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Outlook para Android</a>
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De: Formularios de Google<br>
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Enviado: mi=E9rcoles, 15 de mayo 12:44<br>
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Asunto: Registro de Atenci=F3n Domiciliaria Oncovida<br>
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Para: abdul2508@hotmail.com<br>
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Gracias por rellenar</table>
<a href=3D"https://docs.google.com/forms/d/e/1FAIpQLSdEtSr7xXzExpMb4RkiyPWKMwg1WaFIAImkCVv7UFdpPco75w/viewform?usp=3Dmail_form_link">
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Registro de Atenci=F3n Domiciliaria Oncovida</table>
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Esto es lo que nos has enviado:</table>
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Registro de Atenci=F3n Domiciliaria Oncovida</table>
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Este es el sistema de registro de atenciones domiciliarias de Oncovida. Debe ser llenado por el prestador individual, y debe realizarse un registro por cada visita domiciliaria. Si usted no es prestador de Oncovida por favor no llene este formulario. A continuaci=F3n indique su correo electr=F3nico.</table>
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Direcci=F3n de correo electr=F3nico *</table>
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abdul2508@hotmail.com</table>
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Identificaci=F3n del Prestador</table>
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Aqu=ED debe ingresar sus datos personales</table>
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Primer Nombre y Apellido Paterno *</table>
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Abdul sarria</table>
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RUT *</table>
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RUT con Gui=F3n y D=EDgito Verificador, sin puntos ( Ej: 5632200-k)</table>
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26743483-2</table>
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Tipo *</table>
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Si asisten m=E1s de 1 prestador simult=E1neamente, cada uno debe hacer un registro independiente</table>
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MEDICOENFERMERA/O TENSKINESIOLOGA/OPSICOLOGO NUTRICIONISTA</table>
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Identificaci=F3n del Paciente</table>
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En esta secci=F3n debe ingresar los datos del paciente visitado</table>
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Datos Personales del Paciente</table>
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Ingrese el Rut del Paciente *</table>
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RUT con Gui=F3n y D=EDgito Verificador, sin puntos ( Ej: 5632200-k)</table>
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5794927-9</table>
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Ingrese el Primer Nombre y Apellido Paterno del Paciente *</table>
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Luis diaz</table>
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Previsi=F3n *</table>
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BANMEDICA CAPREDENACOLMENA CONSALUDCRUZ BLANCADIPRECA FONASAFUNDACIONISAPRES DEL COBRE NUEVA MASVIDAVIDATRES PARTICULAR</table>
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Ciudad *</table>
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Antofagasta</table>
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Comuna *</table>
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Antofagasta</table>
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Registro de la Atenci=F3n Domiciliaria</table>
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En esta secci=F3n debe ingresar los datos de la atenci=F3n domiciliaria</table>
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Tipo de Atenci=F3n *</table>
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Domicilio Ambulatorio</table>
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Fecha de la Atenci=F3n *</table>
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D=EDa1234 56789 101112 13 141516 17181920 212223 24252627 282930 31 Mesenero febreromarzo abrilmayo juniojulio agostoseptiembre octubrenoviembre diciembre A=F1o1896 18971898 18991900 19011902 19031904 19051906 19071908 19091910 19111912 19131914 19151916 19171918 19191920 19211922 19231924 19251926 19271928 19291930 19311932 19331934 19351936 19371938 19391940 19411942 19431944 19451946 19471948 19491950 19511952 19531954 19551956 19571958 19591960 19611962 19631964 19651966 19671968 19691970 19711972 19731974 19751976 19771978 19791980 19811982 19831984 19851986 19871988 19891990 19911992 19931994 19951996 19971998 19992000 20012002 20032004 20052006 20072008 20092010 20112012 20132014 20152016 20172018 20192020 20212022 20232024 20252026 20272028 20292030 20312032 20332034 20352036 20372038 20392040 20412042 20432044 20452046 20472048 20492050 20512052 20532054 20552056 20572058 20592060 20612062 20632064 20652066 20672068 2069</table>
