<div dir=3D"ltr">
Estimados, adjunto informe de Francisco Soares-Duarte.=C2==A0<br>
Atte.=C2=A0<br>
Viviana Zevallos Ananias<br>
Enfermera=C2=A0=C2=A0<br>
<br>
<div class=3D"gmail_quote">
<div dir=3D"ltr" class=3D"gmail_attr">
---------- Forwarded message ---------<br>
From: <strong class=3D"gmail_sendername" dir=3D"auto">
Formularios de Google</strong>
 <span dir=3D"auto">
&lt;<a href=3D"mailto:forms-receipts-noreply@google.com">
forms-receipts-noreply@google.com</a>
&gt;</span>
<br>
Date: Wed, Aug 7, 2019 at 3:55 AM<br>
Subject: Registro de Atenci=C3=B3n Domiciliaria Oncovida<br>
To:  &lt;<a href=3D"mailto:vivianazevallos@gmail.com">
vivianazevallos@gmail.com</a>
&gt;<br>
</div>
<br>
<br>
<div style=3D"font-family:Roboto,Helvetica,Arial,sans-serif;margin:0;padding:0;height:100%;width:100%">
<table border=3D"0" cellpadding=3D"0" cellspacing=3D"0" style=3D"background-color:rgb(38,4,154)" width=3D"100%">
<tbody>
<tr height=3D"64px">
<td style=3D"padding-left:24px">
<img alt=3D"Formularios de Google" height=3D"26px" style=3D"display:inline-block;margin:0;vertical-align:middle" width=3D"143px" src=3D"https://www.gstatic.com/docs/forms/google_forms_logo_lockup_white_2x.png">
</td>
</tr>
</tbody>
</table>
<div style=3D"padding:24px;background-color:rgb(229,218,254)">
<div align=3D"center" style=3D"background-color:#fff;border-bottom:1px solid #e0e0e0;margin:0 auto;max-width:624px;min-width:154px;padding:0 24px">
<table align=3D"center" cellpadding=3D"0" cellspacing=3D"0" style=3D"background-color:#fff" width=3D"100%">
<tbody>
<tr height=3D"24px">
<td>
</td>
</tr>
<tr>
<td>
<div style=3D"font-size:13px;line-height:18px;color:#424242;font-weight:700">
Gracias por rellenar <a href=3D"https://docs.google.com/forms/d/e/1FAIpQLSdEtSr7xXzExpMb4RkiyPWKMwg1WaFIAImkCVv7UFdpPco75w/viewform?usp=3Dmail_form_link" target=3D"_blank">
Registro de Atenci=C3=B3n Domiciliaria Oncovida</a>
</div>
</td>
</tr>
<tr height=3D"12px">
</tr>
<tr>
<td>
<div style=3D"font-size:13px;line-height:18px;color:#424242">
Esto es lo que nos has enviado:</div>
</td>
</tr>
<tr>
<td>
<div class=3D"m_380496404602365929ss-form-container">
<div class=3D"m_380496404602365929ss-form-heading">
<h1 class=3D"m_380496404602365929ss-form-title" dir=3D"ltr" style=3D"margin:.67em 0">
Registro de Atenci=C3=B3n Domiciliaria Oncovida</h1>
<div class=3D"m_380496404602365929ss-form-desc m_380496404602365929ss-no-ignore-whitespace" style=3D"font:inherit;width:99%;margin:0 0 1em;white-space:pre-wrap;word-wrap:break-word">
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=C3=B3n indique su correo electr=C3=B3nico.</div>
</div>
<div class=3D"m_380496404602365929ss-form">
<form method=3D"GET" id=3D"m_380496404602365929ss-form" target=3D"_blank">
<br>
<div class=3D"m_380496404602365929ss-form-question m_380496404602365929errorbox-good">
<div dir=3D"auto" class=3D"m_380496404602365929ss-item m_380496404602365929ss-item-required m_380496404602365929ss-text" style=3D"margin:12px 0">
<div class=3D"m_380496404602365929ss-form-entry" style=3D"margin-bottom:1.5em;vertical-align:middle;margin-left:0;margin-top:0;max-width:100%">
<label class=3D"m_380496404602365929ss-q-item-label" for=3D"m_380496404602365929emailAddress">
<div class=3D"m_380496404602365929ss-q-title" style=3D"display:block;font-weight:bold;margin-top:.83em;margin-bottom:.83em">
Direcci=C3=B3n de correo electr=C3=B3nico<label for=3D"m_380496404602365929emailAddress">
</label>
<span class=3D"m_380496404602365929ss-required-asterisk" style=3D"color:#c43b1d">
*</span>
</div>
</label>
<div class=3D"m_380496404602365929ss-q-text m_380496404602365929ss-printable-text-line" dir=3D"auto" style=3D"background-color:#eee;max-width:90%;border:1px solid #c0c0c0;padding:5px;white-space:pre-wrap;color:#545454;width:70%">
<a href=3D"mailto:vivianazevallos@gmail.com" target=3D"_blank">
vivianazevallos@gmail.com</a>
</div>
</div>
</div>
</div>
<div class=3D"m_380496404602365929errorbox-good">
<div dir=3D"auto" class=3D"m_380496404602365929ss-item m_380496404602365929ss-embeddable-object-container" style=3D"margin:12px 0;max-width:100%">
<div class=3D"m_380496404602365929ss-form-entry" style=3D"margin-bottom:1.5em;vertical-align:middle;margin-left:0;margin-top:0;max-width:100%">
<h2 class=3D"m_380496404602365929ss-q-title" style=3D"display:block;font-weight:bold;margin-top:.83em;margin-bottom:.83em">
</h2>
<div style=3D"text-align:right">
<img class=3D"m_380496404602365929ss-image" title=3D"" src=3D"https://lh3.googleusercontent.com/00-FWRRIiJNpjLIXj1QrTLVceHhiPxWpIN-K4cI0enEtAvmFFnvOHRJTMz5Lq8yFpMHz7WvBnNdiNVchE6Snklpxxc7gIx3OoqTfn_sB2_iSp_6sx7Sr2pww-0pD" style=3D"width:78px;outline:none" alt=3D"Imagen sin leyenda">
</div>
</div>
</div>
</div>
<br>
 <div class=3D"m_380496404602365929errorbox-good">
<div dir=3D"auto" class=3D"m_380496404602365929ss-item m_380496404602365929ss-page-break" style=3D"margin:12px 0">
<div class=3D"m_380496404602365929ss-form-entry" style=3D"margin-bottom:1.5em;vertical-align:middle;margin-left:0;margin-top:0;max-width:100%">
<h2 class=3D"m_380496404602365929ss-page-title" style=3D"padding:0.4em;background-color:#eee">
Identificaci=C3=B3n del Prestador</h2>
<div class=3D"m_380496404602365929ss-page-description m_380496404602365929ss-no-ignore-whitespace" dir=3D"auto" style=3D"white-space:pre-wrap;word-wrap:break-word">
Aqu=C3=AD debe ingresar sus datos personales</div>
</div>
</div>
</div>
<br>
 <div class=3D"m_380496404602365929ss-form-question m_380496404602365929errorbox-good">
<div dir=3D"auto" class=3D"m_380496404602365929ss-item m_380496404602365929ss-item-required m_380496404602365929ss-text" style=3D"margin:12px 0">
<div class=3D"m_380496404602365929ss-form-entry" style=3D"margin-bottom:1.5em;vertical-align:middle;margin-left:0;margin-top:0;max-width:100%">
<label class=3D"m_380496404602365929ss-q-item-label" for=3D"m_380496404602365929entry_579114469">
<div class=3D"m_380496404602365929ss-q-title" style==3D"display:block;font-weight:bold;margin-top:.83em;margin-bottom:.83em">
Primer Nombre y Apellido Paterno<label for=3D"m_380496404602365929itemView.getDomIdToLabel()">
</label>
<span class=3D"m_380496404602365929ss-required-asterisk" style=3D"color:#c43b1d">
*</span>
</div>
<div class=3D"m_380496404602365929ss-q-help m_380496404602365929ss-secondary-text" dir=3D"auto" style=3D"display:block;margin:.1em 0 .25em 0;color:#666">
</div>
</label>
<div class=3D"m_380496404602365929ss-q-text" dir=3D"auto" style=3D"background-color:#eee;max-width:90%;border:1px solid #c0c0c0;padding:5px;white-space:pre-wrap;color:#545454;width:70%">
Viviana Zevallos</div>
</div>
</div>
</div>
<br>
 <div class=3D"m_380496404602365929ss-form-question m_380496404602365929errorbox-good">
<div dir=3D"auto" class=3D"m_380496404602365929ss-item m_380496404602365929ss-item-required m_380496404602365929ss-text" style=3D"margin:12px 0">
<div class=3D"m_380496404602365929ss-form-entry" style=3D"margin-bottom:1.5em;vertical-align:middle;margin-left:0;margin-top:0;max-width:100%">
<label class=3D"m_380496404602365929ss-q-item-label" for=3D"m_380496404602365929entry_1276273985">
<div class=3D"m_380496404602365929ss-q-title" style==3D"display:block;font-weight:bold;margin-top:.83em;margin-bottom:.83em">
RUT<label for=3D"m_380496404602365929itemView.getDomIdToLabel()">
</label>
<span class=3D"m_380496404602365929ss-required-asterisk" style=3D"color:#c43b1d">
*</span>
</div>
<div class=3D"m_380496404602365929ss-q-help m_380496404602365929ss-secondary-text" dir=3D"auto" style=3D"display:block;margin:.1em 0 .25em 0;color:#666">
RUT con Gui=C3=B3n y D=C3=ADgito Verificador, sin puntos ( Ej: 5632200-k)</div>
</label>
<div class=3D"m_380496404602365929ss-q-text" dir=3D"auto" style=3D"background-color:#eee;max-width:90%;border:1px solid #c0c0c0;padding:5px;white-space:pre-wrap;color:#545454;width:70%">
18413659-7</div>
</div>
</div>
</div>
<br>
 <div class=3D"m_380496404602365929ss-form-question m_380496404602365929errorbox-good">
<div dir=3D"auto" class=3D"m_380496404602365929ss-item m_380496404602365929ss-item-required m_380496404602365929ss-select" style=3D"margin:12px 0">
<div class=3D"m_380496404602365929ss-form-entry" style=3D"margin-bottom:1.5em;vertical-align:middle;margin-left:0;margin-top:0;max-width:100%">
<label class=3D"m_380496404602365929ss-q-item-label" for=3D"m_380496404602365929entry_133691676">
<div class=3D"m_380496404602365929ss-q-title" style==3D"display:block;font-weight:bold;margin-top:.83em;margin-bottom:.83em">
Tipo<label for=3D"m_380496404602365929itemView.getDomIdToLabel()">
</label>
<span class=3D"m_380496404602365929ss-required-asterisk" style=3D"color:#c43b1d">
*</span>
</div>
<div class=3D"m_380496404602365929ss-q-help m_380496404602365929ss-secondary-text" dir=3D"auto" style=3D"display:block;margin:.1em 0 .25em 0;color:#666">
Si asisten m=C3=A1s de 1 prestador simult=C3=A1neamente, cada uno debe hacer un registro independiente</div>
</label>
<select name=3D"entry.133691676" disabled id=3D"m_380496404602365929entry_133691676">
<option value=3D"">
</option>
