Asesmen medis Pasien kolonoskopi.docx - LRJ PEMERINTAH...

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Asesmen Awal Pasien Kolonoskopi ASESMEN AWAL MEDIS PASIEN KOLONOSCOPI Tanggal: ……./………/…….. Jam Datang : ………………. Identitas Pasien Pekerjaan : Alamat : Anamnesa Allo anamnesis Auto Anamnesis Keluhan Utama :………………………………………………..….,sejak……………hari/minggu/bln/thn Anamnesa umum(ringkas)………………………………………………………………………………… Anamnesa khusus: Sakit Perut : Konsumsi Obat: Berak Darah : Lama : Frek: Berak Lendir : Konsumsi Jamu Diare : Lma: Frek: Obstipasi/Konstipasi : Merokok: Lama: Perubahan Pola BAB : Jumlah Penurunan Berat Badan : Konsumsi Alkohol: Turun: Kg/Bln Lama: Frek: Riwayat Keluarga Menderita : Pemeriksaan Fisik Ikterus : Hepatomegali : Asites : Splenomegali : Kaput Medusa : Kolateral : Tensi : Nadi : Saturasi O2 : RR : Temperatur Axila: Pola Makan Nasi Putih : Ayam : Pepaya : Nasi Jagung : Telur : Jeruk/Apel
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