MIME-Version: 1.0 Content-Type: multipart/related; boundary="----=_NextPart_01C920F9.A508C250" Данный документ является веб-страницей в одном файле, также называемой файлом веб-архива. Если вы видите это сообщение, значит данный обозреватель или редактор не поддерживает файлы веб-архива. Загрузите обозреватель, поддерживающий веб-архивы, например Microsoft Internet Explorer. ------=_NextPart_01C920F9.A508C250 Content-Location: file:///C:/30321270/file7888.htm Content-Transfer-Encoding: quoted-printable Content-Type: text/html; charset="us-ascii" Назва міністерстk= 4;а, іншого центральноk= 5;о органу виконавчої влади, у сфері управління яких перебуває заклад_________________________________= __

Назва міністерст&= #1074;а, іншого центрально&= #1075;о органу виконавчої влади, у сфері управління яких перебуває заклад_____________________________= ______

________________________________________

Найменува = 85;ня та повна адреса закладу______________________= _________

_______________________________________

Ідентифік = 72;ційний код за

       ЄДРПОУ       = І__І__І__І__І<= /u>__І__І__І__І<= /u>

 

 

Мед&#= 1080;чна документац&= #1110;я

Фор&#= 1084;а первинної облікової документац&= #1110;ї

 №113/о

 

Зат&#= 1074;ерджено

Нак&#= 1072;з МОЗ України=

 

13.02.2006 №67

 

ОБ= ;МІННА    КАРТА

пол&#= 1086;гового будинку, пологового відділення лікарні=

Тал&#= 1086;н 1. Відомості жіночої консультац&= #1110;ї про вагітну=

(зап&= #1086;внюється на кожну вагітну і видається на руки з моменту становленн&= #1103; на облік)

 =

 
  1. Пріз= ;вище, ім’я, по бат= ькові _______________________________________________________________________
  2. Вік= ;________ 3. Місце проживанн= 103; ______________________= ___________________________________________

___________________________________________________________________________________________________

  1. Пере= ;несені загальні, гінеколог= 110;чні захворюва= 085;ня, операції _____________________________________________

_________________________________________________= __________________________________________________

_________________________________________________= __________________________________________________

_________________________________________________= __________________________________________________

  1. Яка вагітніст= 100; ____________________,       які пологи _________________________________________________
  2. Поло= ;ги: термінові (рік) __________________________________________________________________= _________,

       &n= bsp;      передча= сні (рік, у якому терміні) __________________= _________________________________________________

Дитина народилася<= /span> з вагою _____________,  жива, мертва, померла (пот= ;рібне підкреслит&= #1080;)

  1. Було абортів _________________ штучні (рік, у якому терміні) _________________________________________,=

       &n= bsp;            = ;            &n= bsp;            = ;            &n= bsp;            = ;   самовільн&= #1110; (рік, у якому терміні)  ______________________________<= /span>_______=

  1. Особ= ;ливості перебігу попередні= 093; вагітност= 077;й, пологів, післяполо= 075;ового періоду__________________________

_______________________________________________________________________= ___________________________________

  1. Оста= ;ння менструац= 110;я  ______________________________________________________________= ______________

  (m= 5;исло, місяць, рік)=

  1. Стро= ;к вагітност= 110; _______ тижнів при першому відвідува= 085;ні «____» ___________________200__р.
  2. Перш= ;е ворушіння плоду ______________________________= ________________________________________= ___

(число, місяць, рік)=

  1. Зроб= ;лено відвідува= 085;ь до 30 тижнів _________________,  після 30 тижнів ________________________________
  2. Розм= ;іри таза      &nb= sp; D.sp. _________________  D.cr. ________________  D. torch. ________________

Розміри таза        <= /span>C.ext._________________  C.diag. ______________   C.vera._________________

  1. Зріс= ;т ________________= ________________ Вага (маса) _______________________________________________<= /li>

       &n= bsp;            = ;     (при першому зверненні)

  1. Поло= ;ження плоду ______________________________= _________________________________________________=

Частина, що передлежит&= #1100;:   голівка, сі= ;дниці, не визначаєть&= #1089;я (підкреслит= и)

Серцебиття плоду: ясне, ритмічне, ударів ___за хвилину, зліва, справа (підкреслит= и)

  1. Д= ;ата видачі листка непрацезд= 072;тності або довідка в зв’язку з вагітніст= 102; і пологами<= span style=3D'mso-spacerun:yes'>      <= /span> «__» ___________200__ р.
  2. Пере= ;дбачуваний термін пологів ___________________________________________________________________

Лабора&#= 1090;орні та інші дослідженн&= #1103;

  1. Груп= ;а крові вагітної ________________________     = Rh-належ= 085;ість ________________________________

Титр антитіл (дата) _____________________________________________________________________________

Група кров= 110; батька дитини ___________________       &n= bsp;         Rh<= /span>-н= ;алежність _______________________

 

19. RW

20. ВІЛ

21. HbsAq

|    «     »       &n= bsp;            = ;  200  р. ͏= 0;

|    «     »       &n= bsp;    200  р. ͏= 0;

|    «     »       &n= bsp;       200  р. ͏= 0;

||   «     »       &n= bsp;            = ;  200  р. ͏= 0;

||    «     »       &n= bsp;    200  р. ͏= 0;

 <= /p>

22. Клініч&#= 1085;ий аналіз крові

Дата

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Еритроцити

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Гемоглобін

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Кольоровий показник

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Лейкоци= ти

нейтрофіли

 

 

 

 

 

 

 

 

 

 

 

 

 

 

паличкояде&#= 1088;ні

 

 

 

 

 

 

 

 

 

 

 

 

 

 

сегментояд&#= 1077;рні

 

 

 

 

 

 

 

 

 

 

 

 

 

 

еозинофіли

 

 

 

 

 

 

 

 

 

 

 

 

 

 

базофіли

 

 

 

 

 

 

 

 

 

 

 

 

 

 

лімфоцити

 

 

 

 

 

 

 

 

 

 

 

 

 

 

моноцити

 

 

 

 

 

 

 

 

 

 

 

 

 

 

ШОЕ

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Тромбоцити

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Гематокрит

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Згортальна система

 

 

 

 

 

 

 

 

 

 

 

 

 

 

23. Загальний аналіз сечі

Дата

 

 

 

 

 

 

 

 

 

 

 

 

 

Цукор

 

 

 

 

 

 

 

 

 

 

 

 

 

Білок

 

 

 

 

 

 

 

 

 

 

 

 

 

Лейкоцити

 

 

 

 

 

 

 

 

 

 

 

 

 

Еритроцити

 

 

 

 

 

 

 

 

 

 

 

 

 

Солі

 

 

 

 

 

 

 

 

 

 

 

 

 

Бактерії

 

 

 

 

 

 

 

 

 

 

 

 

 

Б&= #1072;ктеріологі= ;чне дослідженн= 103; сечі: ______________________       &nbs= p;   _______________________

<= span lang=3DUK style=3D'mso-ansi-language:UK'>=             &nb= sp;            =             &nb= sp;            =             &nb= sp;            =             (при першому зверненні)        = ;            &n= bsp;            = ;         (в 35-36 тижнів)=

24. Бактер&#= 1110;оскопічне дослідженн= 103; мазків з піх&= #1074;и

Дата

 

 

 

 

C

V

U

C

V

U

C

V

U

Гон = 86;коки

 <= /p>

 <= /p>

 <= /p>

 <= /p>

 <= /p>

 <= /p>

 <= /p>

 <= /p>

 <= /p>

Лей = 82;оцити

 <= /p>

 <= /p>

 <= /p>

 <= /p>

 <= /p>

 <= /p>

 <= /p>

 <= /p>

 <= /p>

Епі = 90;елій

 <= /p>

 <= /p>

 <= /p>

 <= /p>

 <= /p>

 <= /p>

 <= /p>

 <= /p>

 <= /p>

Фло = 88;а

 <= /p>

 <= /p>

 <= /p>

 <= /p>

 <= /p>

 <= /p>

 <= /p>

 <= /p>

 <= /p>

Три = 93;омонади

 <= /p>

 <= /p>

 <= /p>

 <= /p>

 <= /p>

 <= /p>

 <= /p>

 <= /p>

 <= /p>

Кан = 76;иди

 <= /p>

 <= /p>

 <= /p>

 <= /p>

 <= /p>

 <= /p>

 <= /p>

 <= /p>

 <= /p>

Клю = 95;ові клітини

 <= /p>

 <= /p>

 <= /p>

 <= /p>

 <= /p>

 <= /p>

 <= /p>

 <= /p>

 <= /p>

 <= /p>

 <= /p>

 <= /p>

 <= /p>

 <= /p>

 <= /p>

 <= /p>

 <= /p>

 <= /p>

 <= /p>

25.     Біохі= ;мічні дослідженн= 103; (з= а показами)

= 1.=   __________________________________________________________________________= ___________________________

= 2.=   = ___________________________________________________________________________= __________________________

= 3.=   __________________________________________________________________________= ___________________________

= 4.=   __________________________________________________________________________= ___________________________

 

26.    Резул= ьтати обстеження на TORCH – інфекції

1.=         ___________________________________= ________________________________________________________________=

2.=         ___________________________________= ________________________________________________________________=

3.=         ___________________________________= ________________________________________________________________=

4.=         ___________________________________= ________________________________________________________________=

 

 

П&#= 1088;одовження ф.№113/о

27.    <= /span>Ін&= #1096;і методи дослідженн= 103;

1.     &nbs= p;  ___________________________________________________= __________________________________________________

2.     &nbs= p;  ___________________________________________________= __________________________________________________

3.     &nbs= p;  ___________________________________________________= __________________________________________________

4.     &nbs= p;  ___________________________________________________= __________________________________________________

 

28.    <= /span>Об&= #1089;теження в інших спеціаліст= 110;в _____________________________________________________________________=

       &nbs= p;      Терапевт |._________________________________________________= _______________________= __________________

||. _________________________________________________________________________= _______________

       &nbs= p;   Стоматоло= 075; =  _________________________= ______________________________________________________= ________

       __________________________________________________________________= ____________________________= _______<= /span>

       __= ___________________________________________________________________________= _________________= _______<= /span>

       __= _________________= ___________________________________________________________________________= _______<= /span>

        __________________________________________________________________= ____________________________= _______<= /span>

 

29.    <= /span>Ко&= #1085;сультація лікаря-гене&#= 1090;ика (6-8 тижнів):

1.___________________________________________________________________= ______________________________= ________<= /span>

_____________________________________________________________________= _____________________________= ________

2. Скринінг на вроджені вади розвитку плоду (16-18 тижнів):

АФП _________________________________________________________________________= ____________________= ________

вХГЧ ________________________________________= _____________________________________________________= _______<= /span>

Естріол  __________________________________________________________________= _________________________= _______<= /span>

 

30.     Обсте= ;ження сім’ї на туберкульо= 079;:

ч&= #1086;ловік (ФЛГ)__________________________________________________= ___________________________________

д&= #1110;ти (р. Манту) ____________________________________________________________________________________

31.     Ультр= ;азвукове дослідженн= 103;

1. (10-13 тижнів)______________________________= __________________________________________________________________________<= o:p>

____________________________= ___________________________________________________________________________= ________________

____________________________= _______________________________________________П.І.Б. лікаря_______________________________= ___

____________________________= ___________________________________________________________________________= ________________

2. (16-21 ти = 78;день)___________________________________________= ____________________________________________________________

____________________________= ___________________________________________________________________________= ________________

____________________________= _______________________________________________П.І.Б. лікаря_______________________________= ___

