Ficha de Avaliao Fisioteraputica: Motora e Respiratria Peditrica

DADOS DA CRIANA:Nome:_____________________________________________________Data de nasc.:__/__/____ Sexo:____ Id. cronolgica:______ Id. corrigida:________Local de nascimento:____________ Peso ao nascer:_______ Peso atual:_______Apgar: 1 min.____ 5 min.____

DADOS DA ME:Nome:______________________________________________________Data de nasc.:__/__/____ Idade:______Ocupao:_________________ Escolaridade:__________________________Etilista:______ Tabagista:______ Drogas:_____________________________

DADOS DO PARTO:Descrever tipo de parto bem como se houve intercorrncias:_________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

OBSERVAES GERAIS:______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

AVALIAO DA CRIANA:

Colorao:_______________ FR:______ FC: ______ SpO2: _______

Ausculta pulmonar:_____________________________________

Esforo respiratrio: ____________________________________

Tnus: ____________________________________________

Reflexos primitivos: ____________________________________________________________________________________

Posio viciosa: ______________________________________________________________________________________

Limitaes de ADM:___________________________________________________________________________________________________________________________________

Fora muscular: ______________________________________________________________________________________

Marcos motores:_____________________________________________________________________________________________________________________________________

Equilbrio: __________________________________________

Postura (realiza troca): __________________________________________________________________________________

Marcha:_________________________________________________________________________________________________________________________________________

DIAGNSTICO FISIOTERAPUTICO:__________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

OBSERVAES:__________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________