7/25/2019 FO Zi Chirurgie Final

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CHIRURGIE ONCOLOGICA -

INTERNARE de ZI

EXAMEN LOCAL

Tumora:____________________________________________________________________________________________________________________________________________________________________________________________________________________Adenopatii:________________________________________________________________________________________________________________________________________

Sist.Endocrin_________________________Ficat, splina, caibiliare______________________________________________________________________________________________Staregenerala________________________Stare denutritie_______________________Stare deconstienta____________________

Tuseuvaginal_________________________________________________________________________________________________________________________________________________________________________________Tuseu rectal,prostata___________________________________________________________________________________________________________________________________________________________________________

Altele______________________________

______________________________________

_

STATUS: RC RP STAT

PROGR

EXAMEN CLINIC GENERAL = normal

Tegumente simucoase________________________Fanere______________________________

Ap. Locomotor_______________________

Sist.ervos__________________________________Tes. con!unctivo"adipos_____________________________________________________________Ap.#espirator______________________________________________________________________________________________________________________________________________________________________________________________________________________________________Ap.$ardiovascular__________________________________________________________________________________________________________________________________________________

_________________________________________________________________________________Ap.

%igestiv______________________________________________________________________

_________________________________________________________________________________

TA & ' mm (g) A* & ' min ) Tranzit intestinal: prezent'absent) %iureza: prezenta'absenta) (emoragii

Evolutia (de la ultimul on!ult"# mot$vele internarii atuale:

_________________________________________________________________________

___________________________________________________________________________________________________________________________

___________________________________________________________________________________________________________________________

___________________________________________________________________________________________________________________________

%ia&no!ti la internare:''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''CO%

%RG''''''''''''ormulare li)era:

____________________________________________________________________________________________________________

*oli a!oiate:

______________________________________________________________________

_________________________________________________________________________________

A!i&urat+status asig tipasigurare+tip asig card national +csr card europ+nr ce ' nr. -asaport+nr pas ' Formular European +orm eur

/ME +nume -#E/ME++renumeSex: +M'F*irsta: +aniani $etatenie: +romana, x

$-: +$- $0: +$0 seria, nr

%omiciliu legal: +!udet'sector, localitate, str. , nr, bl, sc., ap

Mediul+/'# Stare civila: +st civ 1cupatia: +ocupatiaLoc munca: +locmunca

Teleon pacient: +telpac Apartinator re: +numeap teleon+telap

GRUP SINGE:+grup singe, #(

ALERGII

2. +alergie

3. +alergie

4.

5.

0naltimea: cm 6 &

%o!ar uni

nr, -Medic: +mediSectia: +C.IRURGIE/0dent8cator internare+identintTip internare:+codcriteriu+crit%ata internarii: +dataintern

%ata externarii: ___ ' ___ ' _____

$M la externare: ____ zile

7/25/2019 FO Zi Chirurgie Final

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EPICRI0A

Medi urant

CO%URI PROCE%URI:1,'''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''CO%''''''''''

''2,'''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''CO%''''''''''''3,'''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''CO%''''''''''

%&, +rini+al lae4ternare:''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''CO%''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''%&, !eundare:1,'''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''CO%''''''''''''2,'''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''CO%''''''''''

''3,'''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''CO%''''''''''''5,'''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''CO%''''''''''''6,'''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''CO%''''''''''''7,'''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''CO%''''''''''''8,'''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''CO%''''''''''''9,'''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''CO%''''''''''

Con!imtamantul +aientului-a+artinatoruluipentru toate investigatiile si tratamentele considerate necesare demedical curant 9inclusive transuzii sangvine'produse de sange, precum si cu interventia c;irurgicala propusa sianestezie, ale caror bene8cii, riscuri si posibile complicatii au ost explicate

ALTE EXAMENE %E SPECIALITATE:EXAMENE PARACLINICE -IMAGISTICE

ANTERIOARE INTERNARII: