
#3FEN: Weight 1005g, up 39g. TF's remain at 150cc/kg/d of
BM30 with BP/ PE30. 25cc q 4 hours gavaged over 1 hour.
abdomen is soft and round, +b... | 00000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000... | NPN
#2RESP: Infant remains on NC 500cc at 25-27% fio2. Lung
sounds are clear/=. IC/SC retractions noted. No spells thus
far this shift. A:NC P:Continue to monitor for spells
#3FEN: Weight 1005g, up 39g. TF's remain at 150cc/kg/d of
BM30 with BP/ PE30. 25cc q 4 hours gavaged over 1 hour.
abdomen is soft and round, +b... | ["NPN\n\n\n#2RESP: Infant remains on NC 500cc at 25-27% fio2. Lung\nsounds are clear/=. IC/SC retractions noted. No spells thus\nfar this shift. A:NC P:Continue to monitor for spells\n\n#3FEN: Weight 1005g, up 39g. TF's remain at 150cc/kg/d of\nBM30 with BP/ PE30. 25cc q 4 hours gavaged over 1 hour.\nabdomen is soft an... | ||
2079904 | 32242 | 163974.0 | 2121-12-10 | 2121-12-10 06:13:00 | 2121-12-10 06:15:00 | Nursing/other | Report | 20104.0 | [** 82**] On-Call
Physical Exam
General: infant in isolette, on nasal cannulaO2
Skin: warm and dry; color pink
HEENT; anterior fontanel open, level; sutures opposed; [** 136**] gaze; eyes clear
Chest: breath sounds clear/=; minimal work of breathing
Abd: full, soft; no masses; active bowel sounds; cord healed
GU: norm... | <Digit>12</Digit> On-Call
Physical Exam
General: infant in isolette, on nasal cannulaO2
Skin: warm and dry; color pink
HEENT; anterior fontanel open, level; sutures opposed; <Digit>244</Digit> gaze; eyes clear
Chest: breath sounds clear/=; minimal work of breathing
Abd: full, soft; no masses; active bowel sounds; cord... | 11000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000011100000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000... | 12 On-Call
Physical Exam
General: infant in isolette, on nasal cannulaO2
Skin: warm and dry; color pink
HEENT; anterior fontanel open, level; sutures opposed; 244 gaze; eyes clear
Chest: breath sounds clear/=; minimal work of breathing
Abd: full, soft; no masses; active bowel sounds; cord healed
GU: normal preterm mal... | ['12 On-Call\nPhysical Exam\nGeneral: infant in isolette, on nasal cannulaO2\nSkin: warm and dry; color pink\nHEENT; anterior fontanel open, level; sutures opposed; 244 gaze; eyes clear\nChest: breath sounds clear/=; minimal work of breathing\nAbd: full, soft; no masses; active bowel sounds; cord healed\nGU: normal pr... | ||
2079905 | 32242 | 163974.0 | 2121-12-10 | 2121-12-10 11:04:00 | 2121-12-10 11:06:00 | Nursing/other | Report | 16888.0 | Neonatology
Looking well on high flow NCo2 after dc of CPAP yetserday. WIll trial on lower flow this am. Comfortable appearinbg.
Wt 1005 up 39. Tolerating feeds at 150 cc/k/d. Abdomen benign.
Lytes in good range.
Temp stable.
Spoke with mother at bedside eysterday.
Continue as at present. Monitor resp status.
| Neonatology
Looking well on high flow NCo2 after dc of CPAP yetserday. WIll trial on lower flow this am. Comfortable appearinbg.
Wt 1005 up 39. Tolerating feeds at 150 cc/k/d. Abdomen benign.
Lytes in good range.
Temp stable.
Spoke with mother at bedside eysterday.
Continue as at present. Monitor resp status.
| 000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000 | Neonatology
Looking well on high flow NCo2 after dc of CPAP yetserday. WIll trial on lower flow this am. Comfortable appearinbg.
Wt 1005 up 39. Tolerating feeds at 150 cc/k/d. Abdomen benign.
Lytes in good range.
Temp stable.
Spoke with mother at bedside eysterday.
Continue as at present. Monitor resp status.
| ['Neonatology\nLooking well on high flow NCo2 after dc of CPAP yetserday. WIll trial on lower flow this am. Comfortable appearinbg.\n\nWt 1005 up 39. Tolerating feeds at 150 cc/k/d. Abdomen benign.\nLytes in good range.\n\nTemp stable.\n\nSpoke with mother at bedside eysterday.\n\nContinue as at present. Monitor resp s... | ||
2079906 | 32242 | 163974.0 | 2121-12-10 | 2121-12-10 14:41:00 | 2121-12-10 14:50:00 | Nursing/other | Report | 19271.0 | Nursing Progress Note
#2 O; cont in high flow nasal cannula .5L 23-30% FiO2. Lungs
clear/equal, color pink/well perfused. RR 30's-60's w/mild
baseline sc/ic retractions. Some drifting when in deep
sleep. Caffeine as ordered, bradys x2 this afternoon w/mild
stim for one. A: occ bradys now that [** **] off cpap P:
moni... | Nursing Progress Note
#2 O; cont in high flow nasal cannula .5L 23-30% FiO2. Lungs
clear/equal, color pink/well perfused. RR 30's-60's w/mild
baseline sc/ic retractions. Some drifting when in deep
sleep. Caffeine as ordered, bradys x2 this afternoon w/mild
stim for one. A: occ bradys now that off cpap P:
monitor clo... | 00000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000... | Nursing Progress Note
#2 O; cont in high flow nasal cannula .5L 23-30% FiO2. Lungs
clear/equal, color pink/well perfused. RR 30's-60's w/mild
baseline sc/ic retractions. Some drifting when in deep
sleep. Caffeine as ordered, bradys x2 this afternoon w/mild
stim for one. A: occ bradys now that off cpap P:
monitor clo... | ["Nursing Progress Note\n\n\n#2 O; cont in high flow nasal cannula .5L 23-30% FiO2. Lungs\nclear/equal, color pink/well perfused. RR 30's-60's w/mild\nbaseline sc/ic retractions. Some drifting when in deep\nsleep. Caffeine as ordered, bradys x2 this afternoon w/mild\nstim for one. A: occ bradys now that off cpap P:\nm... | ||
2076070 | 31675 | 119394.0 | 2118-10-26 | 2118-10-26 15:26:00 | 2118-10-26 15:31:00 | Nursing/other | Report | 20522.0 | Nursing Progress Note
1. RESP Received infant in RA. Infant remains in RA. LS
CL=. Mild SCR noted. No bradys noted thus far. Sat drift
to 80's with bottle feed, Mom watching infant cues, removed
bottle infant able to self correct. Cont to assess RESP
needs.
3. FEN TF=min of 130cc/kg/day BM26. Infant BF q3... | Nursing Progress Note
1. RESP Received infant in RA. Infant remains in RA. LS
CL=. Mild SCR noted. No bradys noted thus far. Sat drift
to 80's with bottle feed, Mom watching infant cues, removed
bottle infant able to self correct. Cont to assess RESP
needs.
3. FEN TF=min of 130cc/kg/day BM26. Infant BF q3... | 00000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000... | Nursing Progress Note
1. RESP Received infant in RA. Infant remains in RA. LS
CL=. Mild SCR noted. No bradys noted thus far. Sat drift
to 80's with bottle feed, Mom watching infant cues, removed
bottle infant able to self correct. Cont to assess RESP
needs.
3. FEN TF=min of 130cc/kg/day BM26. Infant BF q3... | ["Nursing Progress Note\n\n\n1. RESP Received infant in RA. Infant remains in RA. LS\nCL=. Mild SCR noted. No bradys noted thus far. Sat drift\nto 80's with bottle feed, Mom watching infant cues, removed\nbottle infant able to self correct. Cont to assess RESP\nneeds.\n\n3. FEN TF=min of 130cc/kg/day BM26. I... | ||
2076071 | 31675 | 119394.0 | 2118-10-27 | 2118-10-27 02:16:00 | 2118-10-27 02:18:00 | Nursing/other | Report | 20296.0 | NPN 1900-0700
RESP: Remains in room air, LS clear/=, mild SC retractions.
