OB Prenatal Visit A/P

OB Prenatal Visit A/P
[checkbox name="obplaninitialob" memo="INITIAL OB VISIT
" memo_color="mediumpurple" value=""][conditional field="obplaninitialob" condition="(obplaninitialob).is('')"][checkbox value="-Confirmed that patient met with OB care coordinator for intake social history and education
"][checkbox value="-History reviewed (OB and PMH) including FMHx of congenital diseases on both maternal and paternal side of family
"][checkbox name="initialobPE" value="-Performed physical exam - "][/conditional][conditional field="obplaninitialob|initialobPE" condition="(obplaninitialob).is('')&&(initialobPE).is('-Performed physical exam - ')"][checkbox value="pelvic exam performed|pelvic exam deferred|breast exam performed|breast exam deferred"]; [text memo="rationale" memo_size="small" memo_color="lightyellow" size="80"]
[/conditional][conditional field="obplaninitialob" condition="(obplaninitialob).is('')"][comment memo="
" memo_color="whitesmoke" memo_size="small"][checkbox value="-Prenatal labs reviewed including prenatal profile, Hgb, UA/UCx, HIV, most recent PAP (if ≥21yo), GC, Chlamydia
"][comment memo="
" memo_color="whitesmoke" memo_size="small"][checkbox memo="if African descent or African American" memo_size="small" memo_color="peachpuff" value="-Hgb electrophoresis ordered
"][comment memo="
" memo_color="whitesmoke" memo_size="small"][checkbox memo="1hr GTT or HgbA1c if prepregnancy BMI≥30, hx of GDM, hx fo delivered infant >4000g" memo_size="small" memo_color="peachpuff" value="-Early glucose screening ordered
"][comment memo="
" memo_color="whitesmoke" memo_size="small"][checkbox memo="if Hep B Ag positive; reporting to public health dept" memo_size="small" memo_color="peachpuff" value="-Hep B Antigen positive - reported to local communicable disease department
"][comment memo="
" memo_color="whitesmoke" memo_size="small"][checkbox name="initialobGC" memo="if GC/Chl positive" memo_size="small" memo_color="peachpuff" value="-GC/Chl test positive"][/conditional][conditional field="obplaninitialob|initialobGC" condition="(obplaninitialob).is('')&&(initialobGC).is('-GC/Chl test positive')"] - [textarea cols="80" rows="2" memo="action?" memo_size="small" memo_color="lightyellow" default="discussed treatment f/b test of cure in 3-4wks and once test of cure negative to repeat in 3rd trimester"]
[/conditional][conditional field="obplaninitialob" condition="(obplaninitialob).is('')"][comment memo="
" memo_color="whitesmoke" memo_size="small"][checkbox name="initialobPNV" value="-Discussed prenatal vitamins"][/conditional][conditional field="obplaninitialob|initialobPNV" condition="(obplaninitialob).is('')&&(initialobPNV).is('-Discussed prenatal vitamins')"] - [select value="already ordered with adequate supply|ordered today"]; [text memo="other" memo_size="small" memo_color="lightyellow" size="80"]
[/conditional][conditional field="obplaninitialob" condition="(obplaninitialob).is('')"][comment memo="
" memo_color="whitesmoke" memo_size="small"]-EDD  determination [select value="- EDD based on LMP c/b 1st tri U/S|- EDD based on 1st tri U/S with unsure dates|- EDD based on 1st tri U/S with discordant dates|- EDD not yet confirmed and 1st trimester U/S pending"]
[checkbox value="-Discussed nuisance sx and care of: fatigue, nausea, vomiting, heartburn, urinary frequency, constipation, sking changes
"][comment memo="
" memo_color="whitesmoke" memo_size="small"][checkbox value="-Discussed WARNING SIGNS and how to access care for: bleeding, cramping, excessive vomiting, fevers
"][comment memo="
" memo_color="whitesmoke" memo_size="small"][checkbox value="-Discussed these basic topics:
--nutrition
--weight gain
--use of drugs, smoking, alcohol
--avoiding exposure to infections
--miscarriage
--exercise
--employment
--sex
--douching
--congenital abnormalities
--genetic screening and amniocentesis (if indicated)
"][comment memo="
" memo_color="whitesmoke" memo_size="small"][checkbox name="initialobwtgain" value="-Recommended following weight gain for patient"][/conditional][conditional field="obplaninitialob|initialobwtgain" condition="(obplaninitialob).is('')&&(initialobwtgain).is('-Recommended following weight gain for patient')"] - [checkbox value="BMI < 18.5 -> 28-40lbs, 1lb/wk in 2nd/3rd trimesters|BMI  18.5-24.9 -> 25-35lbs, 1lb/wk in 2nd/3rd trimesters|BMI  25-29.9 -> 15-25lbs, 0.6lb/wk in 2nd/3rd trimesters|BMI ≥ 30 -> 11-20lbs, 0.5lb/wk in 2nd/3rd trimesters"]
