Kraamzorg Invulformulier dossier -...

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Kraamzorgdossier

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We adviseren je dit dossier tenminste vijf jaar te bewaren. Het kan namelijk voor zorgverleners handig zijn om medische gegevens te raadplegen, mocht er iets met je kind(je) aan de hand zijn. Natuurlijk is het dossier ook gewoon leuk voor later.

Vanwege kwaliteitstoetsing behoudt Yunio Kraamzorg zich het recht voor dit dossier tijdelijk bij je op te vragen.

Kraamzorg YunioPostbus 21907420 AD Deventer


Ruim 99% van onze cliënten

is tevreden tot zeer tevreden over

onze kraamzorg

Bel088 - 7777 654

Yunio Kraamzorg is 7 dagen per week, 24 uur per dag bereikbaar op 088 - 7777 654

Andere belangrijke nummers:Borstvoedingslijn 088 - 7777 680 dagelijks van 08.00 - 20.00 uur(door lactatiekundigen) Flesvoedingslijn 088 - 7777 656 dagelijks van 09.00 - 17.00 uur

Naam + tel. nummer verloskundige : ______________________________________________

Naam + tel. nummer huisarts : ______________________________________________

Naam + tel. nummer ziekenhuis : ______________________________________________

Naam + tel. nummer van JGZ : ______________________________________________

________________________________ : ______________________________________________

________________________________ : ______________________________________________

________________________________ : ______________________________________________

Bewaar hier alle losse formulieren, zoals de zorgovereenkomst van Yunio en alle losse formulieren die je bijvoorbeeld van

de verloskundige en het ziekenhuis hebt ontvangen. De medewerkers van het consultatiebureau zullen er naar vragen.

Temperatuurlijst moeder binnenkant omslag voorTemperatuurlijst baby binnenkant omslag achterBevallingsverslag 3Afsprakenblad 5Dag 1 t/m 8 Rapportage, observatie en zorgafspraken 6 t/m 21Rapportage, observatie en zorgafspraken (op indicatie) 22 Checklist voorlichting 24Aantekeningen 26

Inhoudsopgave

Geboren op

Mijn ouders zijn

Ik heb broertjes en zusjes. Hun namen zijn

De voornaam van mijn kraamverzorgende is

Dag 1 ________________ dag van ______________ tot ______________ uur = ____________ uur ____________ uur








(SUB)TOTAAL = ____________ UUR ____________ UUR



(SUB)TOTAAL = ____________ UUR ____________ uur

TOTAAL ____________ UUR

Mijn afgesproken uren kraamzorg:

Naam:

Invulformulier

Baby

Babymassage

kraamzorgyunio.nl

Beste cliënt,

Voor je ligt het Kraamzorgdossier van Yunio. In je kraamtijd wordt dit dossier ingevuld.

Gezondheid en welbevindenJe kraamtijd is een van de belangrijkste momenten in je leven. Wij van Yunio doen er alles aan om jou, je kindje en jullie gezin de beste start te geven. De gezondheid en het welbe-vinden van jou en je kindje staan voor ons voorop. Het Kraamzorgdossier is een hulpmiddel om dit te controleren, te registreren en te bewaken. Zo kan, als het nodig is, tijdig hulp worden ingeschakeld.

Dagelijks gebruikJe kraamverzorgende beschrijft elke dag hoe het met jullie gaat. Hoe jij als kraamvrouw herstelt van je bevalling en hoe je kindje het in deze voor hem totaal nieuwe omgeving doet. Ze noteert bijvoorbeeld jullie temperatuur en de momenten waarop je baby is gevoed, heeft geplast en poept. Aan de hand van het Kraamzorgdossier bespreekt je kraamverzorgende elke dag de zorg voor jou en je kindje. Afspraken, belangrijke gegevens en bijzonderheden legt ze vast.

Kwaliteit van (kraam)zorgAnderzijds is het Kraamzorgdossier belangrijk voor de kwaliteit van onze kraamzorg. Het is deels een checklist voor je kraamverzorgende om er zeker van te zijn dat ze je voorlichting, advies en/of instructie geeft over alle onderwerpen die in deze periode voorbij komen. En het helpt haar om een nog beter beeld te krijgen van jullie gezondheid en welbevinden, zodat ze, als het nodig is de zorg kan aanpassen of hulp van bijvoorbeeld je verloskundige kan inschakelen.

PrivacyUiteraard gaan we zeer vertrouwelijk met jouw persoonlijke gegevens om. Kraamzorg Yunio houdt zich aan de geldende wet- en regelgeving met betrekking tot privacy. Onze mede werkers hebben een zwijgplicht en delen alleen jouw gegevens met andere hulp-verleners na jouw toestemming.

Niet tevreden?Wij doen ons uiterste best om jullie de beste start te bieden. Kraamzorg blijft echter voor een belangrijk deel mensenwerk. Ben je in de kraamweek om wat voor reden dan ook niet tevreden met onze zorg? Maak het bespreekbaar met je kraamverzorgende. Door samen te praten kom je al snel tot een verbetering of oplossing. Blijf je ontevreden of vind je het lastig om het gesprek aan te gaan? Twijfel niet en bel ons op 088 - 77 77 654. We zijn 24 uur per dag bereikbaar.