____________________________= ___________________________________________________________________________= ________________

3. (32-36 тижнів, за показами)________________= _________________________________________________________________________

____________________________= ___________________________________________________________________________= ________________

____________________________= _______________________________________________П.І.Б. лікаря_______________________________= ___

 

32= .     Психопрофі= 083;актична підготовка (Школа підго&= #1090;овки сім’ї до пологів)<= /p>

Тема заняття=

Дата

Хто проводить

Вну = 90;рішньоутро&#= 1073;ний розвиток плоду

 

 

Гіг = 10;єна вагітної жінки. Режим праці та відпочинку. Раціональн&= #1077; харчування<= o:p>

 

 

Озн = 72;ки початку пологової діяльності. Перебіг пологів (періоди, типи дихання, прийоми знеболення)=

 

 

Піс = 83;япологовий період. Профілакти&= #1082;а непланован&= #1086;ї вагітності<= o:p>

 

 

Гру = 76;не вигодовува&= #1085;ня. 10 принципів=

 

 

Пси = 93;опрофілакт&#= 1080;чна роль партнерськ&= #1086;ї підтримки під час пологів

 

 

Сім = 77;йні пологи – «народжуєм&= #1086; разом»

 

 

Лист госпіталіз= 072;ції під час вагітності

№

Дата

Назва лікувально&= #1075;о закладу=

Діагноз=

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

<= span lang=3DEN-US style=3D'font-size:10.0pt;line-height:130%;mso-ansi-language= :EN-US'>

Щоденник наступних відвідуван= 100;

 

Дата

Маса тіла

+/- на тиждень

АТ на обох руках

Положення та серцебиття плоду

Діагноз та рекомендац&= #1110;ї лікаря

Наступне відвідуван&= #1085;я

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Тест рухів плоду (ТРП)

У комплексні= 081; оцінці стану внутрішньо= 075;о плоду велике значення має його рухова акти&#= 1074;ність. Зменшення рухів плоду або зміну їх характеру необхідно розглядати як симптом порушення його стану. Тест руху «Рахуй до 10» реєструє сама вагітн&#= 1072;, починаючи з 28 тижнів і до пологів на спеціальні= 081; карті. Під час чергового відвідуван= 085;я вагітна пред’являє карту тесту рухів плоду лікарю.

 Окріl= 4; тесту «Рахуй до 10», можна викор&#= 1080;стовувати підрахунок числа рухів &= #1087;ротягом 1 години 3 разl= 0; на день (7.00-8.00, 12.00-13.00, 18.00-19.00). Зниження числа рухів плоду до 10 і менше за 12 годин або 3 і менше за 1 годину (у кожному інтервалі, я&= #1082;ий вимірюєтьс= 103;) розглядаєт= 100;ся як сигнал тр&= #1080;воги і потребує кардіомоні= 090;орного контролю.

 

Години

. . . тиждень

 

 

 

 

 

 

 

 

09.00

 

 

 

 

 

 

 

 

09.30

 

 

 

 

 

 

 

 

10.00

 

 

 

 

 

 

 

 

10.30

 

 

 

 

 

 

 

 

11.00

 

 

 

 

 

 

 

 

11.30

 

 

 

 

 

 

 

 

12.00

 

 

 

 

 

 

 

 

12.30

 

 

 

 

 

 

 

 

13.00

 

 

 

 

 

 

 

 

13.30

 

 

 

 

 

 

 

 

14.00

 

 

 

 

 

 

 

 

14.30

 

 

 

 

 

 

 

 

15.00

 

 

 

 

 

 

 

 

15.30

 

 

 

 

 

 

 

 

16.00

 

 

 

 

 

 

 

 

16.30

 

 

 

 

 

 

 

 

17.00

 

 

 

 

 

 

 

 

17.30

 

 

 

 

 

 

 

 

18.00

 

 

 

 

 

 

 

 

18.30

 

 

 

 

 

 

 