[/conditional][conditional field="obplaninitialob" condition="(obplaninitialob).is('')"][comment memo="
" memo_color="whitesmoke" memo_size="small"][checkbox name="initialobpreE" memo="ie. prior preeclampsia, chronic HTN, underlying renal disease" memo_size="small" memo_color="peachpuff" value="-Assessed risk for preeclampsia"][/conditional][conditional field="obplaninitialob|initialobpreE" condition="(obplaninitialob).is('')&&(initialobpreE).is('-Assessed risk for preeclampsia')"] - [checkbox value="low/average risk|high risk|baseline 24hr total protein ordered|ASA 81mg to be started at 16wks (if no contraindication)"]
[/conditional][conditional field="obplaninitialob" condition="(obplaninitialob).is('')"][comment memo="
" memo_color="whitesmoke" memo_size="small"][checkbox name="initialobpretermbirth" value="-Assessed risk for preterm birth"][/conditional][conditional field="obplaninitialob|initialobpretermbirth" condition="(obplaninitialob).is('')&&(initialobpretermbirth).is('-Assessed risk for preterm birth')"] - [select value="low/average risk|high risk (significant h/o preterm birth(s)"][comment memo="
if high risk
" memo_size="small" memo_color="orange"][checkbox value=" -> determined candidacy for progesterone injections|not a candidate|candidate"][comment memo="if candidate
" memo_size="small" memo_color="orange"][checkbox value=" -> discussed option with patient|patient declined|patient desired"][comment memo="if patient desired
" memo_size="small" memo_color="orange"][checkbox value=" -> began process for ordering"]
[/conditional][conditional field="obplaninitialob" condition="(obplaninitialob).is('')"][comment memo="
" memo_color="whitesmoke" memo_size="small"][checkbox name="initialobcsec" value="-Hx of cesarean delivery
"][/conditional][conditional field="obplaninitialob|initialobcsec" condition="(obplaninitialob).is('')&&(initialobcsec).is('-Hx of cesarean delivery
')"]--Indication: [select value="|non-reassuring fetal heart tracing|arrest of descent/failure to progress|elective"]; [text memo="other" memo_size="small" memo_color="lightyellow" size="80"]
[checkbox value="--Obtained and reviewed operative report
"][checkbox value="--Will submit request for operative report
"][checkbox value="--Patient desires vaginal delivery - referred for TOLAC counseling
"][checkbox value="--Patient desires elective repeat c/section - Referred for Ceserean counseling
"][/conditional][comment memo="
*EVERY OB VISIT*
" memo_color="mediumpurple"][checkbox name="qobfreq" value="-Discussed expected frequency of upcoming visits, currently - "][conditional field="qobfreq" condition="(qobfreq).is('-Discussed expected frequency of upcoming visits, currently - ')"][select value="q4wks (0-32wks)|q2wk (0-32wks and high risk)|q2wks (32-36wks)|q1wks (36wks-delivery)"] [text memo="other" memo_size="small" memo_color="lightyellow" size="60"]
[/conditional][checkbox name="qobUTI" value="-Assessed for UTI/vaginal symptoms - "][conditional field="qobUTI" condition="(qobUTI).is('-Assessed for UTI/vaginal symptoms - ')"][checkbox value="no issues"] [text memo="other" memo_size="small" memo_color="lightyellow" size="60"]
[/conditional][checkbox name="qobFHT" memo="after 10wks GA" memo_size="small" memo_color="peachpuff" value="-Assessed fetal heart tones - "][conditional field="qobFHT" condition="(qobFHT).is('-Assessed fetal heart tones - ')"][checkbox value="no issues"] [text memo="other" memo_size="small" memo_color="lightyellow" size="60"]
[/conditional][checkbox name="qobwtgain" memo="after 10wks GA" memo_size="small" memo_color="peachpuff" value="-Assessed weight gain - "][conditional field="qobwtgain" condition="(qobwtgain).is('-Assessed weight gain - ')"][checkbox value="weight gain appropriate|too little weight gain|excessive weight gain"]; [text memo="comments" memo_size="small" memo_color="lightyellow" size="60"]
[/conditional][checkbox name="qobfundalht" memo="after 18-20wks GA" memo_size="small" memo_color="peachpuff" value="-Assessed fundal height - "][conditional field="qobfundalht" condition="(qobfundalht).is('-Assessed fundal height - ')"][checkbox value="appropriate"] [text memo="actions/concerns if applicable" memo_size="small" memo_color="lightyellow" size="80"]