OverdrachtNa de kraamperiode blijft het Kraamzorgdossier in je bezit. De jeugdverpleegkundige neemt gegevens uit het document over als jullie worden overgedragen aan de jeugdgezond-heidszorg (consultatiebureau). We adviseren je het Kraamzorgdossier tenminste vijf jaar te bewaren. Het kan voor andere zorgverleners en bij kwaliteitscontroles handig zijn om over de gegevens uit de kraamweek te beschikken.

We wensen je een ontspannen en onvergetelijke kraamtijd toe. En natuurlijk hopen we dat je zelf later met warme herinneringen dit document nog eens doorleest.

Met hartelijke groet,

Ginel E. van WeeringDirecteur-bestuurder - Naviva Kraamzorg b.v.

Bezoekadres Keulenstraat 19 - 7418 ET Deventer Postadres Postbus 2190 - 7420 AD Deventer

T 088 - 7777 654F 088 - 7777 699

E [email protected] www.kraamzorgyunio.nl

kraamzorgyunio.nl

Aandacht voor het hele gezin

Borst- of flesvoeding

Verwennen hoort erbij

Babymassage

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Verzorging

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5

Zwangerschap en bevallingsverslag Naam baby: ______________________________________________________________

Samenvatting zwangerschapHoeveelste zwangerschap ___________ Hoeveelste bevalling ______________Zwangerschapsintoxicatie � Geen � Roken � Alcohol � Drugs � Medicijnen, nl. _______________________________________________________ � Anders, nl.: ____________________________________________________________________________________________________________Zwangerschapspathologie � Geen � Hypertensie � Diabetes � Bloedverlies 1e Tremester � 2e Tremester � Stuitligging laatste 3 mnd. � Anders, nl.: ____________________________________________________________________________________________________________Zwangerschapsduur ___________ weken _____ dagen � Prematuur < 37 Weken � Serotien, > 42 Weken _______ dagenPrenatale zorgverlener � Geen � Verloskundige � Huisarts � Gynaecoloog Specialistisch onderzoek � Geen � Vruchtwaterpunctie � Echoscopie � RöntgenfotoBijzonderheden vorige zwangerschappen � Evt. miskramen, aantal: ________ � Abortus � Vrouwelijke genitale verminking � Vruchtwaterpunctie � Echoscopie � Röntgenfoto van: ____________________________ � Hypertensie � Hellp-syndroom � Diabetes � Bloedverlies. Noteer in welke maand(en): ________________________________________________________________ � Kunstmatige bevruchting � Candida infectie � Herpes virus � Streptokokken B bacterie � Anders: _______________________________________________________________BevallingAlleen invullen na een thuisbevalling en als er geen bevallingsverslag vanuit het ziekenhuis in het gezin achter blijft.Plaats bevalling : � Thuis � Poliklinisch � Primair klinisch � Secundair klinisch Bijzonderheden: _______________________________________________________________________ Couveuse dagen: _________________ Dysmatuur: � Ja � Nee Meerling: � Ja � Nee Volgnr. bij meerling: � 1e � 2e � Andes ______________________ Aard van de bevalling: � Spontaan � Vacuüm � Tang � Keizersnede Bijzonderheden: ____________________________________________________________________________________________________________ Opname kinderafdeling: (periode) ___________________________________________________________________________________________Gegevens bevalling d.d.: ______________ Duur uitdrijving ______________ minuten. Duur bevalling: ______________ uren en ______________ minuten. Gekatheteriseerd � Ja � NeeGebroken vliezen Om : ______________ uur Kleur vruchtwater normaal � Ja � Meconium � Bloederig � Onbekend � Anders: _________________________________Stuitligging laatste 3 mnd � Ja � NeeLigging bij geboorte � Achterhoofd voor � Achterhoofd achter � Kruin � Aangezicht � Voorhoofd � Hoofdligging anders � Volkomen stuit � Onvolkomen stuit � Dwars � Onbekend � Anders: __________________________________________________________________________________________________________________ Baby geboren om: ______________ uur Placenta geboren om: ______________ uur, compleet � Ja � Nee

Kraamvrouw BijzonderhedenEpisiotomie � Ja � Nee _____________________________________________________________________________________________Ruptuur � Ja � Nee _____________________________________________________________________________________________Hechtingen � Ja � Nee Soort: _____________________________________________________________________________________________Medicijnen � Ja � Nee Soort: _______________________________________________________________________________ Anti D � Ja Fluxus (verlies ca. 1000 cc) � Ja � Nee Aantal cc’s: _____________________________________________________________________________________________Uterus goed gecontraheerd � Ja � NeeGeürineerd na de bevalling � Ja � Nee Tijdstip: ______________________________________________________________________________________________Algehele toestand ______________________________________________________________________________________________________________________________

