Professional Documents
Culture Documents
DADOS PESSOAIS
I.
Identificao
Nome:________________________________________________________________________________
Idade:_____________anos
Escola:________________________________________________________________________________
Pai:___________________________________________________________________________________
Idade:_______________________Profisso Atual:_____________________________________________
Me:__________________________________________________________________________________
Idade:_________________________Profisso Atual:___________________________________________
II.
III.
1.
Antecedentes pessoais
Concepo
A criana foi desejada?_________Posio na ordem das gestaes:_________________________________
Posio na ordem dos nascimentos:__________________________________________________________
Abortos naturais: __________________________Provocados:____________________________________
Natimortos:_______________________________Filhos mortos:__________________________________
Causa mortis:_____________________________Idade:_________________________________________
ANAMNESE INFANTIL
GENETOGRAMA
2.
Gestao
Quanto tempo aps o casamento? ______________________ Enjoou quanto tempo? __________________
Vomitou quanto tempo?______________________________________________________
Quais as sensaes psicolgicas sentidas durante a gravidez?
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Quando sentiu a criana mexer e como reagiu a esta sensao?
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Fez pr-natal? ______________ Exame de Sangue?_____________ Urina?__________________________
Fez preparao para parto sem dor?__________________________________________________________
Tirou radiografias, em que ms e por qu?____________________________________________________
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Doenas durante a gestao: _______________________________________________________________
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Medicamentos durante a gestao: __________________________________________________________
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Observaes:____________________________________________________________________________
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3.
Condies do nascimento
Local: _________________________________________________________________________________
Desenvolvimento do parto: Natural ( )
Frceps ( )
Cesria ( )
seco ( )
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Posio do nascimento: de cabea ( )
de ndegas ( )
ombro ( )
transversal ( )
ANAMNESE INFANTIL
Primeiras reaes: chorou logo?________________ ficou roxo demais? ____________________________
Ficou preto? ___________ quanto tempo? ____________________Precisou de oxignio?______________
Reaes aps o primeiro dia de vida: Ficou ictrico? ____________________________________________
Observaes:
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4.
ANAMNESE INFANTIL
Atitude do desmame:
Seio: __________________________________________________________________________________
Mamadeira:_____________________________________________________________________________
Rejeitou alimentao alguma vez: __________________________________________________________
ou foi forado (a) a comer? ______________________________________________________________
Quando forado (a) vomitou? ______________________________________________________________
Atitude tomada: _________________________________________________________________________
ou foi super alimentado (a) ?______________________________________________________________
Observaes:____________________________________________________________________________
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DESENVOLVIMENTO
Quando ele (a): Sorriu:____________Engatinhou:_____________Sentou:___________Andou:__________
Ficou em p:__________Falou as primeiras palavras:_________Corretamente:_______________________
Trocou as letras?_________________________________________________________________________
Falou muito errado?________________________ Gaguejou?_____________________________________
Controle dos esfncteres: Anal diurno: _____________Vesical diurno:______________________________
Como foi ensinado o controle dos esfncteres?_________________________________________________
Dextro ou sinistro?_________________ Dentio:______________________________________________
Observaes:____________________________________________________________________________
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Brinca com crianas de sua idade, mais velhas ou mais novas? ___________________________________
Lidera nos brinquedos?____________Adapta-se bem ao meio? ___________________________________
Quem so os companheiros da criana?_______________________________________________________
Quem os escolhe?________________________________________________________________________
Observaes:____________________________________________________________________________
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Doenas: _______________________________________________________________________________
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Como passou?___________________________________________________________________________
Convulses?____________________________________________________________________________
Desmaios? _______________Ficou roxo alguma vez?___________________________________________
Ficou mole?_____________________Ficou duro?______________________________________________
Estagirio: Rodrigo Souza Walmeling
Pgina 4
ANAMNESE INFANTIL
Observaes:____________________________________________________________________________
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Foi operado (a), idade, qual e anestesia? ______________________________________________________
Vacinas?______________________________Febre?____________________________________________
Sofreu algum traumatismo?________________________________________________________________
Observaes:____________________________________________________________________________
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ANTECEDENTES FAMILIARES
Nervosismo? Quem? Como?_______________________________________________________________
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Dficit mental?__________________________________________________________________________
Doena mental?________Internado, quantas vezes?_________Sintomas ou diagnstico?_______________
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Alcoolismo?____________________________________________________________________________
Jogo?__________________________________________________________________________________
Fuga?__________________________________________________________________________________
MANIPULAES
Usou chupeta at quando?________________Chupou dedo at quando?_____________________________
Roeu ou ri unhas at quando?_________________________Puxa a orelha?_________________________
Arranca os cabelos?___________________________Morde os lbios?______________________________
Qual a atitude diante desses hbitos?_________________________________________________________
Tiques: ________________________________________________________________________________
Atitudes tomadas:________________________________________________________________________
Observaes:____________________________________________________________________________
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SEXUALIDADE
Curiosidade sexual?______________________________________________________________________
Atitude dos pais:_________________________________________________________________________
Masturbao, em que idade, frequncia? ______________________________________________________
Por quem feita a educao sexual, quando e como?____________________________________________
Observaes:____________________________________________________________________________
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Estagirio: Rodrigo Souza Walmeling
Pgina 5
ANAMNESE INFANTIL
SOCIABILIDADE
Tem companheiros os prefere brincar sozinho (a)? _____________________________________________
Faz amigos facilmente? _______________D-se bem com eles?___________________________________
Desinteressa-se logo dos brinquedos? ________ Que tipo de brinquedos/brincadeiras prefere?
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excessivamente cuidadoso (a) com seus brinquedos?___________________________________________
AMBIENTE FAMILIAR
Entre os pais: ___________________________________________________________________________
Entre a me e a criana: __________________________________________________________________
Entre o pai e a criana: ___________________________________________________________________
Entre os irmos: _________________________________________________________________________
Entre os avs e pais da criana: _____________________________________________________________
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Entre os pais e os demais irmos: ___________________________________________________________
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Entre os avs e a criana: __________________________________________________________________
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ESCOLARIDADE
Vai bem na escola?________Gosta de estudar?____________Os pais estudam com a criana?___________
Quer ser o primeiro aluno?______________________Gosta da professora?__________________________
castigado (a) quando no tira boas notas?___________________________________________________
Dificuldade em matemtica?_____________Leitura?___________Escrita?__________________________
Interpretao de texto?_________Memorizao?___________Ateno?__________Concentrao?_______
Alguma outra dificuldade?_________________________________________________________________
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Nervosismo excessivo em provas?_______________ irrequieto na classe?_________________________
Foi reprovado alguma vez? Por qu? _________________________________________________________
Esteve em escola infantil?__________Frequentou Jardim de Infncia?______________________________
Mudou muito de escola?___________________________________________________________________
Observaes:____________________________________________________________________________
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ANAMNESE INFANTIL
Pedir informaes sobre um dia da semana da criana, sua rotina, atividade; e um dia no final de semana.
(Resumido).
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