No bradys or desats thus far this shift.
FEN: Tolerating ad lib PO feeds well, no spits. Bottles with
good coordination, no issues thus far. Abdomen soft/round,
good bs, V&S (Criticaid applied). Continues on iron and
multivitamins.
G/D: Temp ... | NPN 1900-0700
RESP: Remains in room air, LS clear/=, mild SC retractions.
No bradys or desats thus far this shift.
FEN: Tolerating ad lib PO feeds well, no spits. Bottles with
good coordination, no issues thus far. Abdomen soft/round,
good bs, V&S (Criticaid applied). Continues on iron and
multivitamins.
G/D: Temp ... | 00000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000... | NPN 1900-0700
RESP: Remains in room air, LS clear/=, mild SC retractions.
No bradys or desats thus far this shift.
FEN: Tolerating ad lib PO feeds well, no spits. Bottles with
good coordination, no issues thus far. Abdomen soft/round,
good bs, V&S (Criticaid applied). Continues on iron and
multivitamins.
G/D: Temp ... | ['NPN 1900-0700\n\n\nRESP: Remains in room air, LS clear/=, mild SC retractions.\nNo bradys or desats thus far this shift.\n\nFEN: Tolerating ad lib PO feeds well, no spits. Bottles with\ngood coordination, no issues thus far. Abdomen soft/round,\ngood bs, V&S (Criticaid applied). Continues on iron and\nmultivitamins.\... | ||
2076072 | 31675 | 119394.0 | 2118-10-27 | 2118-10-27 12:44:00 | 2118-10-27 12:45:00 | Nursing/other | Report | 19199.0 | Neonatology Fellow PE Note
[** **]. [** 193**]
AFOF. MMM
CTA B/L.
Normal S1 and S2 with no murmur. Pulses 2+
Soft, ND abdomen BS present
AGA tone and neonatal reflexes
MAEW
| Neonatology Fellow PE Note
. <Digit>425</Digit>
AFOF. MMM
CTA B/L.
Normal S1 and S2 with no murmur. Pulses 2+
Soft, ND abdomen BS present
AGA tone and neonatal reflexes
MAEW
| 000000000000000000000000000001110000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000 | Neonatology Fellow PE Note
. 425
AFOF. MMM
CTA B/L.
Normal S1 and S2 with no murmur. Pulses 2+
Soft, ND abdomen BS present
AGA tone and neonatal reflexes
MAEW
| ['Neonatology Fellow PE Note\n. 425\nAFOF. MMM\nCTA B/L.\nNormal S1 and S2 with no murmur. Pulses 2+\nSoft, ND abdomen BS present\nAGA tone and neonatal reflexes\nMAEW\n'] | ||
2076073 | 31675 | 119394.0 | 2118-10-27 | 2118-10-27 15:28:00 | 2118-10-27 15:45:00 | Nursing/other | Report | 21232.0 | NPN 7A-7P
#1 In RA, no desat's or brady's during feeds or at rest.
Monitor.
#3 BF well x 2 today, also bottled 60cc's with mom this
afternoon between breastfeeds. (Mom putting infant to breast
2 x day during full day visits, and infant is offered
supplement depending on activity). Sometimes wakes early
depending on ... | NPN 7A-7P
#1 In RA, no desat's or brady's during feeds or at rest.
Monitor.
#3 BF well x 2 today, also bottled 60cc's with mom this
afternoon between breastfeeds. (Mom putting infant to breast
2 x day during full day visits, and infant is offered
supplement depending on activity). Sometimes wakes early
depending on ... | 00000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000... | NPN 7A-7P
#1 In RA, no desat's or brady's during feeds or at rest.
Monitor.
#3 BF well x 2 today, also bottled 60cc's with mom this
afternoon between breastfeeds. (Mom putting infant to breast
2 x day during full day visits, and infant is offered
supplement depending on activity). Sometimes wakes early
depending on ... | ['NPN 7A-7P\n\n\n#1 In RA, no desat\'s or brady\'s during feeds or at rest.\nMonitor.\n\n#3 BF well x 2 today, also bottled 60cc\'s with mom this\nafternoon between breastfeeds. (Mom putting infant to breast\n2 x day during full day visits, and infant is offered\nsupplement depending on activity). Sometimes wakes early... | ||
2076074 | 31675 | 119394.0 | 2118-10-27 | 2118-10-27 17:19:00 | 2118-10-27 17:23:00 | Nursing/other | Report | 15444.0 | Neo Attend
Day 33 now 36.3
wt 2100g, no change.
CV: hr 170-180s is somewhat higher baseline. No apparent reason for such. repeat Hct/Retic are ordered. no murmur,
respr: clear=bs, rr 30-540s.
infant had on sr brady to 49 with spO2 in 90s.
Infant had no clinical symptoms. Not clear that this episode was clinically signi... | Neo Attend
Day 33 now 36.3
wt 2100g, no change.
CV: hr 170-180s is somewhat higher baseline. No apparent reason for such. repeat Hct/Retic are ordered. no murmur,
respr: clear=bs, rr 30-540s.
infant had on sr brady to 49 with spO2 in 90s.
Infant had no clinical symptoms. Not clear that this episode was clinically signi... | 00000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000... | Neo Attend
Day 33 now 36.3
wt 2100g, no change.
CV: hr 170-180s is somewhat higher baseline. No apparent reason for such. repeat Hct/Retic are ordered. no murmur,
respr: clear=bs, rr 30-540s.
infant had on sr brady to 49 with spO2 in 90s.
Infant had no clinical symptoms. Not clear that this episode was clinically signi... | ['Neo Attend\nDay 33 now 36.3\nwt 2100g, no change.\nCV: hr 170-180s is somewhat higher baseline. No apparent reason for such. repeat Hct/Retic are ordered. no murmur,\nrespr: clear=bs, rr 30-540s.\ninfant had on sr brady to 49 with spO2 in 90s.\nInfant had no clinical symptoms. Not clear that this episode was clinical... | ||
2077305 | 31804 | 143960.0 | 2116-07-24 | 2116-07-24 16:47:00 | 2116-07-24 16:52:00 | Nursing/other | Report | 19296.0 | NPN/0700-1900
#1 FEN: TF ^ to 150cc/k/d of BM/PE26. Taking all po's this
shift. BF fair x1, latched on briefly but was sleepy (mom
using [**Name2 (NI) 302**] shield). No spits or aspirates. Abd. exam
benign. Girth=23.5-24cm. V/S. On Fe. Cont. to encourage
po feeds.
#2 DEVELOPMENT: Moved to crib this afternoon... | NPN/0700-1900
#1 FEN: TF ^ to 150cc/k/d of BM/PE26. Taking all po's this
shift. BF fair x1, latched on briefly but was sleepy (mom
using <Name>Elijah Spikes</Name> shield). No spits or aspirates. Abd. exam
benign. Girth=23.5-24cm. V/S. On Fe. Cont. to encourage
po feeds.
#2 DEVELOPMENT: Moved to crib this aft... | 00000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000011111111111110000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000... | NPN/0700-1900
#1 FEN: TF ^ to 150cc/k/d of BM/PE26. Taking all po's this
shift. BF fair x1, latched on briefly but was sleepy (mom
using Elijah Spikes shield). No spits or aspirates. Abd. exam
benign. Girth=23.5-24cm. V/S. On Fe. Cont. to encourage
po feeds.
