CONSULTA PEDIÁTRICA

 SUBJETIVO

IDENTIFICAÇÃO

NOME: _______________________________________________________________________

IDADE: ________________________________ DN: ________________________________

PROCEDÊNCIA: ________________________________________________________________

MÃE: ________________________________________________________________________

ACOMPANHANTE:______________________________________________________________

QUEIXA PRINCIPAL:_____________________________________________________________

HMA:

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HISTÓRIA PATOLÓGICA PREGRESSA:

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ANTECEDENTES PERINATAIS:
GESTAÇÃO:
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PARTO: _______________________________________________________________________

APGAR: _______________________________________________________________________

PESO: COMPRIMENTO: PC: PT:

ICTERÍCIA: FOTOTERAPIA:

PERÍODO NEONATAL IMEDIATO:

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DESENVOLVIMENTO:

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ANTECEDENTES ALIMENTARES:

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HISTÓRIA DO SONO:

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TEMPO DE TELA: _______________________________________________________________

HISTÓRIA DAS ELIMINAÇÕES FISIOLÓGICAS:

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HISTÓRIA VACINAL:

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HISTÓRIA FAMILIAR:

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HISTÓRIA SOCIAL:

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 OBJETIVO

OBSERVAÇÕES/APARÊNCIA/AFETO:

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EXAME FÍSICO:

PESO: ESTATURA: IMC

PC: PT:

GERAL:

PELE:

CABEÇA:

PESCOÇO:

OROSCOPIA:

OTOSCOPIA:
CARDIOVASCULAR:

RESPIRATORIO:

ABDOMINAL:

GENITÁLIA:

RETO:

EXTREMIDADES E DORSO:

NEUROLÓGICO:

EXAMES COMPLEMENTARES:

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 AVALIAÇÃO

LISTA DE PROBLEMAS:

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IMPRESSÃO MÉDICA

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  PLANO
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