[/conditional][checkbox name="obplanqtri" memo="*ONCE PER TRIMESTER*" memo_color="mediumpurple" value=""][conditional field="obplanqtri" condition="(obplanqtri).is('')"][checkbox name="qtriHGB" value="-HGB - "][/conditional][conditional field="obplanqtri|qtriHGB" condition="(obplanqtri).is('')&&(qtriHGB).is('-HGB - ')"][checkbox value="assessed and appropriate|assessed|ordered"]; [text memo="actions/concerns if applicable" memo_size="small" memo_color="lightyellow" size="60"]
[/conditional][checkbox name="obplan6wk" memo="6 - 14 6/7 WEEKS" memo_color="mediumpurple" value=""][conditional field="obplan6wk" condition="(obplan6wk).is('')"][checkbox name="6wkaneuploidy" value="-Discussed screening for aneuploidy (Trisomy 21, 13, 18)
"][checkbox value="-Discussed screening for nuchal translucency for aneuploidy
"][checkbox value="-Discussed procedure for chorionic villous sampling
"][checkbox value="-Hx of aneuploidy or high risk for aneuploidy - referred to MFM
"][/conditional][conditional field="obplan6wk|6wkaneuploidy" condition="(obplan6wk).is('')&&(6wkaneuploidy).is('-Discussed screening for aneuploidy (Trisomy 21, 13, 18)
')"]--[checkbox value="patient declined 1st trimester testing|patient declined 2nd trimester testing|patient desired testing|cfDNA test ordered|quad screen ordered"] [text memo="other" memo_size="small" memo_color="lightyellow" size="60"]
[/conditional][conditional field="obplan6wk" condition="(obplan6wk).is('')"][checkbox name="6wkEPDS" value="-Edinburg Postnatal Depression Scale screening performed - "][/conditional][conditional field="obplan6wk|6wkEPDS" condition="(obplan6wk).is('')&&(6wkEPDS).is('-Edinburg Postnatal Depression Scale screening performed - ')"][checkbox value="negative/no concerns"] [text memo="actions/concerns if applicable" memo_size="small" memo_color="lightyellow" size="60"]
[/conditional][checkbox name="obplan11wk" memo="11 - 13 6/7 WEEKS" memo_color="mediumpurple" value=""][conditional field="obplan11wk" condition="(obplan11wk).is('')"][checkbox name="11wknuchal" value="-Nuchal translucency U/S performed by MFM (combined with serum marker testing) - "][/conditional][conditional field="obplan11wk|11wknuchal" condition="(obplan11wk).is('')&&(11wknuchal).is('-Nuchal translucency U/S performed by MFM (combined with serum marker testing) - ')"][checkbox name="11wknuchal95" value="Nuchal translucency U/S positive|Nuchal translucency U/S negative|Offered an isolated MSAFP performed at 16-20wk|Aneuploidy serum tests negative but nuchal translucency U/S ≥95%ile -> comprehensive US and fetal echo recommended d/t increased risk for congenital heart defect - "][/conditional][conditional field="obplan11wk|11wknuchal|11wknuchal95" condition="(obplan11wk).is('')&&(11wknuchal).is('-Nuchal translucency U/S performed by MFM (combined with serum marker testing) - ')&&(11wknuchal95).is('Aneuploidy serum tests negative but nuchal translucency U/S ≥95%ile -> comprehensive US and fetal echo recommended d/t increased risk for congenital heart defect - ')"][checkbox value="already arranged|not yet performed, assisted patient with information regarding scheduling/referral with MFM"][/conditional][conditional field="obplan11wk|11wknuchal" condition="(obplan11wk).is('')&&(11wknuchal).is('-Nuchal translucency U/S performed by MFM (combined with serum marker testing) - ')"][text memo="actions/concerns if applicable" memo_size="small" memo_color="lightyellow" size="80"]
[/conditional][checkbox name="obplan16wk" memo="16 - 18 WEEKS" memo_color="mediumpurple" value=""][conditional field="obplan16wk" condition="(obplan16wk).is('')"][checkbox value="-Discussed signs of quickening
"][checkbox name="16wkquad" memo="if patient declined 1st trimester screening" memo_size="small" memo_color="peachpuff" value="-Offered Quad screen to patient
"][checkbox name="16wkMSAFP" memo="if patient received 1st trimester screening for aneuploidy" memo_size="small" memo_color="peachpuff" value="-Offered isolated MSAFP
"][checkbox name="16wkgenecouns" memo="if age >35yo" memo_size="small" memo_color="peachpuff" value="-Offered referral for genetic counseling with MFM
"][checkbox name="16wkUScervlength" memo="if high risk for preterm labor" memo_size="small" memo_color="peachpuff" value="-Offered U/S assessment of cervical length