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Hora de la Atenci=F3n *</table>
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h0001 02030405 060708 09101112 13141516 171819 20212223 : min00 010203 04050607 080910 11121314 151617 18192021 222324 25262728 293031 32333435 363738 39404142 434445 46474849 505152 53545556 575859</table>
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Performance Status ECOG del Paciente *</table>
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0 12 34</table>
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Escala Dolor EVA Actual</table>
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<td rowspan=3D"1" colspan=3D"1">
</td>
</tr>
<tr>
</tr>
</tbody>
</table>
<table width=3D"100%" cellpadding=3D"0" cellspacing=3D"0" style=3D"background-color:#fff">
0</table>
<table id=3D"entry_1421689035" border=3D"0" cellpadding=3D"5" cellspacing==3D"0">
<tbody>
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</tr>
</tbody>
</table>
<table width=3D"100%" cellpadding=3D"0" cellspacing=3D"0" style=3D"background-color:#fff">
1</table>
<table id=3D"entry_1421689035" border=3D"0" cellpadding=3D"5" cellspacing==3D"0">
<tbody>
<tr>
<td rowspan=3D"1" colspan=3D"1">
</td>
</tr>
<tr>
</tr>
</tbody>
</table>
<table width=3D"100%" cellpadding=3D"0" cellspacing=3D"0" style=3D"background-color:#fff">
2</table>
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<tbody>
<tr>
<td rowspan=3D"1" colspan=3D"1">
</td>
</tr>
<tr>
</tr>
</tbody>
</table>
<table width=3D"100%" cellpadding=3D"0" cellspacing=3D"0" style=3D"background-color:#fff">
3</table>
<table id=3D"entry_1421689035" border=3D"0" cellpadding=3D"5" cellspacing==3D"0">
<tbody>
<tr>
<td rowspan=3D"1" colspan=3D"1">
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<tr>
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</tbody>
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<table width=3D"100%" cellpadding=3D"0" cellspacing=3D"0" style=3D"background-color:#fff">
4</table>
<table id=3D"entry_1421689035" border=3D"0" cellpadding=3D"5" cellspacing==3D"0">
<tbody>
<tr>
<td rowspan=3D"1" colspan=3D"1">
</td>
</tr>
<tr>
</tr>
</tbody>
</table>
<table width=3D"100%" cellpadding=3D"0" cellspacing=3D"0" style=3D"background-color:#fff">
5</table>
<table id=3D"entry_1421689035" border=3D"0" cellpadding=3D"5" cellspacing==3D"0">
<tbody>
<tr>
<td rowspan=3D"1" colspan=3D"1">
</td>
</tr>
<tr>
</tr>
</tbody>
</table>
<table width=3D"100%" cellpadding=3D"0" cellspacing=3D"0" style=3D"background-color:#fff">
6</table>
<table id=3D"entry_1421689035" border=3D"0" cellpadding=3D"5" cellspacing==3D"0">
<tbody>
<tr>
<td rowspan=3D"1" colspan=3D"1">
</td>
</tr>
<tr>
</tr>
</tbody>
</table>
<table width=3D"100%" cellpadding=3D"0" cellspacing=3D"0" style=3D"background-color:#fff">
7</table>
<table id=3D"entry_1421689035" border=3D"0" cellpadding=3D"5" cellspacing==3D"0">
<tbody>
<tr>
<td rowspan=3D"1" colspan=3D"1">
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<tr>
</tr>
</tbody>
</table>
<table width=3D"100%" cellpadding=3D"0" cellspacing=3D"0" style=3D"background-color:#fff">
8</table>
<table id=3D"entry_1421689035" border=3D"0" cellpadding=3D"5" cellspacing==3D"0">
<tbody>
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</tbody>
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9</table>
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<tbody>
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10</table>
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<tbody>
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<td rowspan=3D"1" colspan=3D"1">
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</tbody>
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</table>
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Escala Dolor EVA M=E1ximo</table>
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<tbody>
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<td rowspan=3D"1" colspan=3D"1">
</td>
</tr>
<tr>
</tr>
</tbody>
</table>
<table width=3D"100%" cellpadding=3D"0" cellspacing=3D"0" style=3D"background-color:#fff">
0</table>
<table id=3D"entry_1244707512" border=3D"0" cellpadding=3D"5" cellspacing==3D"0">
<tbody>
<tr>
<td rowspan=3D"1" colspan=3D"1">
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Escala Dolor EVA M=EDnimo</table>
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5</table>
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7</table>
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8</table>
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9</table>
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10</table>
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<table width=3D"100%" cellpadding=3D"0" cellspacing=3D"0" style=3D"background-color:#fff">
Anamnesis/Evoluci=F3n *</table>
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</div>
<div dir=3D"auto" style=3D"direction: ltr; margin: 0; padding: 0; font-family: sans-serif; font-size: 11pt; color: black; ">
<table width=3D"100%" cellpadding=3D"0" cellspacing=3D"0" style=3D"background-color:#fff">