<option value=3D"MEDICO" disabled>
MEDICO</option>
 <option value=3D"ENFERMERA/O" disabled selected>
ENFERMERA/O</option>
 <option value=3D"TENS" disabled>
TENS</option>
 <option value=3D"KINESIOLOGA/O" disabled>
KINESIOLOGA/O</option>
 <option value=3D"PSICOLOGO" disabled>
PSICOLOGO</option>
 <option value==3D"NUTRICIONISTA" disabled>
NUTRICIONISTA</option>
</select>
</div>
</div>
</div>
<br>
 <div class=3D"m_380496404602365929errorbox-good">
<div dir=3D"auto" class=3D"m_380496404602365929ss-item m_380496404602365929ss-embeddable-object-container" style=3D"margin:12px 0;max-width:100%">
<div class=3D"m_380496404602365929ss-form-entry" style=3D"margin-bottom:1.5em;vertical-align:middle;margin-left:0;margin-top:0;max-width:100%">
<h2 class=3D"m_380496404602365929ss-q-title" style=3D"display:block;font-weight:bold;margin-top:.83em;margin-bottom:.83em">
</h2>
<div style=3D"text-align:right">
<img class=3D"m_380496404602365929ss-image" title=3D"" src=3D"https://lh3.googleusercontent.com/mRJInQVKRU12r9blREv2jmlzETLT9JfIHWC0FaeXYfPraPFE9ebBRX8P_hmpfiBP6BNpOgjPBYU0zwBxYxgoLvjQ7EjfjoRTJ2_-8flTaiU_wC008XC8LpcEJ_Yp" style=3D"width:78px;outline:none" alt=3D"Imagen sin leyenda">
</div>
</div>
</div>
</div>
<br>
 <div class=3D"m_380496404602365929errorbox-good">
<div dir=3D"auto" class=3D"m_380496404602365929ss-item m_380496404602365929ss-page-break" style=3D"margin:12px 0">
<div class=3D"m_380496404602365929ss-form-entry" style=3D"margin-bottom:1.5em;vertical-align:middle;margin-left:0;margin-top:0;max-width:100%">
<h2 class=3D"m_380496404602365929ss-page-title" style=3D"padding:0.4em;background-color:#eee">
Identificaci=C3=B3n del Paciente</h2>
<div class=3D"m_380496404602365929ss-page-description m_380496404602365929ss-no-ignore-whitespace" dir=3D"auto" style=3D"white-space:pre-wrap;word-wrap:break-word">
En esta secci=C3=B3n debe ingresar los datos del paciente visitado</div>
</div>
</div>
</div>
<br>
 <div class=3D"m_380496404602365929errorbox-good">
<div dir=3D"auto" class=3D"m_380496404602365929ss-item m_380496404602365929ss-section-header" style=3D"margin:12px 0">
<div class=3D"m_380496404602365929ss-form-entry" style=3D"margin-bottom:1.5em;vertical-align:middle;margin-left:0;margin-top:0;max-width:100%">
<h2 class=3D"m_380496404602365929ss-section-title" style=3D"background-color:#eee;padding:0.4em">
Datos Personales del Paciente</h2>
<div class=3D"m_380496404602365929ss-section-description m_380496404602365929ss-no-ignore-whitespace" style=3D"margin-top:0.5em;white-space:pre-wrap;word-wrap:break-word">
</div>
</div>
</div>
</div>
<br>
 <div class=3D"m_380496404602365929ss-form-question m_380496404602365929errorbox-good">
<div dir=3D"auto" class=3D"m_380496404602365929ss-item m_380496404602365929ss-item-required m_380496404602365929ss-text" style=3D"margin:12px 0">
<div class=3D"m_380496404602365929ss-form-entry" style=3D"margin-bottom:1.5em;vertical-align:middle;margin-left:0;margin-top:0;max-width:100%">
<label class=3D"m_380496404602365929ss-q-item-label" for=3D"m_380496404602365929entry_823811303">
<div class=3D"m_380496404602365929ss-q-title" style==3D"display:block;font-weight:bold;margin-top:.83em;margin-bottom:.83em">
Ingrese el Rut del Paciente<label for=3D"m_380496404602365929itemView.getDomIdToLabel()">
</label>
<span class=3D"m_380496404602365929ss-required-asterisk" style=3D"color:#c43b1d">
*</span>
</div>
<div class=3D"m_380496404602365929ss-q-help m_380496404602365929ss-secondary-text" dir=3D"auto" style=3D"display:block;margin:.1em 0 .25em 0;color:#666">
RUT con Gui=C3=B3n y D=C3=ADgito Verificador, sin puntos ( Ej: 5632200-k)</div>
</label>
<div class=3D"m_380496404602365929ss-q-text" dir=3D"auto" style=3D"background-color:#eee;max-width:90%;border:1px solid #c0c0c0;padding:5px;white-space:pre-wrap;color:#545454;width:70%">
23372096-8</div>
</div>
</div>
</div>
<br>
 <div class=3D"m_380496404602365929ss-form-question m_380496404602365929errorbox-good">
<div dir=3D"auto" class=3D"m_380496404602365929ss-item m_380496404602365929ss-item-required m_380496404602365929ss-text" style=3D"margin:12px 0">
<div class=3D"m_380496404602365929ss-form-entry" style=3D"margin-bottom:1.5em;vertical-align:middle;margin-left:0;margin-top:0;max-width:100%">
<label class=3D"m_380496404602365929ss-q-item-label" for=3D"m_380496404602365929entry_1959365839">
<div class=3D"m_380496404602365929ss-q-title" style==3D"display:block;font-weight:bold;margin-top:.83em;margin-bottom:.83em">
Ingrese el Primer Nombre y Apellido Paterno del Paciente<label for=3D"m_380496404602365929itemView.getDomIdToLabel()">
</label>
<span class=3D"m_380496404602365929ss-required-asterisk" style=3D"color:#c43b1d">
*</span>
</div>
<div class=3D"m_380496404602365929ss-q-help m_380496404602365929ss-secondary-text" dir=3D"auto" style=3D"display:block;margin:.1em 0 .25em 0;color:#666">
</div>
</label>
<div class=3D"m_380496404602365929ss-q-text" dir=3D"auto" style=3D"background-color:#eee;max-width:90%;border:1px solid #c0c0c0;padding:5px;white-space:pre-wrap;color:#545454;width:70%">
Francisco Soares-Duarte</div>
</div>
</div>
</div>
<br>
 <div class=3D"m_380496404602365929ss-form-question m_380496404602365929errorbox-good">
<div dir=3D"auto" class=3D"m_380496404602365929ss-item m_380496404602365929ss-item-required m_380496404602365929ss-select" style=3D"margin:12px 0">
<div class=3D"m_380496404602365929ss-form-entry" style=3D"margin-bottom:1.5em;vertical-align:middle;margin-left:0;margin-top:0;max-width:100%">
<label class=3D"m_380496404602365929ss-q-item-label" for=3D"m_380496404602365929entry_545002227">
<div class=3D"m_380496404602365929ss-q-title" style==3D"display:block;font-weight:bold;margin-top:.83em;margin-bottom:.83em">
Previsi=C3=B3n<label for=3D"m_380496404602365929itemView.getDomIdToLabel()">
</label>
<span class=3D"m_380496404602365929ss-required-asterisk" style=3D"color:#c43b1d">
*</span>
</div>
<div class=3D"m_380496404602365929ss-q-help m_380496404602365929ss-secondary-text" dir=3D"auto" style=3D"display:block;margin:.1em 0 .25em 0;color:#666">
</div>
</label>
<select name=3D"entry.545002227" disabled id=3D"m_380496404602365929entry_545002227">
<option value=3D"">
</option>
<option value=3D"BANMEDICA" disabled>
BANMEDICA</option>
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CAPREDENA</option>
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COLMENA</option>
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CONSALUD</option>
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CRUZ BLANCA</option>
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DIPRECA</option>
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FONASA</option>
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FUNDACION</option>
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ISAPRES DEL COBRE</option>
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NUEVA MASVIDA</option>
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VIDATRES</option>
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PARTICULAR</option>
</select>
</div>
</div>
</div>
<br>
 <div class=3D"m_380496404602365929ss-form-question m_380496404602365929errorbox-good">
<div dir=3D"auto" class=3D"m_380496404602365929ss-item m_380496404602365929ss-item-required m_380496404602365929ss-text" style=3D"margin:12px 0">
<div class=3D"m_380496404602365929ss-form-entry" style=3D"margin-bottom:1.5em;vertical-align:middle;margin-left:0;margin-top:0;max-width:100%">
<label class=3D"m_380496404602365929ss-q-item-label" for=3D"m_380496404602365929entry_1900161356">
<div class=3D"m_380496404602365929ss-q-title" style==3D"display:block;font-weight:bold;margin-top:.83em;margin-bottom:.83em">
Ciudad<label for=3D"m_380496404602365929itemView.getDomIdToLabel()">
</label>
<span class=3D"m_380496404602365929ss-required-asterisk" style=3D"color:#c43b1d">
*</span>
</div>
<div class=3D"m_380496404602365929ss-q-help m_380496404602365929ss-secondary-text" dir=3D"auto" style=3D"display:block;margin:.1em 0 .25em 0;color:#666">
</div>
</label>
<div class=3D"m_380496404602365929ss-q-text" dir=3D"auto" style=3D"background-color:#eee;max-width:90%;border:1px solid #c0c0c0;padding:5px;white-space:pre-wrap;color:#545454;width:70%">
Concepci=C3=B3n</div>
</div>
</div>
</div>
<br>
 <div class=3D"m_380496404602365929ss-form-question m_380496404602365929errorbox-good">
<div dir=3D"auto" class=3D"m_380496404602365929ss-item m_380496404602365929ss-item-required m_380496404602365929ss-text" style=3D"margin:12px 0">
<div class=3D"m_380496404602365929ss-form-entry" style=3D"margin-bottom:1.5em;vertical-align:middle;margin-left:0;margin-top:0;max-width:100%">
<label class=3D"m_380496404602365929ss-q-item-label" for=3D"m_380496404602365929entry_1298871758">
<div class=3D"m_380496404602365929ss-q-title" style==3D"display:block;font-weight:bold;margin-top:.83em;margin-bottom:.83em">
Comuna<label for=3D"m_380496404602365929itemView.getDomIdToLabel()">
</label>
<span class=3D"m_380496404602365929ss-required-asterisk" style=3D"color:#c43b1d">
*</span>
</div>