#2 DEVELOPMENT: Moved to crib this afternoon, temps... | ["NPN/0700-1900\n\n\n#1 FEN: TF ^ to 150cc/k/d of BM/PE26. Taking all po's this\nshift. BF fair x1, latched on briefly but was sleepy (mom\nusing Elijah Spikes shield). No spits or aspirates. Abd. exam\nbenign. Girth=23.5-24cm. V/S. On Fe. Cont. to encourage\npo feeds.\n#2 DEVELOPMENT: Moved to crib this aftern... | ||
2077306 | 31804 | 143960.0 | 2116-07-24 | 2116-07-24 17:41:00 | 2116-07-24 17:41:00 | Nursing/other | Report | 15444.0 | Neo Attend PE note
Twin I appears healthy, breath sounds clear=, cv exam wnl, abd soft,
well perfused, no distress.
| Neo Attend PE note
Twin I appears healthy, breath sounds clear=, cv exam wnl, abd soft,
well perfused, no distress.
| 00000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000 | Neo Attend PE note
Twin I appears healthy, breath sounds clear=, cv exam wnl, abd soft,
well perfused, no distress.
| ['Neo Attend PE note\nTwin I appears healthy, breath sounds clear=, cv exam wnl, abd soft,\nwell perfused, no distress.\n'] | ||
2077307 | 31804 | 143960.0 | 2116-07-25 | 2116-07-25 03:07:00 | 2116-07-25 03:12:00 | Nursing/other | Report | 18929.0 | NPN
FEN- Wt=1720g up 35. TF@150cc/kg/d of BM/PE26=43ccs q4h
PO/PG. Tolerating feeds fairly with occasional small spits
and max asp=3.2ccs. Abd is benign with no visible loops and
+BS. Girth remains stable. V&S. Will continue to monitor
and support.
DEV- Temps remain stable swaddled in an OAC. A&A with cares
an... | NPN
FEN- Wt=1720g up 35. TF@150cc/kg/d of BM/PE26=43ccs q4h
PO/PG. Tolerating feeds fairly with occasional small spits
and max asp=3.2ccs. Abd is benign with no visible loops and
+BS. Girth remains stable. V&S. Will continue to monitor
and support.
DEV- Temps remain stable swaddled in an OAC. A&A with cares
an... | 00000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000... | NPN
FEN- Wt=1720g up 35. TF@150cc/kg/d of BM/PE26=43ccs q4h
PO/PG. Tolerating feeds fairly with occasional small spits
and max asp=3.2ccs. Abd is benign with no visible loops and
+BS. Girth remains stable. V&S. Will continue to monitor
and support.
DEV- Temps remain stable swaddled in an OAC. A&A with cares
an... | ['NPN\n\n\nFEN- Wt=1720g up 35. TF@150cc/kg/d of BM/PE26=43ccs q4h\nPO/PG. Tolerating feeds fairly with occasional small spits\nand max asp=3.2ccs. Abd is benign with no visible loops and\n+BS. Girth remains stable. V&S. Will continue to monitor\nand support.\n\nDEV- Temps remain stable swaddled in an OAC. A&A wi... | ||
2077308 | 31804 | 143960.0 | 2116-07-25 | 2116-07-25 12:34:00 | 2116-07-25 12:41:00 | Nursing/other | Report | 18056.0 | Neonatology Attending Note
DOL# 8, CGA 35 [**3-7**] wk
In RA, RR 30-60s
Clear BS
No spells
P 130-170s
MBP 58
Wt 1720 (up 35 gm)
TF 150 cc/kg Bm 26/PE 26
Most PO but some gavage
Voiding and stooling
A/P:
Premature infant with feeding immaturity
RESP: Monitor resp status on RA.
CV: Stable BPs.
FEN: COntinue to wor... | Neonatology Attending Note
DOL# 8, CGA 35 <Date>1-2</Date> wk
In RA, RR 30-60s
Clear BS
No spells
P 130-170s
MBP 58
Wt 1720 (up 35 gm)
TF 150 cc/kg Bm 26/PE 26
Most PO but some gavage
Voiding and stooling
A/P:
Premature infant with feeding immaturity
RESP: Monitor resp status on RA.
CV: Stable BPs.
FEN: COntinue... | 00000000000000000000000000000000000000000011100000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000... | Neonatology Attending Note
DOL# 8, CGA 35 1-2 wk
In RA, RR 30-60s
Clear BS
No spells
P 130-170s
MBP 58
Wt 1720 (up 35 gm)
TF 150 cc/kg Bm 26/PE 26
Most PO but some gavage
Voiding and stooling
A/P:
Premature infant with feeding immaturity
RESP: Monitor resp status on RA.
CV: Stable BPs.
FEN: COntinue to work on P... | ['Neonatology Attending Note\nDOL# 8, CGA 35 1-2 wk\n\nIn RA, RR 30-60s\nClear BS\nNo spells\n\nP 130-170s\nMBP 58\n\nWt 1720 (up 35 gm)\nTF 150 cc/kg Bm 26/PE 26\nMost PO but some gavage\n\nVoiding and stooling\n\nA/P:\nPremature infant with feeding immaturity\nRESP: Monitor resp status on RA.\nCV: Stable BPs.\nFEN: ... | ||
2077309 | 31804 | 143960.0 | 2116-07-25 | 2116-07-25 13:30:00 | 2116-07-25 13:47:00 | Nursing/other | Report | 14461.0 | 1. FEN
TF= 150cc/k/d of BM/PE26 po/pg. 43cc q4 over 45mins when pg.
Baby wakes for feeds. Abd is benign. No spits so far this
shift. Max asp of 4.4cc of partial digested milk that was
refed. Voiding and stooling. Last hemoccult was negative.
A. Baby is tolerating feeds and gaining weight.
P. Continue to monitor FEN sta... | 1. FEN
TF= 150cc/k/d of BM/PE26 po/pg. 43cc q4 over 45mins when pg.
Baby wakes for feeds. Abd is benign. No spits so far this
shift. Max asp of 4.4cc of partial digested milk that was
refed. Voiding and stooling. Last hemoccult was negative.
A. Baby is tolerating feeds and gaining weight.
P. Continue to monitor FEN sta... | 00000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000... | 1. FEN
TF= 150cc/k/d of BM/PE26 po/pg. 43cc q4 over 45mins when pg.
Baby wakes for feeds. Abd is benign. No spits so far this
shift. Max asp of 4.4cc of partial digested milk that was
refed. Voiding and stooling. Last hemoccult was negative.
A. Baby is tolerating feeds and gaining weight.
P. Continue to monitor FEN sta... | ['1. FEN\nTF= 150cc/k/d of BM/PE26 po/pg. 43cc q4 over 45mins when pg.\nBaby wakes for feeds. Abd is benign. No spits so far this\nshift. Max asp of 4.4cc of partial digested milk that was\nrefed. Voiding and stooling. Last hemoccult was negative.\nA. Baby is tolerating feeds and gaining weight.\nP. Continue to monitor... | ||
2078409 | 31944 | 173538.0 | 2174-07-24 | 2174-07-24 04:54:00 | 2174-07-24 05:04:00 | Nursing/other | Report | 15931.0 | NPN 7p-7a
#1 [**Known lastname 544**] has done quite well tonight po feeding. she had
taken 55, 105 & 55cc BM. Abd remains unchanged, soft, +BS,
no loops or distention, vdg, stooling qs. weight no change
A: feeding improving P: no change at present
#2 cont in NC O2 at 50cc 100% with SaO2 90-98%. LS clear and
equal, n... | NPN 7p-7a
#1 <Name>Casenhiser</Name> has done quite well tonight po feeding. she had
taken 55, 105 & 55cc BM. Abd remains unchanged, soft, +BS,
no loops or distention, vdg, stooling qs. weight no change
A: feeding improving P: no change at present
#2 cont in NC O2 at 50cc 100% with SaO2 90-98%. LS clear and
equal, no... | 00000000000000011111111110000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000... | NPN 7p-7a
#1 Casenhiser has done quite well tonight po feeding. she had
taken 55, 105 & 55cc BM. Abd remains unchanged, soft, +BS,
no loops or distention, vdg, stooling qs. weight no change
A: feeding improving P: no change at present
#2 cont in NC O2 at 50cc 100% with SaO2 90-98%. LS clear and
equal, no GFR, color p... | ["NPN 7p-7a\n\n\n#1 Casenhiser has done quite well tonight po feeding. she had\ntaken 55, 105 & 55cc BM. Abd remains unchanged, soft, +BS,\nno loops or distention, vdg, stooling qs. weight no change\nA: feeding improving P: no change at present\n#2 cont in NC O2 at 50cc 100% with SaO2 90-98%. LS clear and\nequal, no GF... | ||
2078410 | 31944 | 173538.0 | 2174-07-24 | 2174-07-24 14:46:00 | 2174-07-24 18:14:00 | Nursing/other | Report | 14943.0 | Neonatology Attending
Physical Exam:
Resting comfortably in open crib. Mildly jaundiced. +NC, +NG. Lungs CTA, =. CV RRR, no murmur, 2+FP. Abd soft, +BS. GU normal female. Ext warm, pink and well perfused. General decreased tone, occassional myoclonic jerks.