paciente de 73 a=F1os de edad, con HTA controlada, con DX de CA en estudio desde el 11 de marzo 2019 por reporte de biopsia de extracci=F3n de adenopatia considerable a nivel inguinal derecha : met=E1stasis linfodonal masiva carcinoma solido invasor poco diferenciado con necrosis tumoral y extensi=F3n, con foco a identificar, con m=FAltiples estudios imagenologicos endoscopia-colonoscopia -cistoscopia y tomograf==EDa generalizada cuyos reportes son normales, inicio de quimiotierapia 26/4/2019 1/6 GEMCITABINA -CARBOPLATINO, en el momento con mejor=EDa de lesiones de caracter=EDsticas de reacci=F3n al=E9rgica, en tto con cam una cada 8h, adem=E1s con plt de 77.000 por lo que el oncologo aplaz=F3 quimioterapia hasta buen control de plaquetas y descartar alergia a la quimioterapia, sin nuevos episodios de fiebre, tolera via oral funcional, no hay compromiso del sue==F1o, niega nauseas, paciente luce en buenas condiciones aparentes.</table>
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Examen F=EDsico *</table>
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<div dir=3D"auto" style=3D"direction: ltr; margin: 0; padding: 0; font-family: sans-serif; font-size: 11pt; color: black; ">
<table width=3D"100%" cellpadding=3D"0" cellspacing=3D"0" style=3D"background-color:#fff">
paciente en buenas condiciones, sin signos de dificultad respiratoria, no dolor agudo, colaborador, orientado en sus tres esferas mentales, con svt ta 130/70 fc 77 fr 17 sto 96% t36 cabeza y cuello sin adenopatias, escleras anictericas, conjuntivas rosadas, mucosas hidratadas, cat=E9ter para quimioterapia localizado en hombro derecho sin signos inflamatorios locales, ruidos card=EDacos r=EDtmicos y regulares no se auscultan soplos, campos pulmonares bien ventilados sin sobre agregados, abdomen globoso no doloroso peristaltismo normal, con cicatriz QX en zona inguinal derecha sana, se evidencia edema pelvico doloroso a la palpaci=F3n profunda leve, con edema testicular de gran tama=F1o que compromete zona del pene con igual dolor leve a la movilizaci=F3n, no es posible palpar test=EDculos por igual edema, lesiones m=E1cula hipercromicas secuelas de reacci=F3n al=E9rgica con lesiones inguinal es excoriativas con buena evoluci=F3n sin signos de sobreinfeccion, extremidades m=F3viles sim=E9tricas sin edemas pulsos presentes, piel sin otras lesiones evidentes. glasgow 15/15</table>
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Diagn=F3stico *</table>
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Ca de origen desconocido en tto</table>
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Plan de Tratamiento e Indicaciones *</table>
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</div>
<div dir=3D"auto" style=3D"direction: ltr; margin: 0; padding: 0; font-family: sans-serif; font-size: 11pt; color: black; ">
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Paciente con mejor=EDa de reacci=F3n al=E9rgicas y lesi=F3nes inguinales, se educa sobre buena higiene y mantener zona limpia de lesiones, se suspende tto atb y antihistam=EDnicos por orden de oncologo e inicia cam, en buenas condiciones, seguir igual manejo para el dolor en caso de dolor. Pendiente pr=F3xima quimioterapia, definir alergia?.</table>
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Medicamentos Indicados</table>
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Paracetamol 500MG sos</table>
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Fecha aproximada del Pr=F3ximo Control con usted</table>
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D=EDa1234 56789 101112 13141516 171819 20212223 24252627 282930 31 Mesenero febreromarzo abrilmayo juniojulio agostoseptiembre octubrenoviembre diciembre A=F1o1896 18971898 18991900 19011902 19031904 19051906 19071908 19091910 19111912 19131914 19151916 19171918 19191920 19211922 19231924 19251926 19271928 19291930 19311932 19331934 19351936 19371938 19391940 19411942 19431944 19451946 19471948 19491950 19511952 19531954 19551956 19571958 19591960 19611962 19631964 19651966 19671968 19691970 19711972 19731974 19751976 19771978 19791980 19811982 19831984 19851986 19871988 19891990 19911992 19931994 19951996 19971998 19992000 20012002 20032004 20052006 20072008 20092010 20112012 20132014 20152016 20172018 20192020 20212022 20232024 20252026 20272028 20292030 20312032 20332034 20352036 20372038 20392040 20412042 20432044 20452046 20472048 20492050 20512052 20532054 20552056 20572058 20592060 20612062 20632064 20652066 20672068 2069</table>
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Tratamiento Realizado (si corresponde)</table>
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Derivaci=F3n a otro Prestador Domiciliario</table>
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S=F3lo llene esta secci=F3n si es m=E9dico y solicita la visita de otro prestador del equipo</table>
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ENFERMERA TENS NUTRICIONISTA KINESIOLOGO PSICOLOGO</table>
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Crea tu propio formulario de Google</table>
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