PRESENTACION DEL PACIENTE

Nombre: ___________________________________________________ Edad: _________

Lugar de origen: __________________________. Estado civil: ___________. Sexo (m) (f)

Descripcin del paciente: ____________________________________________________

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Dependencia: ______________________________________________________________
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Diagnostico Medico: ________________________________________________________

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Diagnostico Psiquitrico: ____________________________________________________

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Nutricin: ________________________________________________________________
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Evaluacin Psicosocial: ______________________________________________________

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Valoracin Espiritual: _______________________________________________________

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Evaluacin de Actividades: ___________________________________________________

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Consejeria: ________________________________________________________________
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 PROCESO SEMANAL DEL PACIENTE

Semana 1
Observaciones mdicas: _____________________________________________________
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Observaciones clnicas: ______________________________________________________
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Semana 2
Observaciones mdicas: _____________________________________________________
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Observaciones clnicas:______________________________________________________
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Semana 3
Observaciones mdicas: _____________________________________________________
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Observaciones clnicas: ______________________________________________________
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Semana 4
Observaciones mdicas/familia: _______________________________________________
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Observaciones clnicas: ______________________________________________________
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Semana 5
Recomendaciones mdicas:___________________________________________________
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Recomendaciones clnicas: ___________________________________________________
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Pacifica