| Neonatology Attending
Physical Exam:
Resting comfortably in open crib. Mildly jaundiced. +NC, +NG. Lungs CTA, =. CV RRR, no murmur, 2+FP. Abd soft, +BS. GU normal female. Ext warm, pink and well perfused. General decreased tone, occassional myoclonic jerks.
| 000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000 | Neonatology Attending
Physical Exam:
Resting comfortably in open crib. Mildly jaundiced. +NC, +NG. Lungs CTA, =. CV RRR, no murmur, 2+FP. Abd soft, +BS. GU normal female. Ext warm, pink and well perfused. General decreased tone, occassional myoclonic jerks.
| ['Neonatology Attending\nPhysical Exam:\nResting comfortably in open crib. Mildly jaundiced. +NC, +NG. Lungs CTA, =. CV RRR, no murmur, 2+FP. Abd soft, +BS. GU normal female. Ext warm, pink and well perfused. General decreased tone, occassional myoclonic jerks.\n'] | ||
2078411 | 31944 | 173538.0 | 2174-07-24 | 2174-07-24 14:46:00 | 2174-07-24 14:50:00 | Nursing/other | Report | 14943.0 | Neonatology Attending
Day 22, PMA 42 3
NC/RA trial. RR30-40s. No murmur. HR 120-150s.
Wt 4225, no change. TF 150 BM20. PO/PG. Voiding and stooling.
Pyridoxime.
Crib.
A/P:
Cont current management. Plans for family to meet Hospice care staff tomorrow.
| Neonatology Attending
Day 22, PMA 42 3
NC/RA trial. RR30-40s. No murmur. HR 120-150s.
Wt 4225, no change. TF 150 BM20. PO/PG. Voiding and stooling.
Pyridoxime.
Crib.
A/P:
Cont current management. Plans for family to meet Hospice care staff tomorrow.
| 000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000 | Neonatology Attending
Day 22, PMA 42 3
NC/RA trial. RR30-40s. No murmur. HR 120-150s.
Wt 4225, no change. TF 150 BM20. PO/PG. Voiding and stooling.
Pyridoxime.
Crib.
A/P:
Cont current management. Plans for family to meet Hospice care staff tomorrow.
| ['Neonatology Attending\nDay 22, PMA 42 3\n\nNC/RA trial. RR30-40s. No murmur. HR 120-150s.\nWt 4225, no change. TF 150 BM20. PO/PG. Voiding and stooling.\nPyridoxime.\nCrib.\n\nA/P:\nCont current management. Plans for family to meet Hospice care staff tomorrow.\n'] | ||
2078412 | 31944 | 173538.0 | 2174-07-24 | 2174-07-24 17:08:00 | 2174-07-24 17:17:00 | Nursing/other | Report | 18246.0 | NPN 0700-1900
#1 FEN O: Infant remains on TF 150cc/kday, bottling fair
today, BF fair X2, tol gavage feeds well, no spits or
aspirates. abd soft and nondistended, voiding and stooling
well. A:Alt in FEN P: Cont to offer po feeds as tolerated.
#2 RESP O: Infant remains on NC 50cc/100% 02, initial trial
off on RA today... | NPN 0700-1900
#1 FEN O: Infant remains on TF 150cc/kday, bottling fair
today, BF fair X2, tol gavage feeds well, no spits or
aspirates. abd soft and nondistended, voiding and stooling
well. A:Alt in FEN P: Cont to offer po feeds as tolerated.
#2 RESP O: Infant remains on NC 50cc/100% 02, initial trial
off on RA today... | 00000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000... | NPN 0700-1900
#1 FEN O: Infant remains on TF 150cc/kday, bottling fair
today, BF fair X2, tol gavage feeds well, no spits or
aspirates. abd soft and nondistended, voiding and stooling
well. A:Alt in FEN P: Cont to offer po feeds as tolerated.
#2 RESP O: Infant remains on NC 50cc/100% 02, initial trial
off on RA today... | ["NPN 0700-1900\n\n\n#1 FEN O: Infant remains on TF 150cc/kday, bottling fair\ntoday, BF fair X2, tol gavage feeds well, no spits or\naspirates. abd soft and nondistended, voiding and stooling\nwell. A:Alt in FEN P: Cont to offer po feeds as tolerated.\n#2 RESP O: Infant remains on NC 50cc/100% 02, initial trial\noff o... | ||
2078413 | 31944 | 173538.0 | 2174-07-25 | 2174-07-25 07:24:00 | 2174-07-25 07:26:00 | Nursing/other | Report | 19591.0 | NP NOTE
PE: growing term infant supine in ospen crib. Pink, well perfused in RA.
AFOF sutures approximated, eyes clear, ng in place, MMMP
Chest is symmetric with clear and equal bs, seesaw resp pattern
CV: RRR, no murmur, pulses+2=
Abd: soft round with active bs, no HSM
GU: normal external female genitalia
EXT: well de... | NP NOTE
PE: growing term infant supine in ospen crib. Pink, well perfused in RA.
AFOF sutures approximated, eyes clear, ng in place, MMMP
Chest is symmetric with clear and equal bs, seesaw resp pattern
CV: RRR, no murmur, pulses+2=
Abd: soft round with active bs, no HSM
GU: normal external female genitalia
EXT: well de... | 00000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000... | NP NOTE
PE: growing term infant supine in ospen crib. Pink, well perfused in RA.
AFOF sutures approximated, eyes clear, ng in place, MMMP
Chest is symmetric with clear and equal bs, seesaw resp pattern
CV: RRR, no murmur, pulses+2=
Abd: soft round with active bs, no HSM
GU: normal external female genitalia
EXT: well de... | ['NP NOTE\nPE: growing term infant supine in ospen crib. Pink, well perfused in RA.\nAFOF sutures approximated, eyes clear, ng in place, MMMP\nChest is symmetric with clear and equal bs, seesaw resp pattern\nCV: RRR, no murmur, pulses+2=\nAbd: soft round with active bs, no HSM\nGU: normal external female genitalia\nEXT... | ||
2079378 | 32149 | 103888.0 | 2130-06-15 | 2130-06-15 11:36:00 | 2130-06-15 11:50:00 | Nursing/other | Report | 17671.0 | Nrs transfer note
Baby Girl [**Known lastname 780**] [**Known lastname 775**] was born yesterday [**2130-6-14**] at
1338hrs. Mom is 26 G4P3, has 8 & 5 yr olds at home.
Maternal hx of Subutex and Xanax, migraines, cigarettes.
Induction for IUGR, Apgars [**7-27**], vigorous at birth, bulb
suctioned. To NICU for gestion... | Nrs transfer note
Baby Girl <Name>Lewis</Name> <Name>Merino</Name> was born yesterday <Date>1953-3-17</Date> at
1338hrs. Mom is 26 G4P3, has 8 & 5 yr olds at home.
Maternal hx of Subutex and Xanax, migraines, cigarettes.
Induction for IUGR, Apgars <Date>9-22</Date>, vigorous at birth, bulb
suctioned. To NICU for gest... | 00000000000000000000000000000011111011111100000000000000000000111111111000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000001111000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000... | Nrs transfer note
Baby Girl Lewis Merino was born yesterday 1953-3-17 at
1338hrs. Mom is 26 G4P3, has 8 & 5 yr olds at home.
Maternal hx of Subutex and Xanax, migraines, cigarettes.
