Subjective: This newborn patient presents today for a weight and color check. They have been feeding and voiding well. There is no increase in jaundice as per the parents. No peri-partum complications. No family history of jaundice. Objective: .vitals Birth Weight – Percent Weight Change – Head – There is no caput or hematoma Eyes – No scleral icterus Skin – No jaundice Bili Meter Reading - Assessment/Plan: The patient is doing well. Follow-up – Testing -
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Autotext Dot Phrases for Cerner EHR
All templates, "autotexts", procedure notes, and other documents on these pages are intended as examples only for educational purposes. Your documentation in the medical record should always reflect precisely your specific interaction with an individual patient. Do not merely copy and paste a prewritten note element into a patient's chart - "cloning" is unethical, unsafe, and potentially fradulent.
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