Baby Apgarscore 1 minuut ______ 5 minuten ______ 10 minuten ______ Gewicht: ____________ gr. Lengte*: _______ cm. Schedelomtrek*: _______ cm.Benoem oorzaak Apgarscore < 5: _______________________________________________________________________________________________________________________ � Blauw gezien � Kortstondige ademnood � Zuurstof gehad na bevalling � Kunstmatig beademd � Reanimatie babyNavelstreng (3 navelvaten) � Ja � Nee Bijzonderheden Omstrengeling � Ja � Nee Hoe vaak: _____________________________________________________________________________________________Meconium geloosd � Ja � Nee Tijdstip: ___________________________ Geürineerd � ja � nee Tijdstip : _______________________Aangelegd (BV) in het 1e uur � Ja � Nee Tijdstip: ___________________________ Flesvoeding � ja � nee Tijdstip : _______________________Huid op huidcontact � Ja � Nee Misselijk � Ja � Nee _________________________________________________________________________________________________________Temperatuur gemeten � Ja � Nee Waarde: _____________________________________________________________________________________________Vitamine K toegediend � Ja � Nee Zo niet: _____________________________________________________________________________________________Testikels ingedaald � Ja � Nee Zo niet: ___________________________________________ � Links � Rechts Navelstrengbloed weggebracht ivm toediening Anti D binnen 24 tot 48 uur: � Ja � Nee Zo ja, tijdstip afhandeling: ____________________Gamma immunoglobuline (hep B) � Ja

*Ind

ien

gem

eten

.

(zie het ziekenhuisverslag)

Afspraken verloskundige/eventueel indicatie______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________ Naam verloskundige ______________________________________________________ Voornaam kraamverz. _________________ Medew.nr. _________________Kraamverzorgende aangekomen om ______________________________________ Vertrokken om ________________________________________________________

Tips en adviezen voor de eerste nacht(Denk hierbij aan kruikgebruik, veilig slapen, temperaturen, voeding, fopspeengebruik, etc.)________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

Zie voor belangrijke telefoonnummers het cliëntmagazine.

Ruimte voor aantekeningen________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

Afspraken die de kraamverzorgende met je maakt (afhankelijk van de geïndiceerde zorg)

T.a.v. rusttijden____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

T.a.v. bezoek (o.a. tijdens voeden, aantal personen boven) ______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

T.a.v. andere gezinsleden (Daarbij valt te denken aan eetgewoontes, evt. medicijngebruik, andere ingeschakelde hulpverleers)______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

T.a.v. lunch______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

Veiligheid woonomgeving� Brandveiligheid/vluchtroute _____________________________________________________________________________________________________________________

Kraamkamer� Rooming-inn _____________________________________________________________________________________________________________________� ARBO _____________________________________________________________________________________________________________________� Afstoffen/stofzuigen/dweilen _____________________________________________________________________________________________________________________� Kraambed verschonen _____________________________________________________________________________________________________________________

Babykamer � Afstoffen/stofzuigen/dweilen _____________________________________________________________________________________________________________________� Bedje verschonen _____________________________________________________________________________________________________________________

Aanvullende werkzaamheden� Wasverzorging (wit/bont/fijn) _____________________________________________________________________________________________________________________� Gebruik wasmachine/droger _____________________________________________________________________________________________________________________� Strijken was _____________________________________________________________________________________________________________________� Afwas/vaatwasser _____________________________________________________________________________________________________________________� Bijzonderheden apparatuur _____________________________________________________________________________________________________________________� Scheiden afval _____________________________________________________________________________________________________________________

Sanitair _____________________________________________________________________________________________________________________

Overige werkzaamhedenIndien de tijd dit toelaat, op indicatie of na aankoop van extra kraamzorg uren kan in overleg met de kraamverzorgende één of meerdere van de volgende werkzaamheden uitgevoerd worden t.a.v. onderhoud woon- en slaapkamer en keuken:� Afstoffen beneden/boven _____________________________________________________________________________________________________________________� Stofzuigen beneden/boven _____________________________________________________________________________________________________________________� Trap _____________________________________________________________________________________________________________________� Dweilen beneden/boven _____________________________________________________________________________________________________________________� Verzorging planten _____________________________________________________________________________________________________________________� Bedden verschonen _____________________________________________________________________________________________________________________� Maaltijd verzorgen _____________________________________________________________________________________________________________________

Roken ______________________________________________________________________________________________________________________

Overige afspraken (bv. mantelzorg: halen en brengen van/naar school, boodschappen doen) ______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

De gemaakte afspraken worden in elk geval op de 3e, 5e en 8e dag besproken met het kraamgezin en desgewenst bijgesteld.