"][/conditional][conditional field="obplan16wk|16wkquad|16wkMSAFP|16wkgenecouns|16wkUScervlength" condition="(obplan16wk).is('')&&((16wkquad).is('-Offered Quad screen to patient
')||(16wkMSAFP).is('-Offered isolated MSAFP
')||(16wkgenecouns).is('-Offered referral for genetic counseling with MFM
')||(16wkUScervlength).is('-Offered U/S assessment of cervical length
'))"]--[checkbox value="patient declined|patient agreed,ordered"] [text memo="actions/concerns if applicable" memo_size="small" memo_color="lightyellow" size="80"]
[/conditional][checkbox name="obplan20wk" memo="20 - 24 WEEKS" memo_color="mediumpurple" value=""][conditional field="obplan20wk" condition="(obplan20wk).is('')"][checkbox value="-Timeframe of quickening documented
"][checkbox value="-Discussed:
--diabetes screening for next visit
--childbirth classes
"][checkbox memo="if applicable" memo_size="small" memo_color="peachpuff" value="-Discussed TOLAC
"][checkbox memo="if applicable" memo_size="small" memo_color="peachpuff" value="-Discussed sibling preparation
"][checkbox memo="if applicable" memo_size="small" memo_color="peachpuff" value="-Discussed circumcision
"][checkbox name="20wkhxincompcervix" memo="if hx LEEP, 2nd tri loss, shortened cervix on US, multiple SABs/EABs" memo_size="small" memo_color="peachpuff" value="-Offered cervical exam to check for incompetency of cervix - "][/conditional][conditional field="obplan20wk|20wkhxincompcervix" condition="(obplan20wk).is('')&&(20wkhxincompcervix).is('-Offered cervical exam to check for incompetency of cervix - ')"][checkbox value="patient declined|patient agreed"] [text memo="other/actions if applicable" memo_size="small" memo_color="lightyellow" size="80"]
[/conditional][conditional field="obplan20wk" condition="(obplan20wk).is('')"][checkbox name="20wkppBTL" memo="if applicable" memo_size="small" memo_color="peachpuff" value="-Patient desires post-partum BTL - "][/conditional][conditional field="obplan20wk|20wkppBTL" condition="(obplan20wk).is('')&&(20wkppBTL).is('-Patient desires post-partum BTL - ')"][checkbox value="referred to FMOB clinic"] [text memo="other/actions if applicable" memo_size="small" memo_color="lightyellow" size="80"]
[/conditional][checkbox name="obplan24wk" memo="24 - 28 WEEKS" memo_color="mediumpurple" value=""][conditional field="obplan24wk" condition="(obplan24wk).is('')"][checkbox value="-Discussed nuisance symptoms and care of:
--backache
--heartburn
--shortness of breath
--varicose veins
--hemorrhoids
--constipation
--leg cramps
--round ligament pain
--vaginal discharge
"][checkbox value="-Discussed the following WARNING SIGNS and ways to access care for these:
--bleeding
--cramping
--edema
--headaches
--visual disturbances
--fluid leakage
--signs of preterm labor
"][checkbox memo="if Rh negative" memo_size="small" memo_color="peachpuff" value="-Rh antibody screen repeated and Rhogam to be ordered/given same day
"][checkbox name="24wklabs" value="-Discussed syphilis, HIV, CBC, prenatal glucose testing - "][/conditional][conditional field="obplan24wk|24wklabs" condition="(obplan24wk).is('')&&(24wklabs).is('-Discussed syphilis, HIV, CBC, prenatal glucose testing - ')"][checkbox value="patient agreed/ordered|reviewed/updated in chart|patient declined/address at subsequent visits"] [text memo="other/actions if applicable" memo_size="small" memo_color="lightyellow" size="80"]
[/conditional][conditional field="obplan24wk" condition="(obplan24wk).is('')"][checkbox name="24wkTdap" memo="recommended to give Tdap every pregnancy btwn 27-36wks" memo_size="small" memo_color="peachpuff" value="-Tdap immunization status assessed - "][/conditional][conditional field="obplan24wk|24wkTdap" condition="(obplan24wk).is('')&&(24wkTdap).is('-Tdap immunization status assessed - ')"][checkbox value="patient uptodate/date of Tdap logged in chart|patient needs/recommended to patient|patient agreed/to be given today|patient declined/continue to address at subsequent visits"] [text memo="other/actions if applicable" memo_size="small" memo_color="lightyellow" size="80"]
