UTI CARDIOLGICA

SAE SISTEMATIZAO DA HISTRICO DE ENFERMAGEM DATA ADMISSO:_____/_____/______

ASSISTNCIA DE HORA: ______:______
ENFERMAGEM

IDENTIFICAO
NOME: _____________________________ SEXO: ___________________________
PRONTURIO: ______________________ ESCOLARIDADE: __________________
IDADE: _______________ CONVNIO: ______________________
MDICO RESPONSVEL: _____________ ORIGEM: ________________________
DIAGNSTICO: ___________________________________________________________________________________

INFORMANTE: ( ) PACIENTE ( ) FAMILIAR____________________________

( ) AMIGO________________ ( ) PROF. DE SADE_____________________
( ) OUTROS______________

PERCEPES E EXPECTATIVAS RELACIONADAS DOENA

QUEIXA PRINCIPAL PR-HOSPITALAR: ______________________________________________________________
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HISTRIA DA MOLSTIA ATUAL: ___________________________________________________________________

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HISTRIA PREGRESSA: ANTECEDENTES FAMILIARES:
( )TABAGISTA____CIGARROS/DIA ( )ETILISTA____ANOS ( )CARDIOPATIAS
( )CARDIOPATIAS______________ ( )AVC_____________ ( )DIABETES
( )HAS ( )HEPATOPATIAS___ ( )HAS
( )DIABETES ___________________ ( )CARCINOMAS
( )OUTROS:___________________ ( )NEFROPATIAS____ ( )OUTROS____________
MEDICAES EM USO DOMICILIAR: ANTECEDENTES ALRGICOS:
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HBITO DE SONO E REPOUSO:_____________________________________________________________________
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ELIMINAO URINRIA: ( )HBITO REGULAR___VEZES/DIA ( )HBITO IRREGULAR:________________

ELIMINAO INTESTINAL:

OBSERVAES GERAIS:
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Enfermeiro/Coren