Rapportage, observaties en zorgafspraken Datum en dag: ___________________________________________________________________

Controles door kraamverzorgende volgens temperatuurlijst en checklist zorgovereenkomstObservaties kraamvrouw Observaties baby na de bevalling Observaties twee uur na de bevalling� Vloeien, stolsels � Kleur*, spierspanning, huilen � Lichamelijk� Naweeën, uterusstand � Meconium geloosd, urineren � Emotioneel� Perineum � Navel � Temperatuur� Urineren � Drinkgedrag

Voorlichting door kraamverzorgende (Zie cliëntmagazine voor meer informatie en gebruik het trefwoordenregister)Kraamvrouw Baby� Wat is hevig vloeien en wat moet je doen? � Voordelen rooming-inn � Navelverzorging� Wat zijn grote stolsels en wat moet je doen? � Voeden op verzoek � Aandachtspunten voeding 1e nacht� Urineren � (Veilig) slapen � Gebruik kruiken � Hygiëne/lichaamelijke verzorging � Controle temperatuur � Draaiend verzorgen en buikligging � Huid op huid contact � Verschonen � Hygiëne� Rust & activiteit � Pseudomenstruatie, uraten � Voorkeurshouding � Koortslip � RS virus

Rapportage Eventueel tijdstip ontslag ziekenhuis ___________________________________________________________________________________________________________________

Kraamvrouw: mededelingen - observaties/risicosignalering/acties - verzorgende acties________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________ Baby: mededelingen - observaties/risicosignalering/acties - verzorgende acties____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________ ____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

Afspraken verloskundige/eventueel indicatie____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________ ____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

*Extra controle op gele kleur (hyperbilirubinemie).

dag 1

dag 1Ruimte voor evaluatie en wijzigingen van afspraken(Denk aan de zorg voor de moeder, de baby en overige gezinsleden, de huishoudelijke en overige afspraken en mogelijke zorgen over moeder, baby en/of overige gezinsleden)__________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________ ________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

Tips en adviezen voor de eerste nacht(Denk hierbij aan kruikgebruik, veilig slapen, temperaturen, voeding, fopspeengebruik, etc.) ________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

Tijdstip Voeding (hoelang) Spugen Urine Ontlasting Kruiken Bijzonderheden

In te vullen door kraamgezin


Controles door kraamverzorgende volgens temperatuurlijst Observaties kraamvrouw Observaties baby� Naweeën � Zuigreflex � Reacties van de baby na de bevalling, geel zien Voorlichting door kraamverzorgende (Zie cliëntmagazine voor meer informatie en gebruik het trefwoordenregister)Kraamvrouw Baby� Hygiëne � Voordelen rooming-inn� Je eigen verzorging � (Veilig) slapen en roken� Voorkomen van lichamelijke vermoeidheid/rust � Borst-/flesvoeding: aanlegtechnieken en houdingen, samenstelling � Kraambed oefeningen starten moedermelk, in de eerste dagen, klaarmaken kunstvoeding, op verzoek� Koortslip � Fopspeengebruik bij borstvoeding � Navelverzorging, verschonen baby � Babymassage (vijfluik) en olie � Draaiend verzorgen � Regelen temperatuur, gebruik kruiken � RS virus � Dunstan Babytaal

Algemeen________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

Kraamvrouw observaties/observaties/risicosignalering/acties________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________ Baby observaties/observaties/risicosignalering/acties____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________ ____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________


dag 2

dag 2Ruimte voor evaluatie en wijzigingen van afspraken(Denk aan de zorg voor de moeder, de baby en overige gezinsleden, de huishoudelijke en overige afspraken en mogelijke zorgen over moeder, babyen/of overige gezinsleden)__________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________ ________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

Tips en adviezen voor de nacht(Denk hierbij aan kruikgebruik, veilig slapen, temperaturen, voeding, fopspeengebruik, etc.) ________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________




Controles door kraamverzorgende volgens temperatuurlijstObservaties kraamvrouw Observaties baby� Algemene indruk � Algemene indruk, geel zien � Drinken, starten van het drinken � Zuig- en slikreflex Voorlichting door kraamverzorgende (Zie cliëntmagazine voor meer informatie en gebruik het trefwoordenregister)Kraamvrouw Baby� Voldoende rust � Huilen� Borstverzorging � Slaapsignalen� Voedingsadvies bij borstvoeding � Dagritme, structuur en rust� Controles kraamvrouw en baby � Fles-/borstvoeding: aanlegtechnieken, loslaten of er af halen, genoeg gedronken � Borstvoedingslijn/flesvoedingslijn � Fopspeengebruik bij borstvoeding � Hielprik/gehoorscreening � Dunstan babytaal

Algemeen________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________



dag 3

dag 3Ruimte voor evaluatie en wijzigingen van afspraken(Denk aan de zorg voor de moeder, de baby en overige gezinsleden, de huishoudelijke en overige afspraken en mogelijke zorgen over moeder, baby en/of overige gezinsleden)__________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

Is het nodig om het consultatiebureau te bellen tijdens de kraamdagen i.v.m. aandachtspunten zorgen over de moeder________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

Is het nodig om het consultatiebureau te bellen tijdens de kraamdagen i.v.m. aandachtspunten zorgen over de baby________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

Overige aandachtspunten________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

Zijn de afspraken duidelijk en akkoord________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