Induction for IUGR, Apgars 9-22, vigorous at birth, bulb
suctioned. To NICU for gestional age of 35 5/7weeks. Baby
remained in RA, no di... | ['Nrs transfer note\n\n\nBaby Girl Lewis Merino was born yesterday 1953-3-17 at\n1338hrs. Mom is 26 G4P3, has 8 & 5 yr olds at home.\nMaternal hx of Subutex and Xanax, migraines, cigarettes.\nInduction for IUGR, Apgars 9-22, vigorous at birth, bulb\nsuctioned. To NICU for gestional age of 35 5/7weeks. Baby\nremained in... | ||
2079379 | 32151 | 115098.0 | 2199-09-22 | 2199-09-22 21:15:00 | 2199-09-22 21:22:00 | Nursing/other | Report | 16929.0 | Neonatology Attending Triage Note
Asked to evaluate baby by Dr. [**Last Name (STitle) 207**].
Baby Girl [**Known lastname 782**] is a term female infant delivered to a 32 yr old G2 P0-1 mother. PNS: O pos, Ab neg, HBSAg neg, RPR NR, RI, GBS neg.
Pregnancy was uncomplicated.
Delivery C-section because of failure to p... | Neonatology Attending Triage Note
Asked to evaluate baby by Dr. <Name>Belle</Name>.
Baby Girl <Name>Spikes</Name> is a term female infant delivered to a 32 yr old G2 P0-1 mother. PNS: O pos, Ab neg, HBSAg neg, RPR NR, RI, GBS neg.
Pregnancy was uncomplicated.
Delivery C-section because of failure to progress.
Apgars... | 00000000000000000000000000000000000000000000000000000000000000001111100000000000011111100000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000... | Neonatology Attending Triage Note
Asked to evaluate baby by Dr. Belle.
Baby Girl Spikes is a term female infant delivered to a 32 yr old G2 P0-1 mother. PNS: O pos, Ab neg, HBSAg neg, RPR NR, RI, GBS neg.
Pregnancy was uncomplicated.
Delivery C-section because of failure to progress.
Apgars 8,9.
Mother noted to have... | ['Neonatology Attending Triage Note\nAsked to evaluate baby by Dr. Belle.\nBaby Girl Spikes is a term female infant delivered to a 32 yr old G2 P0-1 mother. PNS: O pos, Ab neg, HBSAg neg, RPR NR, RI, GBS neg.\n\nPregnancy was uncomplicated.\nDelivery C-section because of failure to progress.\nApgars 8,9.\nMother note... | ||
2079380 | 32151 | 115098.0 | 2199-09-22 | 2199-09-22 21:22:00 | 2199-09-22 21:25:00 | Nursing/other | Report | 17858.0 | Admission Note
Baby [**Known lastname 782**] admitted at [**2192**] for a sepsis eval. CBC and BC
sent, see laboratory for details. Amp and Gent started.
No murmur, HR 136, BP 73/34 with a mean of 48. Infant is
[**Year (4 digits) 102**] and well perfused. Normal pulses and brisk cap refill.
RR 60, LS c/=. O2 sat 10... | Admission Note
Baby <Name>Mao</Name> admitted at <Year>1913</Year> for a sepsis eval. CBC and BC
sent, see laboratory for details. Amp and Gent started.
No murmur, HR 136, BP 73/34 with a mean of 48. Infant is
<Year>1925</Year> and well perfused. Normal pulses and brisk cap refill.
RR 60, LS c/=. O2 sat 100%. Abdom... | 00000000000000000000001110000000000000111100000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000001111000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000... | Admission Note
Baby Mao admitted at 1913 for a sepsis eval. CBC and BC
sent, see laboratory for details. Amp and Gent started.
No murmur, HR 136, BP 73/34 with a mean of 48. Infant is
1925 and well perfused. Normal pulses and brisk cap refill.
RR 60, LS c/=. O2 sat 100%. Abdomen is soft and round, good
bowel sounds... | ['Admission Note\n\n\nBaby Mao admitted at 1913 for a sepsis eval. CBC and BC\nsent, see laboratory for details. Amp and Gent started.\n\nNo murmur, HR 136, BP 73/34 with a mean of 48. Infant is\n1925 and well perfused. Normal pulses and brisk cap refill.\n\nRR 60, LS c/=. O2 sat 100%. Abdomen is soft and round, good\n... | ||
2076240 | 31706 | 123295.0 | 2179-08-01 | 2179-08-01 19:57:00 | 2179-08-01 20:04:00 | Nursing/other | Report | 15838.0 | NPN (0700-1900)
1. Resp: Remains on Prong CPAP-5 21%. Mild IC/SC
retractions, LS clear and equal. No A's or B's.
2. F/N: TF's increased to 120cc/kg/d. D/S 49-->51. D12.5
w/heparin added at 20cc/kg/d. Feedings held due to bilious
aspirates, which have lessened throughout day. NG tube
vented and infant positio... | NPN (0700-1900)
1. Resp: Remains on Prong CPAP-5 21%. Mild IC/SC
retractions, LS clear and equal. No A's or B's.
2. F/N: TF's increased to 120cc/kg/d. D/S 49-->51. D12.5
w/heparin added at 20cc/kg/d. Feedings held due to bilious
aspirates, which have lessened throughout day. NG tube
vented and infant positio... | 00000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000>00000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000... | NPN (0700-1900)
1. Resp: Remains on Prong CPAP-5 21%. Mild IC/SC
retractions, LS clear and equal. No A's or B's.
2. F/N: TF's increased to 120cc/kg/d. D/S 49-->51. D12.5
w/heparin added at 20cc/kg/d. Feedings held due to bilious
aspirates, which have lessened throughout day. NG tube
vented and infant positio... | ["NPN (0700-1900)\n\n\n1. Resp: Remains on Prong CPAP-5 21%. Mild IC/SC\nretractions, LS clear and equal. No A's or B's.\n\n2. F/N: TF's increased to 120cc/kg/d. D/S 49-->51. D12.5\nw/heparin added at 20cc/kg/d. Feedings held due to bilious\naspirates, which have lessened throughout day. NG tube\nvented and inf... | ||
2076298 | 31706 | 123295.0 | 2179-08-12 | 2179-08-12 04:39:00 | 2179-08-12 04:47:00 | Nursing/other | Report | 17959.0 | Nursing Progress Note 1900-0700
RESP O/A: Infant remains stable in RA; maintaining O2 sats
>95%. RR 30-60s, LS clear/=, mild ic/sc rtxns. No apnea,
bradycardia or desats noted thus far. P: Cont to monitor.
FEN O/A: Current Wt: 0.866Kg, ^21gms. TF @ 150cc/k/d; BM24.
Infant receives 16cc q3h pg. [**Known lastname 5235... | Nursing Progress Note 1900-0700
RESP O/A: Infant remains stable in RA; maintaining O2 sats
>95%. RR 30-60s, LS clear/=, mild ic/sc rtxns. No apnea,
bradycardia or desats noted thus far. P: Cont to monitor.
FEN O/A: Current Wt: 0.866Kg, ^21gms. TF @ 150cc/k/d; BM24.
Infant receives 16cc q3h pg. <Name>Young</Name> is ... | 000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000>0000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000001111100000000000000000... | Nursing Progress Note 1900-0700
RESP O/A: Infant remains stable in RA; maintaining O2 sats
>95%. RR 30-60s, LS clear/=, mild ic/sc rtxns. No apnea,
bradycardia or desats noted thus far. P: Cont to monitor.
FEN O/A: Current Wt: 0.866Kg, ^21gms. TF @ 150cc/k/d; BM24.
Infant receives 16cc q3h pg. Young is tolerating fe... | ['Nursing Progress Note 1900-0700\n\n\nRESP O/A: Infant remains stable in RA; maintaining O2 sats\n>95%. RR 30-60s, LS clear/=, mild ic/sc rtxns. No apnea,\nbradycardia or desats noted thus far. P: Cont to monitor.\n\nFEN O/A: Current Wt: 0.866Kg, ^21gms. TF @ 150cc/k/d; BM24.\nInfant receives 16cc q3h pg. Young is tol... | ||
2076299 | 31706 | 123295.0 | 2179-08-12 | 2179-08-12 09:59:00 | 2179-08-12 10:03:00 | Nursing/other | Report | 17593.0 | Neonatology Attending
DOl 13 PMA 34 1/7 weeks
Stable in RA. On Vit A. No A/B.
