A Nurse Establishes Prenatal at Med‐School Clinic Dianne Moore Nunnally, RN, MN  JOGN nursing  Volume 3, Issue 1, Pages 41-47 (January 1974) DOI: 10.1111/j.1552-6909.1974.tb00575.x Copyright © 1974 AWHONN, the Association of Women's Health, Obstetric and Neonatal Nurses Terms and Conditions

Figure 1 Front (facing page) and back (below) of the Diet History Form designed by the Dietitian at the Outpatient OB Clinic of the University of Oregon Medical School. All obstetric patients fill out the form, and the Dietitian then reviews each form and notes on the patient’s chart her evaluation of the patient’s diet plus any recommendations which might help the patient improve her diet. JOGN nursing 1974 3, 41-47DOI: (10.1111/j.1552-6909.1974.tb00575.x) Copyright © 1974 AWHONN, the Association of Women's Health, Obstetric and Neonatal Nurses Terms and Conditions

Figure 1 Front (facing page) and back (below) of the Diet History Form designed by the Dietitian at the Outpatient OB Clinic of the University of Oregon Medical School. All obstetric patients fill out the form, and the Dietitian then reviews each form and notes on the patient’s chart her evaluation of the patient’s diet plus any recommendations which might help the patient improve her diet. JOGN nursing 1974 3, 41-47DOI: (10.1111/j.1552-6909.1974.tb00575.x) Copyright © 1974 AWHONN, the Association of Women's Health, Obstetric and Neonatal Nurses Terms and Conditions

Figure 2 Social Services Questionnaire. JOGN nursing 1974 3, 41-47DOI: (10.1111/j.1552-6909.1974.tb00575.x) Copyright © 1974 AWHONN, the Association of Women's Health, Obstetric and Neonatal Nurses Terms and Conditions

Figure 3 Front side of the Maternal-Child Nursing Assessment Care Plan.-The reverse of this form continues the Nursing Care Plan chart and under the heading “Discharge Planning” asks the following questions: 1) Has the baby’s father come to visit the baby and/or mother? 2) Who is at home to help this mother? 3) Which of the following have been discussed: Bathing baby; Sibling rivalry; Baby’s crying; Circumcision care; Navel care; New routine at home; Other. 4) Where will she take baby for well baby care and PKU test? 5) Are any problems anticipated when she goes home? 6) What consults or referrals were planned while in hospital or upon discharge? 7) Date of discharge? There is also a place for the nurse’s signature. JOGN nursing 1974 3, 41-47DOI: (10.1111/j.1552-6909.1974.tb00575.x) Copyright © 1974 AWHONN, the Association of Women's Health, Obstetric and Neonatal Nurses Terms and Conditions

Figure 4 Referral slip for high-risk patients. This form is used in liaison between the OB Clinic and the public health department. JOGN nursing 1974 3, 41-47DOI: (10.1111/j.1552-6909.1974.tb00575.x) Copyright © 1974 AWHONN, the Association of Women's Health, Obstetric and Neonatal Nurses Terms and Conditions