Adviezen voor de nacht(Denk hierbij aan kruikgebruik, veilig slapen, temperaturen, voeding, fopspeengebruik, etc.) ________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________




Controles door kraamverzorgende volgens temperatuurlijstObservaties kraamvrouw Observaties baby� Algemene indruk � Algemene indruk, geel zien� Lichamelijk en emotioneel herstel � Drinken, starten van het drinken � Inslapen na nachtvoeding � Zuig- en slikreflex� De baby in het gezin

Voorlichting door kraamverzorgende (Zie cliëntmagazine voor meer informatie en gebruik het trefwoordenregister)Kraamvrouw Baby� Bewaren van fles -of afgekolfde voeding � Verzorging o.a. navel, oortjes, neusje, nagels � Contact met consultatiebureau gewenst � Omgaan met de baby, laten zien hoe deze reageert op verschillende dingen � Richtlijnborstvoeding.nl � Observeren baby; voedingssignalen, (honger) en voldoende gedronken� Moeder-tot-moeder contact � Babymassage(vijfluik) en olie� Flesvoeding, berekenen en bereiden � Draaiend verzorgen � Dunstan Babytaal

Algemeen________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________



dag 4

dag 4Ruimte voor evaluatie(Denk aan de zorg voor de moeder, de baby en overige gezinsleden, de huishoudelijke en overige afspraken en mogelijke zorgen over moeder, baby en/of overige gezinsleden)__________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________ ________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

Tips en adviezen voor de nacht(Denk hierbij aan kruikgebruik, veilig slapen, temperaturen, voeding, fopspeengebruik, etc.) ________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________




Controles door kraamverzorgende volgens temperatuurlijstObservaties kraamvrouw Observaties baby� Algemene indruk � Algemene indruk, geel zien � Drinkgedrag, slaap-/waakritme � Voorkeurshouding

Voorlichting door kraamverzorgende (Zie cliëntmagazine voor meer informatie en gebruik het trefwoordenregister)Kraamvrouw Baby� Uitleg geven over de gedane controles � Begeleiding bij het baden van de baby door de kraamvrouw

van de kraamvrouw en de baby � De aandachtspunten bij de verzorging van de baby� Flesvoeding zelf klaarmaken � Observeren van de baby; wanneer zie je of de baby iets � Afkolven met de hand of apparatuur prettig vindt, tevreden is, slaap-/voedingssignalen � Borstvoedingslijn � Dunstan Babytaal� Richtlijnborstvoeding.nl � Shaken baby � Moeder-tot-moeder contact � Fopspeengebruik

Algemeen________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________



dag 5

dag 5Ruimte voor evaluatie(Denk aan de zorg voor de moeder, de baby en overige gezinsleden, de huishoudelijke en overige afspraken en mogelijke zorgen over moeder, baby en/of overige gezinsleden)__________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________ ________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

Tips en adviezen voor de eerste nacht(Denk hierbij aan kruikgebruik, veilig slapen, temperaturen, voeding, fopspeengebruik, etc.) ________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________




Controles door kraamverzorgende volgens temperatuurlijstObservaties kraamvrouw Observaties baby� Algemene indruk � Algemene indruk, geel zien � Drinkgedrag, slaap-/waakritme

Voorlichting door kraamverzorgende (Zie cliëntmagazine voor meer informatie en gebruik het trefwoordenregister)Kraamvrouw Baby� Lichamelijke en hormonale veranderingen � Kleding � Omgaan met de veranderde situatie (Dagritme) � Consultatiebureau� Contact met consultatiebureau gewenst � Contact met lactatiekundige lijn gewenst � Huilen/shaken baby met de veranderde

situatie (Dagritme)

Algemeen________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________



dag 6

dag 6Ruimte voor evaluatie(Denk aan de zorg voor de moeder, de baby en overige gezinsleden, de huishoudelijke en overige afspraken en mogelijke zorgen over moeder, baby en/of overige gezinsleden)________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________ ________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

Is het wenselijk contact op te nemen met het consultatiebureau__________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________ ________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

Tips en adviezen voor de nacht(Denk hierbij aan kruikgebruik, veilig slapen, temperaturen, voeding, fopspeengebruik, etc.) ________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________ ________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________




Controles door kraamverzorgende volgens temperatuurlijstObservaties kraamvrouw Observaties baby� Algemene indruk � Algemene indruk, geel zien � Drinkgedrag, slaap-/waakritme

Voorlichting door kraamverzorgende (Zie cliëntmagazine voor meer informatie en gebruik het trefwoordenregister)Kraamvrouw Baby� De zorg voor de baby en het oppakken � Leren kijken naar en observeren van de baby

van lichte activiteiten (Dagritme) o.a. honger en slaapsignalen en voorkeurshouding � Eigen intuïtie volgen bij het omgaan met de baby � Dunstan Babytaal

Algemeen________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________



dag 7

Ruimte voor evaluatie(Denk aan de zorg voor de moeder, de baby en overige gezinsleden, de huishoudelijke en overige afspraken en mogelijke zorgen over moeder, baby en/of overige gezinsleden)__________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