No murmur. BP 74/47 mean 56
On 150 ml/kg/d BM 24 pg q 3. DS 66/58. Voiding. [** **]. Wt 866 grams (up 21).
On iron and Vit E.
[** 14**] in and up to date.
A: Stable. No spells. Tolerating feeds and growing. DS stable on q 3 ... | Neonatology Attending
DOl 13 PMA 34 1/7 weeks
Stable in RA. On Vit A. No A/B.
No murmur. BP 74/47 mean 56
On 150 ml/kg/d BM 24 pg q 3. DS 66/58. Voiding. . Wt 866 grams (up 21).
On iron and Vit E.
<Digit>76</Digit> in and up to date.
A: Stable. No spells. Tolerating feeds and growing. DS stable on q 3... | 00000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000011000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000... | Neonatology Attending
DOl 13 PMA 34 1/7 weeks
Stable in RA. On Vit A. No A/B.
No murmur. BP 74/47 mean 56
On 150 ml/kg/d BM 24 pg q 3. DS 66/58. Voiding. . Wt 866 grams (up 21).
On iron and Vit E.
76 in and up to date.
A: Stable. No spells. Tolerating feeds and growing. DS stable on q 3 regimen.
P: ... | ['Neonatology Attending\n\nDOl 13 PMA 34 1/7 weeks\n\nStable in RA. On Vit A. No A/B.\n\nNo murmur. BP 74/47 mean 56\n\nOn 150 ml/kg/d BM 24 pg q 3. DS 66/58. Voiding. . Wt 866 grams (up 21).\n\nOn iron and Vit E.\n\n76 in and up to date.\n\nA: Stable. No spells. Tolerating feeds and growing. DS stable on q ... | ||
2076300 | 31706 | 123295.0 | 2179-08-12 | 2179-08-12 14:11:00 | 2179-08-12 14:16:00 | Nursing/other | Report | 20320.0 | NICU nursing note
1. Resp=O/Stable in room air. No bradys so far this shift.
(Refer to flowsheet for resp assessments.)
2. FEN=O/TF cont at 150cc/k/d of now BM26 Q3hrs gavaged
over 30min. Abd benign. (Refer to flowsheet for
assessments.) No spits. Voiding/[** 21**], guaiac (-).
Cont on iron and Vit e. A/[** ... | NICU nursing note
1. Resp=O/Stable in room air. No bradys so far this shift.
(Refer to flowsheet for resp assessments.)
2. FEN=O/TF cont at 150cc/k/d of now BM26 Q3hrs gavaged
over 30min. Abd benign. (Refer to flowsheet for
assessments.) No spits. Voiding/<Digit>31</Digit>, guaiac (-).
Cont on iron and Vit e.... | 00000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000110000000000000000000000000000000000000000011000000000... | NICU nursing note
1. Resp=O/Stable in room air. No bradys so far this shift.
(Refer to flowsheet for resp assessments.)
2. FEN=O/TF cont at 150cc/k/d of now BM26 Q3hrs gavaged
over 30min. Abd benign. (Refer to flowsheet for
assessments.) No spits. Voiding/31, guaiac (-).
Cont on iron and Vit e. A/48 current ... | ["NICU nursing note\n\n\n1. Resp=O/Stable in room air. No bradys so far this shift.\n(Refer to flowsheet for resp assessments.)\n\n2. FEN=O/TF cont at 150cc/k/d of now BM26 Q3hrs gavaged\nover 30min. Abd benign. (Refer to flowsheet for\nassessments.) No spits. Voiding/31, guaiac (-).\nCont on iron and Vit e. A/... | ||
2076301 | 31706 | 123295.0 | 2179-08-12 | 2179-08-12 20:58:00 | 2179-08-12 20:59:00 | Nursing/other | Report | 20104.0 | Procedure Note: PICC removal
PICC removed intact without incident.
| Procedure Note: PICC removal
PICC removed intact without incident.
| 0000000000000000000000000000000000000000000000000000000000000000000 | Procedure Note: PICC removal
PICC removed intact without incident.
| ['Procedure Note: PICC removal\nPICC removed intact without incident.\n'] | ||
2077469 | 31844 | 145602.0 | 2149-11-20 | 2149-11-20 17:42:00 | 2149-11-20 17:42:00 | Nursing/other | Report | 17681.0 | 1 Infant with Potential Sepsis
2 alt in resp status
3 Alt in FEN
4 Alt in Development
5 Alt in Family
6 Hyperbilirubinemia
REVISIONS TO PATHWAY:
1 Infant with Potential Sepsis; added
Start date: [**2149-11-20**]
2 alt in resp status; added
Start date: [**2149-11-20**]
3 Alt in FEN; added
Start date:... | 1 Infant with Potential Sepsis
2 alt in resp status
3 Alt in FEN
4 Alt in Development
5 Alt in Family
6 Hyperbilirubinemia
REVISIONS TO PATHWAY:
1 Infant with Potential Sepsis; added
Start date: <Date>2012-1-4</Date>
2 alt in resp status; added
Start date: <Date>2012-1-4</Date>
3 Alt in FEN; added
S... | 00000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000111111110000000000000000000000000000000000000000000000011111111000000000000000000000000000000000000000111111110000000... | 1 Infant with Potential Sepsis
2 alt in resp status
3 Alt in FEN
4 Alt in Development
5 Alt in Family
6 Hyperbilirubinemia
REVISIONS TO PATHWAY:
1 Infant with Potential Sepsis; added
Start date: 2012-1-4
2 alt in resp status; added
Start date: 2012-1-4
3 Alt in FEN; added
Start date: 2012-1-4
4 Al... | ['1 Infant with Potential Sepsis\n2 alt in resp status\n3 Alt in FEN\n4 Alt in Development\n5 Alt in Family\n6 Hyperbilirubinemia\n\nREVISIONS TO PATHWAY:\n\n 1 Infant with Potential Sepsis; added\n Start date: 2012-1-4\n 2 alt in resp status; added\n Start date: 2012-1-4\n 3 Alt in FEN; added\n Start date:... | ||
2077470 | 31844 | 145602.0 | 2149-11-20 | 2149-11-20 17:59:00 | 2149-11-20 18:06:00 | Nursing/other | Report | 21222.0 | Admission Note
Ob-[**Last Name (LF) 279**], [**First Name3 (LF) 335**]
Delivering Ob-[**Last Name (LF) 279**], [**First Name3 (LF) **]
Pedi-not yet identified
Baby boy [**Known lastname 336**] twin #2 is the 700 grams product of a 24 [**2-9**] week gestation EDC [**2149-3-11**] born to a 41 yo G3 P1 mom with PNS blood... | Admission Note
Ob-<Name>Lees</Name>, <Name>Kamran</Name>
Delivering Ob-<Name>Lees</Name>, <Name>Jian</Name>
Pedi-not yet identified
Baby boy <Name>Pettway</Name> twin #2 is the 700 grams product of a 24 <Date>12-11</Date> week gestation EDC <Date>1970-8-19</Date> born to a 41 yo G3 P1 mom with PNS blood type O negativ... | 00000000000000000011110011111100000000000000011110011110000000000000000000000000000000000011111110000000000000000000000000000000000000000001111100000000000000000000111111111000000000000000000000000000000000000000000000000000000000000000000000000000000000000001111111110000000000000000000000000000000000000000000000000000... | Admission Note
Ob-Lees, Kamran
Delivering Ob-Lees, Jian
Pedi-not yet identified
Baby boy Pettway twin #2 is the 700 grams product of a 24 12-11 week gestation EDC 1970-8-19 born to a 41 yo G3 P1 mom with PNS blood type O negative (mom treated with rhogam on 1951-1-22), antibody negative, RPR NR, Rubella Immune, Hep B ... | ['Admission Note\nOb-Lees, Kamran\nDelivering Ob-Lees, Jian\nPedi-not yet identified\n\nBaby boy Pettway twin #2 is the 700 grams product of a 24 12-11 week gestation EDC 1970-8-19 born to a 41 yo G3 P1 mom with PNS blood type O negative (mom treated with rhogam on 1951-1-22), antibody negative, RPR NR, Rubella Immune,... | ||
2077471 | 31844 | 145602.0 | 2149-11-20 | 2149-11-20 17:59:00 | 2149-11-20 18:14:00 | Nursing/other | Report | 21222.0 | Admission Note
weight 700 length 31.5
temp 94 HR 160 BP 37/28 mean 31 sat 91%
skin gelatinouse bruise on right side of back
HEENT normocephalic ant font open flat palate intact eyes fused
neck supple
lung intercostal retractions present
CV regular rate and rhythm
Abd soft with soft bowel sounds
Ext cool with brisk cap ... | Admission Note
weight 700 length 31.5