[/conditional][conditional field="obplan24wk" condition="(obplan24wk).is('')"][checkbox name="24wkHTNdo" memo="if HTN d/o of pregnancy" memo_size="small" memo_color="peachpuff" value="-Urine protein/Cr ratio assessed - "][/conditional][conditional field="obplan24wk|24wkHTNdo" condition="(obplan24wk).is('')&&(24wkHTNdo).is('-Urine protein/Cr ratio assessed - ')"][checkbox value="urine protein/Cr ratio ordered/followup with patient regarding results|recent urine protein/Cr ratio reviewed/normal"] [text memo="other/actions if applicable" memo_size="small" memo_color="lightyellow" size="80"]
[/conditional][conditional field="obplan24wk" condition="(obplan24wk).is('')"][checkbox name="24wkMultiD" memo="due by 28wks" memo_size="small" memo_color="peachpuff" value="-MultiD Intake note in Essentris/EHR (by 28wks) - "][/conditional][conditional field="obplan24wk|24wkMultiD" condition="(obplan24wk).is('')&&(24wkMultiD).is('-MultiD Intake note in Essentris/EHR (by 28wks) - ')"][checkbox value="to be done|confirmed completed"]
[/conditional][conditional field="obplan24wk" condition="(obplan24wk).is('')"][checkbox  name="24wkEPDS" memo="done around 28wks" memo_size="small" memo_color="peachpuff" value="-Edinburg Postnatal Depression Scale screening performed - "][/conditional][conditional field="obplan24wk|24wkEPDS" condition="(obplan24wk).is('')&&(24wkEPDS).is('-Edinburg Postnatal Depression Scale screening performed - ')"][checkbox value="negative/no concerns"] [text memo="actions/concerns if applicable" memo_size="small" memo_color="lightyellow" size="60"]
[/conditional][checkbox name="obplan28wk" memo="28 - 32 WEEKS" memo_color="mediumpurple" value=""][conditional field="obplan28wk" condition="(obplan28wk).is('')"][checkbox value="-Discussed signs of preterm labor
"][checkbox name="28wkppcontracep" value="-Discussed postpartum contraception options - "][/conditional][conditional field="obplan28wk|28wkppcontracep" condition="(obplan28wk).is('')&&(28wkppcontracep).is('-Discussed postpartum contraception options - ')"][checkbox value="patient still unsure/address at subsequent visits"] [textarea memo="patient's preferences" memo_size="small" memo_color="lightyellow" default="patient prefers/leaning towards " cols="80" rows="2"]
[/conditional][conditional field="obplan28wk" condition="(obplan28wk).is('')"][checkbox name="28wkppBTL" memo="if desired and not yet done" memo_size="small" memo_color="peachpuff" value="-Patient desires post-partum BTL - "][/conditional][conditional field="obplan28wk|28wkppBTL" condition="(obplan28wk).is('')&&(28wkppBTL).is('-Patient desires post-partum BTL - ')"][checkbox value="referred to FMOB clinic"] [text memo="other/actions if applicable" memo_size="small" memo_color="lightyellow" size="80"]
[/conditional][conditional field="obplan28wk" condition="(obplan28wk).is('')"][checkbox  name="28wkEPDS" memo="if not already done by 28wks" memo_size="small" memo_color="peachpuff" value="-Edinburg Postnatal Depression Scale screening performed - "][/conditional][conditional field="obplan28wk|28wkEPDS" condition="(obplan28wk).is('')&&(28wkEPDS).is('-Edinburg Postnatal Depression Scale screening performed - ')"][checkbox value="negative/no concerns"] [text memo="actions/concerns if applicable" memo_size="small" memo_color="lightyellow" size="60"]
[/conditional][checkbox name="obplan34wk" memo="34 WEEKS" memo_color="mediumpurple" value=""][conditional field="obplan34wk" condition="(obplan34wk).is('')"][checkbox value="-Discussed the following:
--labor
--how to access labor and delivery
--obtaining car seat
"][checkbox value="-Discussed signs of preterm labor
"][checkbox memo="if hx of c/sec and initial COB referral required 2nd visit" memo_size="small" memo_color="peachpuff" value="-C/sec hx and desires vaginal delivery - referred for TOLAC counseling|-C/Sec hx and desires elective repeat c/section - Referred for elective repeat C/Section
"][checkbox name="34wkppcontracep" value="-Discussed postpartum contraception options - "][/conditional][conditional field="obplan34wk|34wkppcontracep" condition="(obplan34wk).is('')&&(34wkppcontracep).is('-Discussed postpartum contraception options - ')"][checkbox value="patient still unsure/address at subsequent visits"] [textarea memo="patient's preferences" memo_size="small" memo_color="lightyellow" default="patient prefers/leaning towards " cols="80" rows="2"]