Is het wenselijk contact op te nemen met het consultatiebureau______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

Zijn er aandachtspunten bij de moeder______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

Zijn er aandachtspunten bij de baby______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

Zijn er andere aandachtspunten______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

Zijn de afspraken duidelijk en akkoord______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

Adviezen voor de nacht (Indien van toepassing) ____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________ ____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

dag 7




Controles door kraamverzorgende volgens temperatuurlijstObservaties kraamvrouw Observaties baby� Algemene indruk � Algemene indruk � Drinkgedrag, slaap/waakritme

Voorlichting door kraamverzorgende (Zie cliëntmagazine voor meer informatie en gebruik het trefwoordenregister)Kraamvrouw Baby� Bespreken van de (lichamelijke en emotionele) ontwikkeling � Nagaan of er vragen zijn van je baby, het gedrag van de baby in verschillende situaties � Afsluiting van de kraamzorg en wijzen op het evaluatie formulier � Vitamine K en D � Overdracht naar en uitleg over doel J.G.Z. � Tips en adviezen om het dagelijks leven weer op te nemen (Dagritme) � Ouders attenderen op het bestaan van diverse � Verwijderen hoofdluier uit babybedje vanwege de veiligheid borstvoedingsorganisaties en lactatiekundigen� Contact met consultatiebureau gewenst � Fopspeengebruik� Richtlijnborstvoeding.nl

Algemeen________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________



dag 8

dag 8Ruimte voor evaluatie (Denk aan de zorg voor de moeder, de baby en overige gezinsleden, de huishoudelijke en overige afspraken en mogelijke zorgen over moeder, baby en/of overige gezinsleden)________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________ ________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

Is het wenselijk contact op te nemen met het consultatiebureau__________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________ ________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

Adviezen voor de nacht (Indien van toepassing) ______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________ ________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________



Rapportage, observaties en zorgafspraken (alleen op indicatie)

� Verlenging � Uitgestelde kraamzorg

Controles door kraamverzorgende volgens temperatuurlijstObservaties kraamvrouw Observaties baby� Algemene indruk � Algemene indruk� Inschakelen lactatiekundige � Drinkgedrag, slaap/waakritme

Inventariseren en vaststellen van de zorgvraag__________________________________________________________________________________________________________________________________________________________

__________________________________________________________________________________________________________________________________________________________

Datum en dag: ____________________________________________________________

Algemeen______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

Kraamvrouw: mededelingen - observaties/risicosignalering/acties - verzorgende acties________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________ __________________________________________________________________________________________________________________________________________________________ Baby: mededelingen - observaties/risicosignalering/acties - verzorgende acties________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________ __________________________________________________________________________________________________________________________________________________________

Ruimte voor evaluatie (Denk aan de zorg voor de moeder, de baby en overige gezinsleden, de huishoudelijke en overige afspraken en mogelijke zorgen over moeder, baby en/of overige gezinsleden)________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________ __________________________________________________________________________________________________________________________________________________________

evt. dag 9



25

Rapportage, observaties en zorgafspraken (alleen op indicatie)

� Verlenging � Uitgestelde kraamzorg

Controles door kraamverzorgende volgens temperatuurlijstObservaties kraamvrouw Observaties baby� Algemene indruk � Algemene indruk� Inschakelen lactatiekundige � Drinkgedrag, slaap/waakritme

Inventariseren en vaststellen van de zorgvraag__________________________________________________________________________________________________________________________________________________________

__________________________________________________________________________________________________________________________________________________________

Datum en dag: ____________________________________________________________

Algemeen______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

Kraamvrouw: mededelingen - observaties/risicosignalering/acties - verzorgende acties________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________ __________________________________________________________________________________________________________________________________________________________ Baby: mededelingen - observaties/risicosignalering/acties - verzorgende acties________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________ __________________________________________________________________________________________________________________________________________________________

Ruimte voor evaluatie (Denk aan de zorg voor de moeder, de baby en overige gezinsleden, de huishoudelijke en overige afspraken en mogelijke zorgen over moeder, baby en/of overige gezinsleden)________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________ __________________________________________________________________________________________________________________________________________________________

evt. dag 9

evt. dag 10



Deze checklist is bedoeld als controlemiddel voor besproken onder-werpen. Deze worden dagelijks afgevinkt. Bijzonderheden worden op de rapportagebladen van de dag genoteerd. De volgende onderwerpen zijn aan de orde geweest: Tijdens de intake � Vorige kraambed � Rooming-inn � Keus borstvoeding/flesvoeding � Huid-op-huid� Checklist zorgovereenkomst � Op verzoek voeden � Andere hulpverlening � Fopspeen � Het bijkopen van uren � Goed aanleggen/aanbieden � Specifieke gezondheidsvoorlichting � Dunstan Babytaal/app autochtonen/allochtonen � Babymassage � Bijzonderheden: (zachte plantaardige olie) ____________________________________________________________________________________________________________________________________________________ __________________________________________________________________________ Algemeen � Telefoonnummers van Yunio (achterzijde) � Bijkopen van uren � Plaats baby in het gezin/dagritme en structuur van het gezin

(oudere kinderen)� Bewegen en gezonde voeding (oudere kinderen)� Eindevaluatie van de kraamzorg� Overdracht consultatiebureau� Weeg en telefonisch spreekuur J.G.Z.� GroeiGids afgegeven en besproken: o.a. wip-/autostoeltje, koorts� Zorgen binnen het gezin� Overgebleven artikelen uit het kraampakket (www.stichtingbabyhope.org)� Veiligheid (shaken baby syndroom/Gifwijzer)� Bij afsluiting zorg (wijzen op filmpjes: youtube.com/navivakraamzorg)� Melden dat dit dossier i.v.m. kwaliteitstoetsingen door Yunio tijdelijk

kan worden opgevraagd

Bijzondere informatie� Spruw � Veel huilen� Koortslip� Veilig slapen > � verwijderen hoofdluier op dag 8� Specifieke gezondheidsvoorlichting autochtonen/allochtonen� RS virus

Kraamvrouw � Tijd voor huid op huid contact� Rooming-inn� Hormonen en ontzwangeren� De controles van de kraamvrouw � Lichamelijke verzorging van de kraamvrouw � Hygiëne � Voeding van de kraamvrouw � Kraambed oefeningen � Rust en hechting � Kraamtranen � Een huilende baby en de andere kinderen (www.loes.nl) � Taalontwikkeling Partner� Geïnformeerd over avond- en nachtinstructies � Betrokken bij de verzorging van de baby

Verzorging� De controles van de baby � Verzorging van de baby en hechting � Temperatuurregeling � Gebruik van kruiken of Zensy babywarmer (checken vaardigheid en kennis)� Geel zien � Hielprik � Gehoorscreening � Draaiend verzorgen � Gedrag: huilen en slapen � Dunstan Babytaal (www.babytaal.nl) � Voorkeurshouding � Darmkrampjes � Uraten � Pseudo menstruatie � Roken (rookvrijopgroeien.nl) � Babymassage � Rugligging (wiegendood) � Shaken baby syndroom � Baby mee naar buiten Borstvoeding� Rooming-in van de baby� Verschillende aanlegtechnieken� Aanleggen de eerste dagen (hoe vaak)� Werking toeschietreflex � Principe van vraag en aanbod� Verzorgen borsten/zelf borsten controleren� Verzorgen tepels: voorkomen kloven en ontsteking� Voeden op verzoek van de baby� Speen/tepelverwarring� Gebruik fopspeen (zuigverwarring/voedingssignalen)� Krijgt de baby voldoende� Te veel voeding� Te weinig voeding: minimaal 8x voeden

in 24 uur de eerste 2 á 3 weken� Aantal poep/plas luiers � Wegen� Kolven: handmatig of elektrisch� Regeldagen� Voedingsadvies� Vitamine K en D� Bewaren en geven van afgekolfde voeding� Informatie verstrekt over lactatiekundigen en

borstvoedingsorganisaties

� Moeder-tot-moeder contact � Lactatiekundige ingeschakeld voor een huisbezoek

Flesvoeding � Rooming-inn van de baby � Geven van de fles � Voeden op verzoek � Verzorgers aantal beperken: hechting en veiligheid � Drinkgedrag van de baby � Verzorging van de baby na de voeding � Klaarmaken van de voeding � Aantal voedingen per dag � Hoeveelheid voeding per keer, restvoeding � Hoeveelheid voeding per dag � Verschillende spenen en fopspenen � Soorten voedingen � Hygiëne bij het klaarmaken van de voeding � Schoonmaken van de fles na de voeding � Hygiëne van flessen en flessenrager (bewaren) � Hygiëne , verzorgen van (fop)spenen� Vitamine D

Checklist voorlichting

Ruimte voor aantekeningen____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________ ____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________ ____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________ ____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________ ____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________ __________________________________________________________________________________________________________________________________________________________

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groetjes,

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Datum

Dag

Rectaal/oksel mo mi mo mi mo mi mo mi mo mi mo mi mo mi mo mi mo mi mo mi

Temp. cijfers

Polscijfers

Pols (in rood)

140

Temp(in blauw)

40o

120 39o

100 38o

80 37o

60 36o

40 35o

Baarmoederstand

Kraamzuivering

Ontlasting

Perineum (hechtingen)

Urine

Benen

Borsten, stuwing

Bezoek verloskundige

Medicijnen

Bijzonderheden________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

Indien van toepassingOpnamedat. ziekenhuis na partus: _________________________________ Indicatie: ____________________________________ Aantal dgn.: _______________Naam ziekenhuis: __________________________________________________Opnamedat. ziekenhuis tijdens kraamdagen: ______________________ Indicatie: ____________________________________ Aantal dgn.: _______________Naam ziekenhuis: __________________________________________________

Temperatuurlijst van de moederNaam moeder ___________________________________________________________________ Geboortedatum ____________________________________________

Bewaar hier alle belangrijke

papieren !