 

19.00

 

 

 

 

 

 

 

 

19.30

 

 

 

 

 

 

 

 

20.00

 

 

 

 

 

 

 

 

20.30

 

 

 

 

 

 

 

 

21.00

 

 

 

 

 

 

 

 

Число рухів (менше 10)

Число рухів (менше 10)

9

 

 

 

 

 

 

 

8

 

 

 

 

 

 

 

7

 

 

 

 

 

 

 

6

 

 

 

 

 

 

 

5

 

 

 

 

 

 

 

4

 

 

 

 

 

 

 

3

 

 

 

 

 

 

 

2

 

 

 

 

 

 

 

1

 

 

 

 

 

 

 

0

 

 

 

 

 

 

 

 <= /p>

Прі = 79;вище, ім’я, по батькові ________________________________<= /span>_______________= _____________________

Міс = 94;е проживання  ___________________________________________________________________________

Дом = 72;шній телефон ___________________________________________________________________________

Поч = 72;то ________________________ 200___ р.

При терміні вагітності ________ тижнів.

Ру&= #1093;и плоду розпочинай= 090;е рахувати о 9.00. Коли відчує&#= 1090;е 10-й рух, відмітьте в таблиці годину.

= На&= #1087;риклад: 10-й раз зареєстров= 072;ний вами між 13.00 і 13.30 і відмічено у графі 1. Наступного ранку починайте рахувати рухи знову.

Як&= #1097;о з 9.00 до 20.00 ви відчули менше ніж 10 рухів, відмі&= #1090;ьте тільки їх число за цей час у нижній частинці таблиці.

= За&= #1087;ам’ятайте, якщо протягом дня ви спостеріга= 108;те менше ніж 10 рухів плоду, зверніться до лікаря за консультац= 110;єю.

Назва міністерст&= #1074;а, іншого центрально&= #1075;о органу виконавчої влади, у сфері управління яких перебуває заклад_____________________________= ______

________________________________________

Найменува = 85;ня та повна адреса закладу______________________= _________

_______________________________________

Ідентифік = 72;ційний код за

       ЄДРПОУ       = І__І__І__І__І<= /u>__І__І__І__І<= /u>

 

 

Мед&#= 1080;чна документац&= #1110;я

Фор&#= 1084;а первинної облікової документац&= #1110;ї

 №113/о

Зат&#= 1074;ерджено

Нак&#= 1072;з МОЗ України=

 

13.02.2006 №67

 

ОБ= ;МІННА    КАРТА

пол&#= 1086;гового будинку, пологового відділення лікарні=

Талон 2.   Відомості пологового будинку,

пологовог = 86; відділення лікарні про породіллю

 

 

 

1.=   Прізвище, ім’я, по батькові породіллі__________= _______________________________________________________________________<= o:p>

2.=   Місце проживання___= ___________________________________________________________________________= ___________________

3.=   Пологи відбулися (ч&= #1080;сло, місяць, рік) _________________________________________________________________________= ________

4.=   Від якої вагітності за рахунком народилася дитина __________________з терміном вагітності _________ тижнів,

Попередні вагітності закінчилис= 103;: абортами  (штучними, самовільни= 084;и) __________________,

пологами ___________________________________, у т.ч. з мертвим плодом _______________.

5.=   Пологи одноплідні, багатоплід= 085;і (підкреслит&#= 1080;); при багатоплід= 085;их пологах народилася _____________________________ за раху= нком.

6.=   Особливост = 10; перебігу пологів (тривалість, ускладненн= 103; в пологах у матері і плоду) ____________________________________= ___________

__________________________________________________________________________= __________________________________________

__________________________________________________________________________= __________________________________________

7.=   Знеболюван = 85;я: застосовув= 072;лося, ні (підкресл&= #1080;ти), яке, ефективніс= 090;ь ________________________________________________________

____________________________= ___________________________________________________________________________= _____________

____________________________= ___________________________________________________________________________= _____________

8.=   Перебіг післяполог= 086;вого періоду (захворюван&#= 1085;я)______________________________________________________________= __________

____________________________= ___________________________________________________________________________= _____________

____________________________= ___________________________________________________________________________= _____________

9.=   Виписана на ___________________ день після пологів.