[/conditional][conditional field="obplan34wk" condition="(obplan34wk).is('')"][checkbox name="34wkppBTL" memo="if desired and not yet done" memo_size="small" memo_color="peachpuff" value="-Patient desires post-partum BTL - "][/conditional][conditional field="obplan34wk|34wkppBTL" condition="(obplan34wk).is('')&&(34wkppBTL).is('-Patient desires post-partum BTL - ')"][checkbox value="referred to FMOB clinic"] [text memo="other/actions if applicable" memo_size="small" memo_color="lightyellow" size="80"]
[/conditional][checkbox name="obplan36wk" memo="36 WEEKS" memo_color="mediumpurple" value=""][conditional field="obplan36wk" condition="(obplan36wk).is('')"][checkbox value="-Discussed the following
--readiness for breastfeeding
--onset of labor (lightnening, contractions, mucus, show, ROM)
--possible emergencies in labor
"][checkbox name="36wkGBS" value="-Discussed GBS screening - "][/conditional][conditional field="obplan36wk|36wkGBS" condition="(obplan36wk).is('')&&(36wkGBS).is('-Discussed GBS screening - ')"][checkbox value="patient agreed/ordered|reviewed self-swab instructions with patient|reviewed/updated in chart|patient declined/address at subsequent visits"] [text memo="other/actions if applicable" memo_size="small" memo_color="lightyellow" size="80"]
[/conditional][conditional field="obplan36wk" condition="(obplan36wk).is('')"][checkbox name="36wkppcontracep" value="-Discussed postpartum contraception options - "][/conditional][conditional field="obplan36wk|36wkppcontracep" condition="(obplan36wk).is('')&&(36wkppcontracep).is('-Discussed postpartum contraception options - ')"][checkbox value="patient still unsure/address at subsequent visits"] [textarea memo="patient's preferences" memo_size="small" memo_color="lightyellow" default="patient prefers/leaning towards " cols="80" rows="2"]
[/conditional][conditional field="obplan36wk" condition="(obplan36wk).is('')"][checkbox name="36wkcervicalcheck" memo="if patient request/shared decision making or medically indicated" memo_size="small" memo_color="peachpuff" value="-Cervical check performed - "][/conditional][conditional field="obplan36wk|36wkcervicalcheck" condition="(obplan36wk).is('')&&(36wkcervicalcheck).is('-Cervical check performed - ')"][checkbox value="indication-patient requested|indication-medically indicated"]; [textarea memo="chaperone/other/actions if applicable" memo_size="small" memo_color="lightyellow" default="chaperone: " cols="80" rows="2"]
[/conditional][conditional field="obplan36wk" condition="(obplan36wk).is('')"][checkbox name="36wkGC" memo="if age ≤24yo, prior GC(+) in pregnancy, or high risk" memo_size="small" memo_color="peachpuff" value="-Discussed repeat GC/Chlamydia screening - "][/conditional][conditional field="obplan36wk|36wkGC" condition="(obplan36wk).is('')&&(36wkGC).is('-Discussed repeat GC/Chlamydia screening - ')"][checkbox value="patient agreed/ordered|reviewed results/updated in chart|patient declined/address at subsequent visits"] [text memo="other/actions if applicable" memo_size="small" memo_color="lightyellow" size="80"]
[/conditional][conditional field="obplan36wk" condition="(obplan36wk).is('')"][checkbox name="36wkHIV" memo="if high risk for HIV" memo_size="small" memo_color="peachpuff" value="-Discussed repeat HIV screening - "][/conditional][conditional field="obplan36wk|36wkHIV" condition="(obplan36wk).is('')&&(36wkHIV).is('-Discussed repeat HIV screening - ')"][checkbox value="patient agreed/ordered|reviewed results/updated in chart|patient declined/address at subsequent visits"] [text memo="other/actions if applicable" memo_size="small" memo_color="lightyellow" size="80"]
[/conditional][checkbox name="obplan37wk" memo="37 - 39 WEEKS" memo_color="mediumpurple" value=""][conditional field="obplan37wk" condition="(obplan37wk).is('')"][checkbox value="-Discussed the following:
--readiness for breastfeeding
--onset of labor (lightnening, contractions, mucus, show, ROM)
--signs of labor and possible emergencies in labor
"][checkbox value="-Discussed possible partum blues, fatigue, exercise
"][checkbox value="-Discussed how/when to access care - clinic vs L&D
"][checkbox value="-Discussed possible induction if >41 0/7 weeks