Zie ook blz. 3 voor gegevens zwangerschap en bevalling en checklist voorlichting blz. 24 Naam ouder 1 : ___________________________________________________ Naam ouder 2: _________________________________________________________Straat en huisnr. : ___________________________________________________ Postcode, plaats: _______________________________________________________Telefoonnr. cliënt : ___________________________________________________Achternaam baby : _________________________ Voorvoegsel: __________ Voorletters: _____________ Roepnaam: ________________________________Geboortedatum : _________________________ Geslacht: � Jongen � Meisje BSN-nr.: ________________________________________________Aantal dgn. kraamz. : _________________________ Huisarts ingeschakeld: � Nee � Ja, reden: ____________________________________________Andere hulpverleners in gezin? Anders: _____________________________________________________________________________________________

Kraamvrouw ToelichtingBorsten � ______________________________________________________________________________________________________________________________Uterus (o.a. vloeiingen) � ______________________________________________________________________________________________________________________________Perineum � ______________________________________________________________________________________________________________________________Uitscheiding � ______________________________________________________________________________________________________________________________Algehele indruk (o.a. hoge bloeddruk, medicijnen, voeding) __________________________________________________________________________________________________ ______________________________________________________________________________________________________________________________ ______________________________________________________________________________________________________________________________

Baby ToelichtingKleur Geelzucht: � Ja � Nee � Bilirubine bepaald. Datum: ________________ Gehalte: ___________________________ � Lichttherapie � Wisseltransfusie � Anders: __________________________________________________________________________Navel _________________________________________________________________________________________________________________________________Voeding geboortedag � Borstvoeding � Flesvoeding, merk: _________________________________ � Gemengde voeding ______________________________Type bijvoeding � Borstvoeding � Fortifier (suppletie op BV) � Flesvoeding, merk: ___________________________________________________________Introductie bijvoeding � Borstvoeding Datum: ___________________ � Flesvoeding, merk: __________________________________ Datum: ________________Voeding laatste dag � Borstvoeding � Flesvoeding, merk: __________________________________ � Gemengde voeding ______________________________ Type bijvoeding � Borstvoeding � Fortifier (suppletie op BV) � Flesvoeding, merk: ___________________________________________________________Bijzonderheden __________________________________________________________________________________________________________________________________Lactatiekundige ingezet?: � Ja � Nee

Suppletie Vitamine K voorgeschreven? � Ja � Nee Vitamine D voorgeschreven? � Ja � Nee Gewicht Bij de geboorte: ______________ Het laagste gewicht: _________________ Het laatste gewicht: _____________________ Datum: ______________Uitscheiding __________________________________________________________________________________________________________________________________________ 1e meconium datum: ___________________________________________________________________________________________________________________ _________________________________________________________________________________________________________________________________________Temperatuur � Normaal � Ondertemperatuur � Verhoging � Zeer wisselend � Couveuse, aantal dgn. warme kamer: ____________________Gedrag __________________________________________________________________________________________________________________________________________ _________________________________________________________________________________________________________________________________________

*Hielprikscreening stofwisseling Nr.: __________________________________ Plaats: ______________________________________________________________________ � Hielprik Datum: _______________________________ /bijz: _______________________________________________________________________ � Hielprik Datum: _______________________________ /bijz: _______________________________________________________________________

*Gehoorscreening Methode Datum: _______________________________ Uitslag ______________________________________________________________________ Links Rechts ___________________________________________________________________________ � V � Onv � V � Onv___________________________________________________________________________ � V � Onv � V � Onv

Samenvatting kraamtijd en de tevredenheid___________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

Specifieke bijzonderheden t.b.v. het consultatiebureau Besproken zorgen over: � Baby � Kraamvrouw � Andere kinderen � Anders, nl.: ___________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________Voornaam kraamverz.: _________________________ Medew.nr.: _____________________ Datum laatste dag kraamzorg: _________________________________

Temperatuurlijst van de babyNaam baby _______________________________________ Geboortedatum ________________________________ Geboortegewicht ________________________

Datum

Dag

Temp mo mi mo mi mo mi mo mi mo mi mo mi mo mi mo mi mo mi mo mi

Cijfers

Gewicht

40o

39o

38o

37o

36o

35o

Voeding Bij borstvoeding: noteer de starttijd (geef bij voorkeur twee borsten). Bij flesvoeding: noter de starttijd en het aantal cc’s.

Merk

Borst/Fles (tot.)

Drinken

Spugen

Urine

Ontlasting

Medicijnen

Kleur

Navel

Ademhaling

Kruiken

Hielprikscreening d.d.: ___________________________ Gehoorscreening d.d.: ___________________________ Resultaat: ________________________________________________________________

Afspraken met de verloskundige: ______________________________________________________________________________________________________________________________________________________

Afsluitende evaluatie en overdracht naar het consultatiebureau, mede namens de verloskundige.

* Dit is een onderdeel van het JGZ dossier

Kraamzorg Invulformulier dossier -...

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