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Curativo
- 1. Dispensação de material para curativo domiciliar __/___/_____ __________________________ __/___/_____ __________________________ __/___/_____ __________________________ __/___/_____ __________________________ __/___/_____ __________________________ __/___/_____ __________________________ __/___/_____ __________________________ __/___/_____ __________________________ __/___/_____ __________________________ __/___/_____ __________________________ __/___/_____ __________________________ __/___/_____ __________________________ __/___/_____ __________________________ __/___/_____ __________________________ __/___/_____ __________________________ __/___/_____ __________________________ __/___/_____ __________________________ __/___/_____ __________________________ __/___/_____ __________________________ __/___/_____ __________________________ __/___/_____ __________________________ __/___/_____ __________________________ __/___/_____ __________________________ __/___/_____ __________________________ __/___/_____ __________________________ __/___/_____ __________________________ __/___/_____ __________________________ __/___/_____ __________________________ __/___/_____ __________________________ __/___/_____ __________________________ __/___/_____ __________________________ __/___/_____ __________________________ __/___/_____ __________________________ __/___/_____ __________________________ __/___/_____ __________________________ __/___/_____ __________________________ __/___/_____ __________________________ __/___/_____ __________________________ __/___/_____ __________________________ __/___/_____ __________________________ __/___/_____ __________________________ __/___/_____ __________________________ __/___/_____ __________________________ __/___/_____ __________________________ __/___/_____ __________________________ __/___/_____ __________________________ __/___/_____ __________________________ __/___/_____ __________________________ __/___/_____ __________________________ __/___/_____ __________________________ __/___/_____ __________________________ __/___/_____ __________________________ __/___/_____ __________________________ __/___/_____ __________________________ __/___/_____ __________________________ __/___/_____ __________________________ __/___/_____ __________________________ __/___/_____ __________________________ __/___/_____ __________________________ __/___/_____ __________________________ __/___/_____ __________________________ __/___/_____ __________________________ __/___/_____ __________________________ __/___/_____ _________________________ __/___/_____ _________________________ __/___/_____ _________________________ _______________________________________________ Assinatura da enfermeira responsável
- 2. Cadastro de paciente em curativo Nome:______________________________________________________________________________________ Endereço: ____________________________________________________________________________________ Data de nascimento:______/______/_________ idade:_________ Telefone:___________________________ Doenças/ Hábitos Hipertenso: ( ) sim ( )Não Cardíaco: ( ) sim ( )Não outros: ______________________ Diabético: ( ) sim ( )Não Vascular: ( ) sim ( )Não Fuma: ( ) sim ( )Não Historia da ferida:______________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ __________________________________________________________________________ Característica da ferida Medicações em uso/pomadas Alergias medicamentosa/pomadas ______________________________ ______________________________ ______________________________ ______________________________ ______________________________ ______________________________ Localização Extensão Tecido Exsudato Odor Epitelização Sim Fétido Granulação Pouco Característico Macerada Médio Sem odor Esfacelo Muito Necrose Debridamento Fibrina Não Cirúrgico UBS Regional Sul