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FICHA DE CONSULTA DE ROTINA NOS PRIMEIROS 6 MESES DE VIDA

NOME: ________________________________________________ IDADE ________________

MOTIVO DA CONSULTA ________________________________________________________


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Diurese _____/24 horas Evacuaes _____/24 horas Regurgitaes ______/24 horas
Caractersticas___________________________________________________________________
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Vacinao (1) completa (0) incompleta, falta(m) ________________________________________
Testes: Pezinho _________ Olhinho _________ Orelhinha __________ Corao ___________
Alimentao Leite materno exclusivo (0) no (1) sim N de mamadas/24 horas _____
Dificuldades para amamentar (0) no (1) sim Comentrios da me ou acompanhante ________
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Outros alimentos __________________________________________________________________
Dificuldades com outros alimentos ___________________________________________________
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Vitaminas _______________________________________________________________________
Sono ___________________________________________________________________________
Banho de sol ____________________________________________________________________

PESO ____ ESTATURA ____ PERMETRO CEFLICO ____ PER. ABDOMINAL ____

Desenvolvimento Reflexos transitrios do RN ( ) Moro ( ) Preenso palmar ( ) Preenso


plantar ( ) Suco ( ) Expulso ( ) Fossadura ( ) Esgrimista
Outros reflexos __________________________________________________________________
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Avaliao da audio reflexo ccleo-palpebral (0) no ____________________________ (1) sim

Aparelhos _______________________________________________________________________
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Fontanelas ______________________________________________________________________
Avaliao do quadril ( ) normal ( ) anormal __________________________________________
Dentes __________________________________________________________________________

Diagnsticos _____________________________________________________________________
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Condutas _______________________________________________________________________
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DATA: ____/____/_______ ___________________________________________