<div class=3D"m_380496404602365929ss-q-help m_380496404602365929ss-secondary-text" dir=3D"auto" style=3D"display:block;margin:.1em 0 .25em 0;color:#666">
</div>
</label>
<div class=3D"m_380496404602365929ss-q-text" dir=3D"auto" style=3D"background-color:#eee;max-width:90%;border:1px solid #c0c0c0;padding:5px;white-space:pre-wrap;color:#545454;width:70%">
Hualpen</div>
</div>
</div>
</div>
<br>
 <div class=3D"m_380496404602365929errorbox-good">
<div dir=3D"auto" class=3D"m_380496404602365929ss-item m_380496404602365929ss-embeddable-object-container" style=3D"margin:12px 0;max-width:100%">
<div class=3D"m_380496404602365929ss-form-entry" style=3D"margin-bottom:1.5em;vertical-align:middle;margin-left:0;margin-top:0;max-width:100%">
<h2 class=3D"m_380496404602365929ss-q-title" style=3D"display:block;font-weight:bold;margin-top:.83em;margin-bottom:.83em">
</h2>
<div style=3D"text-align:right">
<img class=3D"m_380496404602365929ss-image" title=3D"" src=3D"https://lh6.googleusercontent.com/URytM0QWRGW_JEL0xQxvOLvwPRJIHyqlnKOm6ky9DRBfzvYVPaAngXV35GNHnaVG-dm9Orno4lr8sy8E-KB9tMrmIhFbVQiOPWy3vUclqRKAJ51dvLdhjBKgXdLO" style=3D"width:78px;outline:none" alt=3D"Imagen sin leyenda">
</div>
</div>
</div>
</div>
<br>
 <div class=3D"m_380496404602365929errorbox-good">
<div dir=3D"auto" class=3D"m_380496404602365929ss-item m_380496404602365929ss-page-break" style=3D"margin:12px 0">
<div class=3D"m_380496404602365929ss-form-entry" style=3D"margin-bottom:1.5em;vertical-align:middle;margin-left:0;margin-top:0;max-width:100%">
<h2 class=3D"m_380496404602365929ss-page-title" style=3D"padding:0.4em;background-color:#eee">
Registro de la Atenci=C3=B3n Domiciliaria</h2>
<div class=3D"m_380496404602365929ss-page-description m_380496404602365929ss-no-ignore-whitespace" dir=3D"auto" style=3D"white-space:pre-wrap;word-wrap:break-word">
En esta secci=C3=B3n debe ingresar los datos de la atenci=C3==B3n domiciliaria</div>
</div>
</div>
</div>
<br>
 <div class=3D"m_380496404602365929ss-form-question m_380496404602365929errorbox-good">
<div dir=3D"auto" class=3D"m_380496404602365929ss-item m_380496404602365929ss-item-required m_380496404602365929ss-radio" style=3D"margin:12px 0">
<div class=3D"m_380496404602365929ss-form-entry" style=3D"margin-bottom:1.5em;vertical-align:middle;margin-left:0;margin-top:0;max-width:100%">
<label class=3D"m_380496404602365929ss-q-item-label" for=3D"m_380496404602365929entry_2073233714">
<div class=3D"m_380496404602365929ss-q-title" style==3D"display:block;font-weight:bold;margin-top:.83em;margin-bottom:.83em">
Tipo de Atenci=C3=B3n<label for=3D"m_380496404602365929itemView.getDomIdToLabel()">
</label>
<span class=3D"m_380496404602365929ss-required-asterisk" style=3D"color:#c43b1d">
*</span>
</div>
<div class=3D"m_380496404602365929ss-q-help m_380496404602365929ss-secondary-text" dir=3D"auto" style=3D"display:block;margin:.1em 0 .25em 0;color:#666">
</div>
</label>
<ul class=3D"m_380496404602365929ss-choices" style=3D"list-style:none;padding:0;margin:.5em 0 0">
<li class=3D"m_380496404602365929ss-choice-item" style=3D"margin:0;line-height:1.3em;padding-bottom:.5em">
<label>
<span class=3D"m_380496404602365929ss-choice-item-control m_380496404602365929goog-inline-block" style=3D"display:inline-block">
<input type=3D"radio" name=3D"entry.1222378237" disabled checked value=3D"Domicilio" id=3D"m_380496404602365929group_1222378237_1" class=3D"m_380496404602365929ss-q-radio">
</span>
<span class=3D"m_380496404602365929ss-choice-label">
Domicilio</span>
</label>
</li>
 <li class=3D"m_380496404602365929ss-choice-item" style=3D"margin:0;line-height:1.3em;padding-bottom:.5em">
<label>
<span class=3D"m_380496404602365929ss-choice-item-control m_380496404602365929goog-inline-block" style=3D"display:inline-block">
<input type=3D"radio" name=3D"entry.1222378237" disabled value=3D"Ambulatorio" id=3D"m_380496404602365929group_1222378237_2" class=3D"m_380496404602365929ss-q-radio">
</span>
<span class=3D"m_380496404602365929ss-choice-label">
Ambulatorio</span>
</label>
</li>
</ul>
</div>
</div>
</div>
<br>
 <div class=3D"m_380496404602365929ss-form-question m_380496404602365929errorbox-good">
<div dir=3D"auto" class=3D"m_380496404602365929ss-item m_380496404602365929ss-item-required m_380496404602365929ss-date" style=3D"margin:12px 0">
<div class=3D"m_380496404602365929ss-form-entry" style=3D"margin-bottom:1.5em;vertical-align:middle;margin-left:0;margin-top:0;max-width:100%">
<label class=3D"m_380496404602365929ss-q-item-label" for=3D"m_380496404602365929entry_1705849412">
<div class=3D"m_380496404602365929ss-q-title" style==3D"display:block;font-weight:bold;margin-top:.83em;margin-bottom:.83em">
Fecha de la Atenci=C3=B3n<label for=3D"m_380496404602365929itemView.getDomIdToLabel()">
</label>
<span class=3D"m_380496404602365929ss-required-asterisk" style=3D"color:#c43b1d">
*</span>
</div>
<div class=3D"m_380496404602365929ss-q-help m_380496404602365929ss-secondary-text" dir=3D"auto" style=3D"display:block;margin:.1em 0 .25em 0;color:#666">
</div>
</label>
<div class=3D"m_380496404602365929ss-q-date">
<div class=3D"m_380496404602365929ss-datetime-box m_380496404602365929goog-inline-block" style=3D"border:1px solid #dcdcdc;margin-right:2em;min-height:32px;padding-left:3px;vertical-align:middle;margin:4px 3px;display:inline-block">
 <select name=3D"entry.1705849412_day" disabled class=3D"m_380496404602365929ss-day-dropdown" id==3D"m_380496404602365929entry.1705849412_day">
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D=C3=ADa</option>
<option value=3D"1">
1</option>
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2</option>
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3</option>
 <option value=3D"4">
4</option>
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5</option>
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6</option>
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7</option>
 <option value=3D"8">
8</option>
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9</option>
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10</option>
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11</option>
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12</option>
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13</option>
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14</option>
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15</option>
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16</option>
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17</option>
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18</option>
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19</option>
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20</option>
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21</option>
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22</option>
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23</option>
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24</option>
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25</option>
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26</option>
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27</option>
 <option value=3D"28">
28</option>
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29</option>
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30</option>
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31</option>
</select>
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<option value=3D"">
Mes</option>
<option value=3D"1">
enero</option>
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febrero</option>
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marzo</option>
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abril</option>
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mayo</option>
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junio</option>
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julio</option>
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agosto</option>
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septiembre</option>
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octubre</option>
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noviembre</option>
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diciembre</option>
</select>
=20<select name=3D"entry.1705849412_year" disabled id=3D"m_380496404602365929entry.1705849412_year">
<option value=3D"">
A=C3=B1o</option>
<option value=3D"1896">
1896</option>
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1897</option>
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1898</option>
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1899</option>
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1900</option>
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1901</option>
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1902</option>
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1903</option>
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1904</option>
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1905</option>