"][checkbox name="37wkppcontracep" value="-Discussed postpartum contraception options - "][/conditional][conditional field="obplan37wk|37wkppcontracep" condition="(obplan37wk).is('')&&(37wkppcontracep).is('-Discussed postpartum contraception options - ')"][checkbox value="patient still unsure/address at subsequent visits"] [textarea memo="patient's preferences" memo_size="small" memo_color="lightyellow" default="patient prefers/leaning towards " cols="80" rows="2"]
[/conditional][conditional field="obplan37wk" condition="(obplan37wk).is('')"][checkbox name="37wkanalgesia" value="-Discussed analgesia options, patient considering - "][/conditional][conditional field="obplan37wk|37wkanalgesia" condition="(obplan37wk).is('')&&(37wkanalgesia).is('-Discussed analgesia options, patient considering - ')"][checkbox value="no pharmacotherapy|doula|water immersion|parenteral narcotics|epidural|patient unsure/address at subsequent visits"] [text memo="other" memo_size="small" memo_color="lightyellow"  size="80"]
[/conditional][conditional field="obplan37wk" condition="(obplan37wk).is('')"][checkbox name="37wkcervicalcheck" memo="if patient request/shared decision making or medically indicated" memo_size="small" memo_color="peachpuff" value="-Cervical check performed - "][/conditional][conditional field="obplan37wk|37wkcervicalcheck" condition="(obplan37wk).is('')&&(37wkcervicalcheck).is('-Cervical check performed - ')"][checkbox value="indication-patient requested|indication-medically indicated"]; [textarea memo="chaperone/other/actions if applicable" memo_size="small" memo_color="lightyellow" default="chaperone: " cols="80" rows="2"]
[/conditional][conditional field="obplan37wk" condition="(obplan37wk).is('')"][checkbox name="37wkmembranesweep" memo="if patient requested/shared decision making" memo_size="small" memo_color="peachpuff" value="-Discussed cervical membrane sweeping, including following risks/benefits:
--Lower likelihood of delivery postdates
--Possible incidental rupture of membranes"][/conditional][conditional field="obplan37wk|37wkmembranesweep" condition="(obplan37wk).is('')&&(37wkmembranesweep).is('-Discussed cervical membrane sweeping, including following risks/benefits:
--Lower likelihood of delivery postdates
--Possible incidental rupture of membranes')"]
[checkbox value="-->patient declined|-->patient requested/performed"]; [textarea memo="chaperone/other/actions if applicable" memo_size="small" memo_color="lightyellow" default="chaperone: " cols="80" rows="2"]
[/conditional][checkbox name="obplan40wk" memo="40 WEEKS" memo_color="mediumpurple" value=""][conditional field="obplan40wk" condition="(obplan40wk).is('')"][checkbox value="-Discussed the following:
--readiness for breastfeeding
--onset of labor (lightnening, contractions, mucus, show, ROM)
--signs of labor and possible emergencies in labor
"][checkbox value="-Discussed possible partum blues, fatigue, exercise
"][checkbox value="-Discussed how/when to access care - clinic vs L&D
"][checkbox value="-Discussed antenatal testing - referred for this (BPP or AFI with NST 1-2x/wk)
"][checkbox value="Contacted L&D point of contact to put patient on induction schedule
"][checkbox name="40wkppcontracep" value="-Discussed postpartum contraception options - "][/conditional][conditional field="obplan40wk|40wkppcontracep" condition="(obplan40wk).is('')&&(40wkppcontracep).is('-Discussed postpartum contraception options - ')"][checkbox value="patient still unsure/address at subsequent visits"] [textarea memo="patient's preferences" memo_size="small" memo_color="lightyellow" default="patient prefers/leaning towards " cols="80" rows="2"]
[/conditional][conditional field="obplan40wk" condition="(obplan40wk).is('')"][checkbox name="40wkanalgesia" value="-Discussed analgesia options, patient considering - "][/conditional][conditional field="obplan40wk|40wkanalgesia" condition="(obplan40wk).is('')&&(40wkanalgesia).is('-Discussed analgesia options, patient considering - ')"][checkbox value="no pharmacotherapy|doula|water immersion|parenteral narcotics|epidural|patient unsure/address at subsequent visits"] [text memo="other" memo_size="small" memo_color="lightyellow"  size="80"]
[/conditional][conditional field="obplan40wk" condition="(obplan40wk).is('')"][checkbox name="40wkcervicalcheck" memo="for bishops scoring" memo_size="small" memo_color="peachpuff" value="-Cervical check performed - "][/conditional][conditional field="obplan40wk|40wkcervicalcheck" condition="(obplan40wk).is('')&&(40wkcervicalcheck).is('-Cervical check performed - ')"][textarea memo="chaperone/other/actions if applicable" memo_size="small" memo_color="lightyellow"]--chaperone:  