10.     Стан матері при виписці _________________________________________________________________________= ___________________

____________________________= ___________________________________________________________________________= _____________

____________________________= ___________________________________________________________________________= _____________

11.   Стан дитини при народженні _________________________________________________________________________= ________________

____________________________= ___________________________________________________________________________= _____________

____________________________= ___________________________________________________________________________= _____________

у пологовому будинку _______________________= _________________________________________________________________________

при виписці _________________________________________________________________________= ________________________________

____________________________= ___________________________________________________________________________= _____________

12.     Вага дитини: при народженні _____________,  при виписц&#= 1110; __________________

13.     Зріст дитини при народженні __________________________________________

14.     Чи потребує патронаж мати: так, ні (підкреслит&#= 1080;), показання _____________________________________________________________<= /span>

____________________________= ___________________________________________________________________________= _____________

____________________________= ___________________________________________________________________________= _____________

15.     Особл= ;иві зауваження _________________________________________________________________________= _______________________

____________________________= ___________________________________________________________________________= _____________

____________________________= ___________________________________________________________________________= _____________

____________________________= ___________________________________________________________________________= _____________

«______» _________________ 20___ р.

       &nbs= p;            &= nbsp;           &nbs= p;            &= nbsp;           &nbs= p;            &= nbsp;           &nbs= p;       

 

  Ліка = 88; акушер-гіне&#= 1082;олог _________________________

       &nbs= p;            &= nbsp;           &nbs= p;                  &nbs= p;            <= /span>(прізвище, підпис)

 

Назва міністерст&= #1074;а, іншого центрально&= #1075;о органу виконавчої влади, у сфері управління яких перебуває заклад_____________________________= ______

________________________________________

Найменува = 85;ня та повна адреса закладу______________________= _________

_______________________________________

Ідентифік = 72;ційний код за

       ЄДРПОУ       = І__І__І__І__І<= /u>__І__І__І__І<= /u>

 

 

Мед&#= 1080;чна документац&= #1110;я

Фор&#= 1084;а первинної облікової документац&= #1110;ї

 №113/о

Зат&#= 1074;ерджено

Нак&#= 1072;з МОЗ України=

 

13.02.2006 №67

 

ОБ= ;МІННА    КАРТА

пол&#= 1086;гового будинку, пологового відділення лікарні=

Тал&#= 1086;н 3. Відомості пологового будинку,

пол&#= 1086;гового відділення лікарні про новонародж&= #1077;ного

 =

 

1. Прізвище, ім= ;’я, по батькові породіллі _____________________________________________________=

2. Місце проживання _____________________________________________________________________

3. Пологи відбулись ______________________________________________________________________<= o:p>

       &n= bsp;            = ;            &n= bsp;            = ;            &n= bsp;             (число, місn= 3;ць, рік)

4. Від якої вагітності за рахунком народилася дитина _________ з терміном вагітності ______ тижнів

Поперед= ні вагітності закінчилис&= #1100;: абортами (штучними, самовільни&= #1084;и) ________________________,

по= ;логами _________, у тому числі з мертвим плодом __________________

5. Пологи одноплідні, багатоплід&= #1085;і (підкреслит= и); при багатоплід&= #1085;их пологах народилася ______ за рахунком

6. Особливост&= #1110; перебігу вагітності =

 

 

 

_____________= ___________________________________________________________________________= _

7. Особливост&= #1110; перебігу пологів (тривалість, ускладненн&= #1103; в пологах у матері і плоду) _______________<= /p>

 

 

 

8.Зне= болювання застосовув&= #1072;лось, ні (підкресл= ;ити), яке, ефектив= ;ність

 

 

 

 