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1906</option>
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1907</option>
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1908</option>
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1909</option>
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1910</option>
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1911</option>
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1912</option>
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1913</option>
 <option value=3D"1914">
1914</option>
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1915</option>
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1916</option>
 <option value=3D"1917">
1917</option>
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1918</option>
 <option value=3D"1919">
1919</option>
 <option value=3D"1920">
1920</option>
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1921</option>
 <option value=3D"1922">
1922</option>
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1923</option>
 <option value==3D"1924">
1924</option>
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1925</option>
 <option value==3D"1926">
1926</option>
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1927</option>
 <option value==3D"1928">
1928</option>
 <option value=3D"1929">
1929</option>
 <option value==3D"1930">
1930</option>
 <option value=3D"1931">
1931</option>
 <option value==3D"1932">
1932</option>
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1933</option>
 <option value==3D"1934">
1934</option>
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1935</option>
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1936</option>
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1937</option>
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1938</option>
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1939</option>
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1940</option>
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1941</option>
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1942</option>
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1943</option>
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1944</option>
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1945</option>
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1946</option>
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1947</option>
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1948</option>
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1949</option>
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1950</option>
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1951</option>
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1952</option>
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1953</option>
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1954</option>
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1955</option>
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1956</option>
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1957</option>
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1958</option>
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1959</option>
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1960</option>
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1961</option>
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1962</option>
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1963</option>
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1964</option>
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1965</option>
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1966</option>
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1967</option>
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1968</option>
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1969</option>
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1970</option>
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1971</option>
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1972</option>
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1973</option>
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1974</option>
 <option value=3D"1975">
1975</option>
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1976</option>
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1977</option>
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1978</option>
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1979</option>
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1980</option>
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1981</option>
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1982</option>
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1983</option>
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1984</option>
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1985</option>
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1986</option>
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1987</option>
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1988</option>
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1989</option>
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1990</option>
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1991</option>
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1992</option>
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1993</option>
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1994</option>
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1995</option>
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1996</option>
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1997</option>
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1998</option>
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1999</option>
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2000</option>
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2001</option>
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2002</option>
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2003</option>
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2004</option>
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2005</option>
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2006</option>
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2007</option>
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2008</option>
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2009</option>
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2010</option>
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2011</option>
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2012</option>
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2013</option>
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2014</option>
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2015</option>
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2016</option>
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2017</option>
 <option value==3D"2018">
2018</option>
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2019</option>
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2020</option>
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2021</option>
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2022</option>
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2023</option>
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2024</option>
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2025</option>
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2026</option>
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2027</option>
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2028</option>
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2029</option>
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2030</option>
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2031</option>
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2032</option>
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2033</option>
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2034</option>
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2035</option>
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2036</option>
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2037</option>
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2038</option>
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2039</option>
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2040</option>
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2041</option>
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2042</option>
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2043</option>
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2044</option>
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2045</option>
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2046</option>