--bishops score: 
--offered cervical ripening (if unfavorable cervix): 
[/textarea]
[/conditional][conditional field="obplan40wk" condition="(obplan40wk).is('')"][checkbox name="40wkmembranesweep" memo="if patient requested/shared decision making" memo_size="small" memo_color="peachpuff" value="-Discussed cervical membrane sweeping, including following risks/benefits:
--Lower likelihood of delivery postdates
--Possible incidental rupture of membranes"][/conditional][conditional field="obplan40wk|40wkmembranesweep" condition="(obplan40wk).is('')&&(40wkmembranesweep).is('-Discussed cervical membrane sweeping, including following risks/benefits:
--Lower likelihood of delivery postdates
--Possible incidental rupture of membranes')"]
[checkbox value="-->patient declined|-->patient requested/performed along with cervical check"]; [textarea memo="other/actions if applicable" memo_size="small" memo_color="lightyellow" cols="80" rows="2"]
[/conditional][checkbox name="obplan41wk" memo="41 - 42 WEEKS" memo_color="mediumpurple" value=""][conditional field="obplan41wk" condition="(obplan41wk).is('')"][checkbox value="-Discussed the following
-readiness for breastfeeding
-onset of labor (lightnening, contractions, mucus, show, ROM)
-signs of labor and possible emergencies in labor
"][checkbox value="-Discussed possible partum blues, fatigue, exercise
"][checkbox value="-Discussed how/when to access care - clinic vs L&D
"][checkbox value="-Continue antenatal testing (BPP or AFI with NST 1-2x/wk)
"][checkbox memo="if not already done" memo_size="small" memo_color="peachpuff" value="-Contacted L&D point of contact to put patient on induction schedule
"][checkbox name="41wkppcontracep" value="-Discussed postpartum contraception options - "][/conditional][conditional field="obplan41wk|41wkppcontracep" condition="(obplan41wk).is('')&&(41wkppcontracep).is('-Discussed postpartum contraception options - ')"][checkbox value="patient still unsure/address at subsequent visits"] [textarea memo="patient's preferences" memo_size="small" memo_color="lightyellow" default="patient prefers/leaning towards " cols="80" rows="2"]
[/conditional][conditional field="obplan41wk" condition="(obplan41wk).is('')"][checkbox name="41wkanalgesia" value="-Discussed analgesia options, patient considering - "][/conditional][conditional field="obplan41wk|41wkanalgesia" condition="(obplan41wk).is('')&&(41wkanalgesia).is('-Discussed analgesia options, patient considering - ')"][checkbox value="no pharmacotherapy|doula|water immersion|parenteral narcotics|epidural|patient unsure/address at subsequent visits"] [text memo="other" memo_size="small" memo_color="lightyellow"  size="80"]
[/conditional][conditional field="obplan41wk" condition="(obplan41wk).is('')"][checkbox name="41wkcervicalcheck" memo="for bishops scoring" memo_size="small" memo_color="peachpuff" value="-Cervical check performed - "][/conditional][conditional field="obplan41wk|41wkcervicalcheck" condition="(obplan41wk).is('')&&(41wkcervicalcheck).is('-Cervical check performed - ')"]
[textarea memo="chaperone/other/actions if applicable" memo_size="small" memo_color="lightyellow"]--chaperone:  
--bishops score: 
--offered cervical ripening (if unfavorable cervix): 
[/textarea]
[/conditional][conditional field="obplan41wk" condition="(obplan41wk).is('')"][checkbox name="41wkmembranesweep" memo="if patient requested/shared decision making" memo_size="small" memo_color="peachpuff" value="-Discussed cervical membrane sweeping, including following risks/benefits:
--Lower likelihood of delivery postdates
--Possible incidental rupture of membranes"][/conditional][conditional field="obplan41wk|41wkmembranesweep" condition="(obplan41wk).is('')&&(41wkmembranesweep).is('-Discussed cervical membrane sweeping, including following risks/benefits:
--Lower likelihood of delivery postdates
--Possible incidental rupture of membranes')"]
[checkbox value="-->patient declined|-->patient requested/performed along with cervical check"]; [textarea memo="other/actions if applicable" memo_size="small" memo_color="lightyellow" cols="80" rows="2"]
[/conditional]