9. Перебіг післяполог&= #1086;вого періоду (захворюван= ня)

 

 

 

 

10. Виписаний на _________ день після пологів

11. Стан матері при виписці______________________= ___________________________________________

 

 

 

 

 

 

 

Від&#= 1086;мості про новонародж&= #1077;ного

12. Стать дитини: хлопчик, дівчинка (підкреслит= и), зріст при народженні _______________ см,

       вага при народженні ____________г,  при виписці _____________г.=

13. Фізіологіч&= #1085;а втрата маси тіла _______________ г, вага стабілізув&= #1072;лась на ________ добу.=

14. Стан дитини= :

при народженні – оцінка за шкалою Апгар – закр= ;ичав: зразу, ні (підкреслит= и),

чи проводилис&= #1100; засоби щодо оживлення (які) _______________________________________________= ___

 

 

 

спі&#= 1083;ьне перебуванн&= #1103; з матір‘ю з ________ години після пологів,

при&#= 1082;ладання до грудей на _________ годині після полог= ів, лактація достатня: так, ні (підкреслит= и),

виг&#= 1086;довування – грудне, зцідженим молоком матері (підкреслит= и), у вразі переведенн&= #1103; на штучне вигодовува&= #1085;ня – указати причину ___________________________________________________________<= /span>

 

виг&#= 1086;довування молочною сумішшю, додоювання (указати, чиl= 4; саме) в об’ємі_______________________=

 

зал&#= 1080;шок пуповини відпав на ___________ добу, стан  пупкової ранки (чиста= ;, суха, інше)____________= __

_______________________= ___________________________________________________________________<= span lang=3DUK style=3D'font-size:11.0pt;mso-ansi-language:UK'>

 15. Перебіг періоду адаптації

 

 

16. Додаткові обстеження<= o:p>

 

 

 

17. Терапія, режим

 

 

 

18. Вакцинація БЦЖ ___________20__р., 0,05 мг = 74; 1 мл; серія ________,  контроль ___________. Якщо ні, то вказати при= чину _______________________________________________________________________= ___________,

ВГВ__= ___________________________________________________________________________= ________________

Стр&#= 1086;к придатност&= #1110; ____________________________, виробник ___________________________________________

19. Скринінг на ФКУ: дата _______________________, результат________= __________________________________

20. Лекція з догляду за дитиною та вигодовува&= #1085;ня проведена _______= __,

ким  (лікар-неон= ;атолог, медсестра) ____________________________________________________________________

21. Дитина виписана в задовільно&= #1084;у стані на ________дl= 6;бу з вагою тіла __________________________ г

22. Діагноз _______________________________________________________________________= _________________

 

 

23. Рекомендов&= #1072;но огляд дільничног&= #1086; лікаря в перші дві доби після виписки, консультац&= #1110;ї.

24. Група здоров’я _______________________________________________________________________= _________

<= span lang=3DUK style=3D'font-size:10.0pt;mso-ansi-language:UK'>25. Рекомендац&= #1110;ї

 

 

26. Особливі зауваження =

 

„_____” ____________ 20___р.

Лі= ;кар акушер-гіне= колог__________________________Лі= кар педіатр-нео= натолог _____________________________

       &nb= sp;            =             &nb= sp;            =         (прі= 079;вище, підпис)            = ;            &n= bsp;            = ;            &n= bsp;            = ;    (прізвиm= 7;е, підпис)

       &nb= sp;            =             &nb= sp;            =             &nb= sp;            =             &nb= sp;            =      Зав. відділення&= #1084; новонародж&= #1077;них ______________________

       &nb= sp;            =             &nb= sp;            =             &nb= sp;            =             &nb= sp;            =             &nb= sp;            =             &nb= sp;            =             &nb= sp;            =       (прізв&= #1080;ще, підпис)

Начальник Центру медстатист&= #1080;ки

МОЗ Україн= 080;

 =

М.В.Г= олубчиков<= /span>

 

 

 

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