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2047</option>
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2048</option>
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2049</option>
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2050</option>
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2051</option>
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2052</option>
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2053</option>
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2054</option>
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2055</option>
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2056</option>
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2057</option>
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2058</option>
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2059</option>
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2060</option>
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2061</option>
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2062</option>
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2063</option>
 <option value==3D"2064">
2064</option>
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2065</option>
 <option value==3D"2066">
2066</option>
 <option value=3D"2067">
2067</option>
 <option value==3D"2068">
2068</option>
 <option value=3D"2069">
2069</option>
</select>
</div>
</div>
</div>
</div>
</div>
<br>
 <div class=3D"m_380496404602365929ss-form-question m_380496404602365929errorbox-good">
<div dir=3D"auto" class=3D"m_380496404602365929ss-item m_380496404602365929ss-item-required m_380496404602365929ss-time" style=3D"margin:12px 0;font:inherit">
<div class=3D"m_380496404602365929ss-form-entry" style=3D"margin-bottom:1.5em;vertical-align:middle;margin-left:0;margin-top:0;max-width:100%">
<label class=3D"m_380496404602365929ss-q-item-label" for=3D"m_380496404602365929entry_206244955">
<div class=3D"m_380496404602365929ss-q-title" style==3D"display:block;font-weight:bold;margin-top:.83em;margin-bottom:.83em">
Hora de la Atenci=C3=B3n<label for=3D"m_380496404602365929itemView.getDomIdToLabel()">
</label>
<span class=3D"m_380496404602365929ss-required-asterisk" style=3D"color:#c43b1d">
*</span>
</div>
<div class=3D"m_380496404602365929ss-q-help m_380496404602365929ss-secondary-text" dir=3D"auto" style=3D"display:block;margin:.1em 0 .25em 0;color:#666">
</div>
</label>
<div class=3D"m_380496404602365929ss-q-time">
<div class=3D"m_380496404602365929ss-datetime-box m_380496404602365929goog-inline-block" dir=3D"ltr" style=3D"border:1px solid #dcdcdc;margin-right:2em;min-height:32px;padding-left:3px;vertical-align:middle;margin:4px 3px;display:inline-block">
<select name=3D"entry.206244955_hour" disabled id=3D"m_380496404602365929entry.206244955_hour">
<option value=3D"">
h</option>
<option value=3D"00">
00</option>
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01</option>
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02</option>
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03</option>
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04</option>
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05</option>
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06</option>
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07</option>
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08</option>
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09</option>
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10</option>
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11</option>
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12</option>
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13</option>
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14</option>
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15</option>
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16</option>
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17</option>
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18</option>
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19</option>
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20</option>
 <option value=3D"21">
21</option>
 <option value==3D"22">
22</option>
 <option value=3D"23">
23</option>
</select>
:<select name=3D"entry.206244955_minute" disabled id=3D"m_380496404602365929entry.206244955_minute">
<option value=3D"">
min</option>
<option value=3D"00" selected>
00</option>
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01</option>
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02</option>
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03</option>
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04</option>
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05</option>
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06</option>
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07</option>
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08</option>
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11</option>
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12</option>
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13</option>
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14</option>
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15</option>
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16</option>
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17</option>
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18</option>
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19</option>
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20</option>
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21</option>
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22</option>
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23</option>
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24</option>
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25</option>
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26</option>
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27</option>
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28</option>
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29</option>
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30</option>
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31</option>
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32</option>
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33</option>
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34</option>
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35</option>
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36</option>
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37</option>
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38</option>
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39</option>
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40</option>
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41</option>
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42</option>
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43</option>
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44</option>
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45</option>
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46</option>
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47</option>
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48</option>
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49</option>
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50</option>
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51</option>
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52</option>
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53</option>
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54</option>
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55</option>
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56</option>
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57</option>
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58</option>
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59</option>
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<span class=3D"m_380496404602365929ss-required-asterisk" style=3D"color:#c43b1d">
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3</option>
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4</option>
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<div class=3D"m_380496404602365929ss-form-entry" style=3D"margin-bottom:1.5em;vertical-align:middle;margin-left:0;margin-top:0;max-width:100%">
<label class=3D"m_380496404602365929ss-q-item-label" for=3D"m_380496404602365929entry_1716090865">
<div class=3D"m_380496404602365929ss-q-title" style==3D"display:block;font-weight:bold;margin-top:.83em;margin-bottom:.83em">
Escala Dolor EVA Actual</div>
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</td>
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0</label>