temp 94 HR 160 BP 37/28 mean 31 sat 91%
skin gelatinouse bruise on right side of back
HEENT normocephalic ant font open flat palate intact eyes fused
neck supple
lung intercostal retractions present
CV regular rate and rhythm
Abd soft with soft bowel sounds
Ext cool with brisk cap ... | 00000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000... | Admission Note
weight 700 length 31.5
temp 94 HR 160 BP 37/28 mean 31 sat 91%
skin gelatinouse bruise on right side of back
HEENT normocephalic ant font open flat palate intact eyes fused
neck supple
lung intercostal retractions present
CV regular rate and rhythm
Abd soft with soft bowel sounds
Ext cool with brisk cap ... | ['Admission Note\nweight 700 length 31.5\ntemp 94 HR 160 BP 37/28 mean 31 sat 91%\nskin gelatinouse bruise on right side of back\nHEENT normocephalic ant font open flat palate intact eyes fused\nneck supple\nlung intercostal retractions present\nCV regular rate and rhythm\nAbd soft with soft bowel sounds\nExt cool with... | ||
2077528 | 31860 | 177493.0 | 2166-08-22 | 2166-08-22 01:48:00 | 2166-08-22 01:57:00 | Nursing/other | Report | 15314.0 | Nursing progress note
#2 O: Remains in room air with equal & clear breath sounds &
mild IC/SC retractions. Baby has had 1 brady to 55 with
desat to 85, that was quickly self resolved. A: A's & B's of
prematurity. P: Cont to assess.
#3 O: Wgt up 25gms. feeds advanced to 150cc/k/d at 9PM. Abd
is soft with active bowel ... | Nursing progress note
#2 O: Remains in room air with equal & clear breath sounds &
mild IC/SC retractions. Baby has had 1 brady to 55 with
desat to 85, that was quickly self resolved. A: A's & B's of
prematurity. P: Cont to assess.
#3 O: Wgt up 25gms. feeds advanced to 150cc/k/d at 9PM. Abd
is soft with active bowel ... | 00000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000... | Nursing progress note
#2 O: Remains in room air with equal & clear breath sounds &
mild IC/SC retractions. Baby has had 1 brady to 55 with
desat to 85, that was quickly self resolved. A: A's & B's of
prematurity. P: Cont to assess.
#3 O: Wgt up 25gms. feeds advanced to 150cc/k/d at 9PM. Abd
is soft with active bowel ... | ["Nursing progress note\n\n\n#2 O: Remains in room air with equal & clear breath sounds &\nmild IC/SC retractions. Baby has had 1 brady to 55 with\ndesat to 85, that was quickly self resolved. A: A's & B's of\nprematurity. P: Cont to assess.\n#3 O: Wgt up 25gms. feeds advanced to 150cc/k/d at 9PM. Abd\nis soft with act... | ||
2078617 | 31954 | 150684.0 | 2116-10-29 | 2116-10-29 02:19:00 | 2116-10-29 02:30:00 | Nursing/other | Report | 17774.0 | 1900-0730 NPN
Resp: Infant remains in RA, RR30-70's. LS clear/=. Mild
IC/SC retractions noted. No spells this shift, no spells in
24hrs. Infant receives Caffeine.P: Continue to monitor.
FEN: BW 1720g, CW 1515g(up 55 g). TF= 150cc/k/d of
BM24/PE24, all, PG, Q4hrs.Abdomen soft, round. Med spit x1,
minimal aspirates. ... | 1900-0730 NPN
Resp: Infant remains in RA, RR30-70's. LS clear/=. Mild
IC/SC retractions noted. No spells this shift, no spells in
24hrs. Infant receives Caffeine.P: Continue to monitor.
FEN: BW 1720g, CW 1515g(up 55 g). TF= 150cc/k/d of
BM24/PE24, all, PG, Q4hrs.Abdomen soft, round. Med spit x1,
minimal aspirates. ... | 00000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000... | 1900-0730 NPN
Resp: Infant remains in RA, RR30-70's. LS clear/=. Mild
IC/SC retractions noted. No spells this shift, no spells in
24hrs. Infant receives Caffeine.P: Continue to monitor.
FEN: BW 1720g, CW 1515g(up 55 g). TF= 150cc/k/d of
BM24/PE24, all, PG, Q4hrs.Abdomen soft, round. Med spit x1,
minimal aspirates. ... | ["1900-0730 NPN\n\n\nResp: Infant remains in RA, RR30-70's. LS clear/=. Mild\nIC/SC retractions noted. No spells this shift, no spells in\n24hrs. Infant receives Caffeine.P: Continue to monitor.\n\nFEN: BW 1720g, CW 1515g(up 55 g). TF= 150cc/k/d of\nBM24/PE24, all, PG, Q4hrs.Abdomen soft, round. Med spit x1,\nminimal a... | ||
2078618 | 31954 | 150684.0 | 2116-10-29 | 2116-10-29 10:09:00 | 2116-10-29 10:14:00 | Nursing/other | Report | 15638.0 | Neonatology Attending
Day 10 PMA 31 [**2-19**] wks
Remains in RA. RR 30-70s. Mild retractions. No bradycardia on caffeine. No murmur. HR 110-150s. BP mean 54. Bilirubin 6.3. Weight 1515g (+55). TF at 150 ml/kg/d- BM/PE 24- pg. Had moderate spit overnight. Passing heme negative stool. On iron. Stable tem... | Neonatology Attending
Day 10 PMA 31 <Date>6-8</Date> wks
Remains in RA. RR 30-70s. Mild retractions. No bradycardia on caffeine. No murmur. HR 110-150s. BP mean 54. Bilirubin 6.3. Weight 1515g (+55). TF at 150 ml/kg/d- BM/PE 24- pg. Had moderate spit overnight. Passing heme negative stool. On iron. Stab... | 00000000000000000000000000000000000000111000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000... | Neonatology Attending
Day 10 PMA 31 6-8 wks
Remains in RA. RR 30-70s. Mild retractions. No bradycardia on caffeine. No murmur. HR 110-150s. BP mean 54. Bilirubin 6.3. Weight 1515g (+55). TF at 150 ml/kg/d- BM/PE 24- pg. Had moderate spit overnight. Passing heme negative stool. On iron. Stable temperatur... | ['Neonatology Attending\n\nDay 10 PMA 31 6-8 wks\n\nRemains in RA. RR 30-70s. Mild retractions. No bradycardia on caffeine. No murmur. HR 110-150s. BP mean 54. Bilirubin 6.3. Weight 1515g (+55). TF at 150 ml/kg/d- BM/PE 24- pg. Had moderate spit overnight. Passing heme negative stool. On iron. Stable temp... | ||
2078619 | 31954 | 150684.0 | 2116-10-29 | 2116-10-29 10:23:00 | 2116-10-29 10:24:00 | Nursing/other | Report | 15787.0 | NICU FELLOW NOTE
in isollete, on RA
GEN: NAD, [** 136**], awake, looking around
HEENT: AFOF
CARDIAC: RR, S1S2, no m/g/r
LUNGS: CTAB
ABD: soft, NT/ND, no HSM, +BS
EXT: WWP, CR< 2 seconds
GU: normal male genitalia, testicles descended bilaterally
2+ femoral pulses
| NICU FELLOW NOTE
in isollete, on RA
GEN: NAD, <Digit>746</Digit>, awake, looking around
HEENT: AFOF
CARDIAC: RR, S1S2, no m/g/r
LUNGS: CTAB
ABD: soft, NT/ND, no HSM, +BS
EXT: WWP, CR< 2 seconds
GU: normal male genitalia, testicles descended bilaterally
2+ femoral pulses
| 00000000000000000000000000000000000000000000001110000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000<0000000000000000000000000000000000000000000000000000000000000000000000000000000000000000 | NICU FELLOW NOTE
in isollete, on RA
GEN: NAD, 746, awake, looking around
HEENT: AFOF
CARDIAC: RR, S1S2, no m/g/r
LUNGS: CTAB
ABD: soft, NT/ND, no HSM, +BS
EXT: WWP, CR< 2 seconds
GU: normal male genitalia, testicles descended bilaterally
2+ femoral pulses
| ['NICU FELLOW NOTE\nin isollete, on RA\nGEN: NAD, 746, awake, looking around\nHEENT: AFOF\nCARDIAC: RR, S1S2, no m/g/r\nLUNGS: CTAB\nABD: soft, NT/ND, no HSM, +BS\nEXT: WWP, CR< 2 seconds\nGU: normal male genitalia, testicles descended bilaterally\n2+ femoral pulses\n'] | ||
2078620 | 31954 | 150684.0 | 2116-10-29 | 2116-10-29 10:51:00 | 2116-10-29 11:03:00 | Nursing/other | Report | 20157.0 | Clinical Nutrition:
O:
~31 [**12-17**] week CGA BB on DOL 10.
