Warning: Undefined array key "name" in /home/public/blog/blogfiles/pdf/biliblank.php on line 14
Deprecated: htmlentities(): Passing null to parameter #1 ($string) of type string is deprecated in /home/public/blog/blogfiles/pdf/biliblank.php on line 14
Born
Warning: Undefined array key "birth" in /home/public/blog/blogfiles/pdf/biliblank.php on line 14
Deprecated: htmlentities(): Passing null to parameter #1 ($string) of type string is deprecated in /home/public/blog/blogfiles/pdf/biliblank.php on line 14
Warning: Undefined array key "birth-time" in /home/public/blog/blogfiles/pdf/biliblank.php on line 14
Deprecated: htmlentities(): Passing null to parameter #1 ($string) of type string is deprecated in /home/public/blog/blogfiles/pdf/biliblank.php on line 14
Date |
Time |
Age (hr) |
Bilirubin |
Serum/ Meter |
Nurse |
Action |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Maternal Blood Type: ______
Baby Blood Type: ______
Coombs: ______
Risk Factors for Severe Jaundice
[ ] Positive Coombs Test
[ ] Jaundice in the first 24 hours
[ ] Sibling with history of jaundice
[ ] 35-38 week gestation
[ ] Exclusive breastfeeding
[ ] Asian ethnicity
[ ] Extensive bruising or
cephalohematoma
|