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<label class=3D"m_380496404602365929ss-scalenumber" for=3D"m_380496404602365929group_1421689035_2" style=3D"display:block;padding:0.5em 0 .5em">
1</label>
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2</label>
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<label class=3D"m_380496404602365929ss-scalenumber" for=3D"m_380496404602365929group_1421689035_4" style=3D"display:block;padding:0.5em 0 .5em">
3</label>
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<label class=3D"m_380496404602365929ss-scalenumber" for=3D"m_380496404602365929group_1421689035_5" style=3D"display:block;padding:0.5em 0 .5em">
4</label>
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<label class=3D"m_380496404602365929ss-scalenumber" for=3D"m_380496404602365929group_1421689035_6" style=3D"display:block;padding:0.5em 0 .5em">
5</label>
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<label class=3D"m_380496404602365929ss-scalenumber" for=3D"m_380496404602365929group_1421689035_7" style=3D"display:block;padding:0.5em 0 .5em">
6</label>
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<label class=3D"m_380496404602365929ss-scalenumber" for=3D"m_380496404602365929group_1421689035_8" style=3D"display:block;padding:0.5em 0 .5em">
7</label>
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8</label>
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9</label>
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10</label>
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<td class=3D"m_380496404602365929ss-scalenumbers" style=3D"text-align:center">
</td>
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<br>
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<div class=3D"m_380496404602365929ss-q-title" style==3D"display:block;font-weight:bold;margin-top:.83em;margin-bottom:.83em">
Escala Dolor EVA M=C3=A1ximo</div>
<div class=3D"m_380496404602365929ss-q-help m_380496404602365929ss-secondary-text" dir=3D"auto" style=3D"display:block;margin:.1em 0 .25em 0;color:#666">
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<tr>
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</td>
<td class=3D"m_380496404602365929ss-scalenumbers" style=3D"text-align:center">
<label class=3D"m_380496404602365929ss-scalenumber" for=3D"m_380496404602365929group_1244707512_1" style=3D"display:block;padding:0.5em 0 .5em">
0</label>
</td>
 <td class=3D"m_380496404602365929ss-scalenumbers" style=3D"text-align:center">
<label class=3D"m_380496404602365929ss-scalenumber" for=3D"m_380496404602365929group_1244707512_2" style=3D"display:block;padding:0.5em 0 .5em">
1</label>
</td>
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<label class=3D"m_380496404602365929ss-scalenumber" for=3D"m_380496404602365929group_1244707512_3" style=3D"display:block;padding:0.5em 0 .5em">
2</label>
</td>
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<label class=3D"m_380496404602365929ss-scalenumber" for=3D"m_380496404602365929group_1244707512_4" style=3D"display:block;padding:0.5em 0 .5em">
3</label>
</td>
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<label class=3D"m_380496404602365929ss-scalenumber" for=3D"m_380496404602365929group_1244707512_5" style=3D"display:block;padding:0.5em 0 .5em">
4</label>
</td>
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<label class=3D"m_380496404602365929ss-scalenumber" for=3D"m_380496404602365929group_1244707512_6" style=3D"display:block;padding:0.5em 0 .5em">
5</label>
</td>
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<label class=3D"m_380496404602365929ss-scalenumber" for=3D"m_380496404602365929group_1244707512_7" style=3D"display:block;padding:0.5em 0 .5em">
6</label>
</td>
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<label class=3D"m_380496404602365929ss-scalenumber" for=3D"m_380496404602365929group_1244707512_8" style=3D"display:block;padding:0.5em 0 .5em">
7</label>
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<label class=3D"m_380496404602365929ss-scalenumber" for=3D"m_380496404602365929group_1244707512_9" style=3D"display:block;padding:0.5em 0 .5em">
8</label>
</td>
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<label class=3D"m_380496404602365929ss-scalenumber" for=3D"m_380496404602365929group_1244707512_10" style=3D"display:block;padding:0.5em 0 .5em">
9</label>
</td>
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10</label>
</td>
<td class=3D"m_380496404602365929ss-scalenumbers" style=3D"text-align:center">
</td>
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<tr>
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Paciente, recibe visita de m=C3=A9dico y enfermera de equipo paliativo, acompa=C3=B1ado de pareja (principal cuidadora), madre y abuelos de pareja.=20El d=C3=ADa 26/7/19 presenta convulsi=C3=B3n en domicilio, por lo que consulta en urgencias y se hospitaliza para manejo, con hidrataci=C3=B3n endovenosa, balance h=C3=ADdrico y restituci=C3=B3n de anticonvulsivantes, los cuales se hab=C3=ADan suspendido por olvido en casa previamente. Por buena evoluci=C3=B3n, se da de alta el d=C3=ADa 29 de julio. Posterior al alta, presenta aumento de temperatura, dolor al orinar y orina de caracter=C3=ADstica turbia seg=C3=BAn refiere cuidadora, aparentemente piuria, por lo que consultan nuevamente en urgencias y se hospitaliza nuevamente el d=C3=ADa 01/8/19 para observaci=C3=B3n. Se toma urocultivo, que indica desarrollo de Proteus Mirabillis, susceptible a ciprofloxacino, por lo que inicia terapia antibi=C3=B3tica y se da de alta el d=C3=ADa 4 de agosto con diagn=C3=B3stico de ITU baja complicada en resoluci=C3=B3n. Recibe indicaciones de terapia antibi=C3=B3tica x 5 d=C3=ADas en domicilio con ciprofloxacino de 500 mg 1 c/12 horas, apoyar deambulaci=C3=B3n temprana, ondansetr=C3=B3n 4 mg vo c/24 horas, dexametasona 4 mg c/8 horas, levetiracetam jarabe 500 mg c/12 horas vo, kinesioterapia f=C3=ADsica c/12 hr a domicilio, deambulaci=C3=B3n temprana, r=C3=A9gimen blando papilla + glucerna, acompa=C3=B1amiento familiar y manejo de equipo paliativos.=20El d=C3=ADa de evoluci=C3=B3n, paciente se encuentra en malas condiciones, irritable, muy poco cooperador, con afasia mantenida, dependiente moderado, se moviliza en cama sin ayuda, deambulaci=C3=B3n muy escasa, sin =C3=B3rtesis, con ayuda de familiares.=20Present=C3=B3 nueva ca=C3=ADda por aparente p=C3=A9rdida de equilibrio en habitaci=C3=B3n, no presenta golpe en la cabeza ni traumatismos asociados, mantuvo reflejos de protecci=C3=B3n (apoyo de brazos en suelo y pared).=20Ha mantenido terapia de nanobiotecnolog=C3=ADa, s=C3=B3lo de administraci==C3=B3n endovenosa de vitaminas + curcumina en suero fisiol=C3=B3gico 0.9% (matraz de 500 cc) diario, el cual se ha llevado a cabo sin incidentes.=20Alimentaci=C3=B3n muy escasa, sin nauseas, sin v=C3=B3mitos, sin malestar g=C3=A1strico referido por familiares, quienes refieren que pcte se encuentra inapetente. Diuresis (+), deposiciones muy escasas debido a pobre alimentaci=C3=B3n, sin diarrea.=20Hidrataci=C3=B3n muy pobre, aprox. 1-2 tazas de agua al d=C3=ADa + infusi==C3=B3n de Suero fisiol=C3=B3gico 500 cc de 3 veces por semana. Diuresis (+), muy escasa, concentrada, cuidadora no refiere piuria.=20Sue=C3=B1o (+) durante noche + siestas diurnas. Cabe destacar que paciente permanece acostado en cama durante todo el d=C3=ADa. Cuidadora refiere que ha intentado levantarlo, pero =C3=A9ste no accede, se mantiene muy irritable con miembros del hogar y prefiere permanecer a solas. Recibe terapia por kinesi=C3=B3logo a domicilio particular, con desempe=C3=B1o variable, que ha mermado posterior a hospitalizaci=C3=B3n. =20Actualmente se mantiene con levetiracetam jarabe 500 mg c/12 horas vo y ciprofloxacino 500 mg 1 comp c/12 horas via oral. Adem=C3=A1s, mantiene zonas de apoyo con abundante lubricaci=C3=B3n con crema.=20Se observa a cuidadora muy cansada, dice no estar durmiendo bien y se refiere a s=C3=AD misma agotada f=C3=ADsica y mentalmente, se encuentra actualmente a cargo de su hijo de 4 a=C3=B1os, adem=C3=A1s del cuidado de d. Francisco. Abuela de cuidadora refiere estar esperando inicio de tratamiento psiqui=C3=A1trico por aparente depresi=C3=B3n, se le nota triste, estresada, dice sentirse sobrepasada, ya que lleva el cuidado de la casa y ayuda en el cuidado del paciente e bisnieto. Madre del paciente muy l=C3=A1bil emocionalmente, evoluciona en llanto, se encuentra al tanto de toda la informaci=C3==B3n cl=C3=ADnica de Francisco. Habla s=C3=B3lo portugu=C3=A9s, entiende espa=C3=B1ol, realiza preguntas sobre servicios de oncolog=C3=ADa y cuidados paliativos del pa=C3=ADs. Hijo de 4 a=C3=B1os presenta actitud hiperactiva, tenacidad y ha presentado episodios de incontinencia.=20Debido a condici=C3=B3n de afasia expresiva, no es posible realizar valoraci=C3=B3n de dolor con escala ENA/EVA.=20</div>
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Examen F=C3=ADsico<label for=3D"m_380496404602365929itemView.getDomIdToLabel()">
