POSTPARTUM /

INFANT CARE
TEACHING
FLOW SHEET PATIENT IDENTIFICATION
MATERNAL CARE
Return Demo/ Return Demo/
Date Verbalizes Date Verbalizes
TOPIC Taught Understanding Initial TOPIC Taught Understanding Initial
Room Orientation Breastfeeding
Self Care i Initiation
i Peri Care i Positioning
i Hygiene i Breaking Suction
i Breasts / Nipples i Massage / Expression
i Exercises i Use of Pump(s)
i Rest / Activity i Frequency / Duration
i Nutrition i Breast Care
i Elimination Complications / S&S
i Fever
Postpartum Changes i Increased Bleeding
i Involution i Vaginal Discharge Odor
i Lochia i Burning with Urination
i Return of Menses i Red / Draining Incision
i PP Adjustments Follow-Up Care
Fertility Awareness
INFANT CARE
Return Demo/ Return Demo/
Date Verbalizes Date Verbalizes
TOPIC Taught Understanding Initial TOPIC Taught Understanding Initial
Use of Bulb Syringe Elimination
Feedings i Urination
i Breast (Per Protocol) i Stools / Patterns
i Bottle (Per Protocol) S&S of Illness
Infant Care Safety Measures
i Bath i Positioning
i Cord Care i Car Seats
i Use of Thermometer i Immunizations
i Diapering & Dressing Follow-Up Testing
i Circumcision Care i Bili
Newborn Characteristics i PKU
i Physical Characteristics Physician Follow-Up
i Newborn Behaviors Classes: Discharge
Newborn Needs
i Infant Stimulation Feeding
i Cuddling / Close Contact
Baby Care
i Sucking Needs
Initial: Signature / Title: Initial: Signature / Title:

Initial: Signature / Title: Initial: Signature / Title:

Initial: Signature / Title: Initial: Signature / Title:

DISCHARGE NURSE Signature / Title: DATE: PATIENT Signature: DATE:

PART OF THE MEDICAL RECORD

8850208 Rev. 05/05 Postpartum / Infant Care Teaching Flow Sheet_ENGLISH_MIH PAGE 1 of 1