WT: 1515g(+55)(25-50 %ile); BWT: 1720g. WT is down ~12% from BWT.
HC: 27cm([**10-8**] %ile); HC @ Birth: 29cm
LN: 41cm (25-50 %ile); LN @ Birth: 41cm
Meds include Fe.
Labs noted.
Nutrition: 150cc/kg/day as BM/PE 24; pg over 90mins. Projected intake for next ... | Clinical Nutrition:
O:
~31 <Date>10-24</Date> week CGA BB on DOL 10.
WT: 1515g(+55)(25-50 %ile); BWT: 1720g. WT is down ~12% from BWT.
HC: 27cm(<Date>3-12</Date> %ile); HC @ Birth: 29cm
LN: 41cm (25-50 %ile); LN @ Birth: 41cm
Meds include Fe.
Labs noted.
Nutrition: 150cc/kg/day as BM/PE 24; pg over 90mins. Projected in... | 00000000000000000000000000011111000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000111100000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000... | Clinical Nutrition:
O:
~31 10-24 week CGA BB on DOL 10.
WT: 1515g(+55)(25-50 %ile); BWT: 1720g. WT is down ~12% from BWT.
HC: 27cm(3-12 %ile); HC @ Birth: 29cm
LN: 41cm (25-50 %ile); LN @ Birth: 41cm
Meds include Fe.
Labs noted.
Nutrition: 150cc/kg/day as BM/PE 24; pg over 90mins. Projected intake for next 24hrs ~120kc... | ['Clinical Nutrition:\nO:\n~31 10-24 week CGA BB on DOL 10.\nWT: 1515g(+55)(25-50 %ile); BWT: 1720g. WT is down ~12% from BWT.\nHC: 27cm(3-12 %ile); HC @ Birth: 29cm\nLN: 41cm (25-50 %ile); LN @ Birth: 41cm\nMeds include Fe.\nLabs noted.\nNutrition: 150cc/kg/day as BM/PE 24; pg over 90mins. Projected intake for next 24... | ||
2078703 | 31954 | 150684.0 | 2116-11-17 | 2116-11-17 15:20:00 | 2116-11-17 15:24:00 | Nursing/other | Report | 16024.0 | NPN Addendum
I have examined infant and agree with above note from [**First Name8 (NamePattern2) 269**] [**Last Name (NamePattern1) 270**], PCA. However, eye exam was done yesterday, not today.
Infant with frequent drifts in O2 sats to mid to low 80's. Appear to be mostly feeding related. No bradys.
| NPN Addendum
I have examined infant and agree with above note from <Name>Melissa</Name> <Name>Yuen</Name>, PCA. However, eye exam was done yesterday, not today.
Infant with frequent drifts in O2 sats to mid to low 80's. Appear to be mostly feeding related. No bradys.
| 000000000000000000000000000000000000000000000000000000000000000000001111111011110000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000 | NPN Addendum
I have examined infant and agree with above note from Melissa Yuen, PCA. However, eye exam was done yesterday, not today.
Infant with frequent drifts in O2 sats to mid to low 80's. Appear to be mostly feeding related. No bradys.
| ["NPN Addendum\nI have examined infant and agree with above note from Melissa Yuen, PCA. However, eye exam was done yesterday, not today.\nInfant with frequent drifts in O2 sats to mid to low 80's. Appear to be mostly feeding related. No bradys.\n"] | ||
2078704 | 31954 | 150684.0 | 2116-11-17 | 2116-11-17 17:40:00 | 2116-11-17 17:41:00 | Nursing/other | Report | 20796.0 | Fellow Physical Exam
General: active, vigorous
HEENT: AFOF
Pulm: CTA b/l
CV: s1s2 rrr
abd: soft, no masses, nd
ext:wwp
GU: normal male genitalia
| Fellow Physical Exam
General: active, vigorous
HEENT: AFOF
Pulm: CTA b/l
CV: s1s2 rrr
abd: soft, no masses, nd
ext:wwp
GU: normal male genitalia
| 0000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000 | Fellow Physical Exam
General: active, vigorous
HEENT: AFOF
Pulm: CTA b/l
CV: s1s2 rrr
abd: soft, no masses, nd
ext:wwp
GU: normal male genitalia
| ['Fellow Physical Exam\nGeneral: active, vigorous\nHEENT: AFOF\nPulm: CTA b/l\nCV: s1s2 rrr\nabd: soft, no masses, nd\next:wwp\nGU: normal male genitalia\n'] | ||
2079470 | 32178 | 109473.0 | 2109-10-07 | 2109-10-07 14:45:00 | 2109-10-07 15:00:00 | Nursing/other | Report | 15638.0 | Neonatology Attending
Infant with NAS referred to NICU by Dr. [**Last Name (STitle) 804**] for cardiac evaluation.
Exam remarkable for well-appearing term infant in no distress with vital signs 98.1, 141, 40 pink color, soft AF, nl facies, intact palate, no gfr, clear breath sounds, 1/6 systolic murmur at llsb, no ga... | Neonatology Attending
Infant with NAS referred to NICU by Dr. <Name>Quinones</Name> for cardiac evaluation.
Exam remarkable for well-appearing term infant in no distress with vital signs 98.1, 141, 40 pink color, soft AF, nl facies, intact palate, no gfr, clear breath sounds, 1/6 systolic murmur at llsb, no gallop, f... | 00000000000000000000000000000000000000000000000000000000000000011111111000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000... | Neonatology Attending
Infant with NAS referred to NICU by Dr. Quinones for cardiac evaluation.
Exam remarkable for well-appearing term infant in no distress with vital signs 98.1, 141, 40 pink color, soft AF, nl facies, intact palate, no gfr, clear breath sounds, 1/6 systolic murmur at llsb, no gallop, fem pulses pre... | ['Neonatology Attending\n\nInfant with NAS referred to NICU by Dr. Quinones for cardiac evaluation.\n\nExam remarkable for well-appearing term infant in no distress with vital signs 98.1, 141, 40 pink color, soft AF, nl facies, intact palate, no gfr, clear breath sounds, 1/6 systolic murmur at llsb, no gallop, fem puls... |
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