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<span class=3D"m_380496404602365929ss-required-asterisk" style=3D"color:#c43b1d">
*</span>
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</div>
</label>
<div class=3D"m_380496404602365929ss-q-text" dir=3D"auto" style=3D"background-color:#eee;max-width:90%;border:1px solid #c0c0c0;padding:5px;white-space:pre-wrap;color:#545454;width:70%">
Bradic=C3=A1rdico, afebril, saturando 98% a Fio2 ambiental. Se intenta medir presi=C3=B3n arterial en 5 ocasiones, paciente no coopera, no fue posible obtener resultado. Paciente poco cooperador para examen f=C3=ADsico.=20Piel y mucosas p=C3=A1lidas, hidratadas, indemnes.=20Cabeza: normoc=C3=A9falo, pupilas isoc=C3=B3ricas, no refiere cefalea.=20Cuello sin adenopat=C3=ADas palpables, T=C3=B3rax sim=C3=A9trico, R1R2 (+), murmullo pulmonar bilateral (+), sin lesiones. Zonas de apoyo indemnes.=20EESS: presentes, movilidad conservada, sin edema, pulsos sim=C3=A9tricos, UPP grado 1 en extremidad superior izquierda (codo), no se visualiza p=C3=A9rdida de continuidad de piel, piel enrojecida, lubricada, no se observa descamaci=C3=B3n.=20Abdomen indoloro.=20EEII: presentes, m=C3=B3viles, sin edema, sin lesiones, zonas de apoyo indemnes. =20Zona sacra/genital: sin alteraciones, zonas de apoyo indemnes.=20</div>
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Diagn=C3=B3stico<label for=3D"m_380496404602365929itemView.getDomIdToLabel()">
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*</span>
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Glioblastoma de alto grado</div>
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Plan de Tratamiento e Indicaciones<label for=3D"m_380496404602365929itemView.getDomIdToLabel()">
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-Continuar terapia antibi=C3=B3tica por d=C3=ADas indicados seg=C3=BAn indicaci=C3=B3n m=C3=A9dica de epicrisis.==20-Mejorar hidrataci=C3=B3n y alimentaci=C3=B3n.=20-Continuar administraci=C3=B3n de levetiracetam por horario.-Manejo y prevenci=C3=B3n de UPP=20-Consultar en urgencias si presenta signos de alarma.=20-Movilizar a tolerancia, mantener kinesiterapia a tolerancia.=20</div>
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<div class=3D"m_380496404602365929ss-q-title" style==3D"display:block;font-weight:bold;margin-top:.83em;margin-bottom:.83em">
Medicamentos Indicados</div>
<div class=3D"m_380496404602365929ss-q-help m_380496404602365929ss-secondary-text" dir=3D"auto" style=3D"display:block;margin:.1em 0 .25em 0;color:#666">
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-Dexametasona 4 mg via oral c/8 horas (intentar cada 12 horas). -Mutivitam=C3=ADnico (Centrum) -Ondansetron 8 mg sos sublingual=20-Paracetamol 1 gramo via oral c/8 horas.Corpitol 1 aplicaci=C3=B3n c/8 hr en zonas de apoyo.=20</div>
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Fecha aproximada del Pr=C3=B3ximo Control con usted</div>
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<div class=3D"m_380496404602365929ss-q-date">
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D=C3=ADa</option>
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1</option>
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2</option>
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3</option>
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4</option>
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5</option>
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6</option>
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7</option>
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8</option>
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11</option>
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12</option>
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13</option>
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14</option>
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15</option>
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16</option>
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17</option>
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18</option>
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19</option>
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20</option>
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21</option>
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22</option>
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23</option>
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24</option>
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25</option>
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26</option>
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27</option>
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28</option>
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Mes</option>
<option value=3D"1">
enero</option>
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febrero</option>
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marzo</option>
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abril</option>
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mayo</option>
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junio</option>
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julio</option>
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agosto</option>
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septiembre</option>
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1911</option>
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1914</option>
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1918</option>
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1919</option>
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1920</option>
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1921</option>
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1923</option>
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1924</option>
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1925</option>
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1926</option>
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1927</option>
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1928</option>
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1929</option>
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1930</option>
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1932</option>
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1959</option>
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1960</option>
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1966</option>
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1967</option>
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1968</option>
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1970</option>
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1971</option>
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1972</option>
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1975</option>
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1982</option>
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1984</option>
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1985</option>
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1986</option>
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1987</option>
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1988</option>
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1990</option>
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1991</option>
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1992</option>
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1993</option>
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1994</option>
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1995</option>
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1996</option>
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1997</option>
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1998</option>
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1999</option>
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2000</option>
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2001</option>
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2002</option>
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2003</option>
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2004</option>
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2005</option>
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2006</option>
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2007</option>
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2008</option>
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2009</option>
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2010</option>
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2011</option>
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2012</option>
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2013</option>
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2014</option>
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2015</option>
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2016</option>
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2017</option>
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2018</option>
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2019</option>
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2020</option>
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2021</option>
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2022</option>
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2023</option>
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2024</option>
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2025</option>
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2026</option>
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2027</option>
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2028</option>
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2029</option>
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2030</option>
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2031</option>
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2032</option>
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2033</option>
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2034</option>
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2035</option>
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2036</option>
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2037</option>
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2038</option>
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2039</option>
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2040</option>
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2041</option>
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2042</option>
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2043</option>
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2044</option>
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2045</option>
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2046</option>
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2047</option>
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2048</option>
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2049</option>
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2050</option>
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2051</option>
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2052</option>
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2053</option>
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2054</option>
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2055</option>
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2056</option>
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2057</option>
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2058</option>
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2059</option>
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2060</option>
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2061</option>
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2062</option>
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2063</option>
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2064</option>
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2065</option>
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2066</option>
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2067</option>
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2068</option>
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2069</option>
</select>
</div>
</div>
</div>
</div>
</div>
<br>
 <div class=3D"m_380496404602365929ss-form-question m_380496404602365929errorbox-good">
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<label class=3D"m_380496404602365929ss-q-item-label" for=3D"m_380496404602365929entry_74766472">
<div class=3D"m_380496404602365929ss-q-title" style=3D"display:block;font-weight:bold;margin-top:.83em;margin-bottom:.83em">
Tratamiento Realizado (si corresponde)</div>
<div class=3D"m_380496404602365929ss-q-help m_380496404602365929ss-secondary-text" dir=3D"auto" style=3D"display:block;margin:.1em 0 .25em 0;color:#666">
</div>
</label>
<div class=3D"m_380496404602365929ss-q-text" dir=3D"auto" style=3D"background-color:#eee;max-width:90%;border:1px solid #c0c0c0;padding:5px;white-space:pre-wrap;color:#545454;width:70%">
-Se recomienda mejorar hidrataci=C3=B3n y alimentaci=C3=B3n.  -Se recomienda no interrumpir terapia de medicamentos, respetar horarios.  -Se educa sobre UPP y prevenci=C3=B3n: lubricaci=C3==B3n de zonas frecuente, vigilar cambio de posici=C3=B3n m=C3=A1ximo cada 2-3 hr, aumentar ingesta de nutrientes.  -Se recomienda movilizar a paciente seg=C3=BAn tolerancia, evitar postraci=C3=B3n.  -Se recomienda disminuci==C3=B3n de est=C3=ADmulos fuertes (luces, ruidos), evitar cefalea.  -Se recomienda a cuidadora y familia distribuir los cuidados, evitar/manejar el s==C3=ADndrome del cuidador, considerar contratar a un cuidador formal.  -Se fomenta expresi=C3=B3n de sentimientos y emociones en familia.  -Se refuerza educaci=C3=B3n sobre prevenci=C3=B3n de infecciones.  -Se recomienda consultar en colegio de hijo peque=C3=B1o de cuidadora por disponibilidad de psic=C3=B3logo escolar.  -Se recomienda consultar en urgencias si presenta nueva convulsi=C3=B3n, fiebre u otros signos de alarma.  -Se refuerza educaci=C3=B3n sobre coordinaci=C3=B3n de visitas de equipo de cuidados paliativos seg=C3=BAn su previsi=C3=B3n. </div>
</div>
</div>
</div>
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<label class=3D"m_380496404602365929ss-q-item-label" for=3D"m_380496404602365929entry_1219705969">
<div class=3D"m_380496404602365929ss-q-title" style==3D"display:block;font-weight:bold;margin-top:.83em;margin-bottom:.83em">
Derivaci=C3=B3n a otro Prestador Domiciliario</div>
<div class=3D"m_380496404602365929ss-q-help m_380496404602365929ss-secondary-text" dir=3D"auto" style=3D"display:block;margin:.1em 0 .25em 0;color:#666">
S=C3=B3lo llene esta secci=C3=B3n si es m=C3=A9dico y solicita la visita de otro prestador del equipo</div>
</label>
<ul class=3D"m_380496404602365929ss-choices" style=3D"list-style:none;padding:0;margin:.5em 0 0">
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<label>
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<input type=3D"checkbox" name=3D"entry.503039759" disabled value=3D"ENFERMERA" id=3D"m_380496404602365929group_503039759_1" class=3D"m_380496404602365929ss-q-checkbox">
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<span class=3D"m_380496404602365929ss-choice-label">
ENFERMERA</span>
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<input type=3D"checkbox" name=3D"entry.503039759" disabled value=3D"TENS" id=3D"m_380496404602365929group_503039759_2" class=3D"m_380496404602365929ss-q-checkbox">
</span>
<span class=3D"m_380496404602365929ss-choice-label">
TENS</span>
</label>
</li>
 <li class=3D"m_380496404602365929ss-choice-item" style=3D"margin:0;line-height:1.3em;padding-bottom:.5em">
<label>
<span class=3D"m_380496404602365929ss-choice-item-control m_380496404602365929goog-inline-block" style=3D"display:inline-block">
<input type=3D"checkbox" name=3D"entry.503039759" disabled value=3D"NUTRICIONISTA" id=3D"m_380496404602365929group_503039759_3" class=3D"m_380496404602365929ss-q-checkbox">
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<span class=3D"m_380496404602365929ss-choice-label">
NUTRICIONISTA</span>
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<span class=3D"m_380496404602365929ss-choice-item-control m_380496404602365929goog-inline-block" style=3D"display:inline-block">
<input type=3D"checkbox" name=3D"entry.503039759" disabled value=3D"KINESIOLOGO" id=3D"m_380496404602365929group_503039759_4" class=3D"m_380496404602365929ss-q-checkbox">
</span>
<span class=3D"m_380496404602365929ss-choice-label">
KINESIOLOGO</span>
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<span class=3D"m_380496404602365929ss-choice-label">
PSICOLOGO</span>
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<br>
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<h2 class=3D"m_380496404602365929ss-q-title" style=3D"display:block;font-weight:bold;margin-top:.83em;margin-bottom:.83em">
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<img class=3D"m_380496404602365929ss-image" title=3D"" src=3D"https://lh5.googleusercontent.com/Bpur5zPteyG-bXtM-WNRuiLwTi8myvetX7lBkdjzbnQyqUlGcuv84zmWyU3x0Ua2-_WXX9PiJ2cMBOO0zhG2nHX7tXXPHH6_X8UTG8MZzIBwxETkF0a8JyZtuxSL" style=3D"width:78px;outline:none" alt=3D"Imagen sin leyenda">
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<a href=3D"https://docs.google.com/forms?usp=3Dmail_form_link" style=3D"color:#424242;font-size:13px" target=3D"_blank">
Crea tu propio formulario de Google</a>
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