Page 98 - Clinical Practice Guideline

ภาคผนวก༛ซ.
฽บบประ฼มินการติดตามการรักษาของผูຌปຆวย฾รคหลอด฼ลือดสมอง฿นชุมชน

ชืไอ.......................................สกุล.........................................༛อายุ.......................ป຃༛༛༛༛ HN๧๧๧๧๧๧..

ครัๅงทีไประ฼มิน
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วัน/฼ดือน/ป຃༛ทีไประ฼มิน༛(ระบุ)
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༛-༛ความดัน฾ลหิต............มม./ปรอท༛༛༛ ...........༛ ...........༛ ...........༛ ...........༛ ...........༛ ...........༛ ...........༛ ...........
༛-༛ชีพจร....................ครัๅง/นาที༛༛ ...........༛ ...........༛ ...........༛ ...........༛ ...........༛ ...........༛ ...........༛ ...........
༛-༛การหาย฿จ.............ครัๅง/นาที༛༛ ...........༛ ...........༛ ...........༛ ...........༛ ...........༛ ...........༛ ...........༛ ...........
༛-༛อุณหภูมิ................องศา฼ซล฼ซียส༛ ...........༛ ...........༛ ...........༛ ...........༛ ...........༛ ...........༛ ...........༛ ...........
จุด฼จใบ༛ระบุต้า฽หน຋ง................................༛ ...........༛ ...........༛ ...........༛ ...........༛ ...........༛ ...........༛ ...........༛ ...........
Pain༛score༛(0༛๜༛10)༛ ...........༛ ...........༛ ...........༛ ...........༛ ...........༛ ...........༛ ...........༛ ...........
การหลุดหลวมขຌอต຋อ༛(cm.)..........................༛ ...........༛ ...........༛ ...........༛ ...........༛ ...........༛ ...........༛ ...........༛ ...........
ดูลักษณะทัไวเป༛(ระบุรายละ฼อียด)༛ ...........༛ ...........༛ ...........༛ ...........༛ ...........༛ ...........༛ ...........༛ ...........
1.༛กลຌาม฼นืๅอ༛(การลีบ/ฝຆอ/ความ฼กรใง)༛ ...........༛ ...........༛ ...........༛ ...........༛ ...........༛ ...........༛ ...........༛ ...........
2.༛การบวม༛ ...........༛ ...........༛ ...........༛ ...........༛ ...........༛ ...........༛ ...........༛ ...........
3.༛ก้า฼ดา༛(ความรຌอน)༛ ...........༛ ...........༛ ...........༛ ...........༛ ...........༛ ...........༛ ...........༛ ...........
4.༛ลักษณะการ฼ดิน༛ ...........༛ ...........༛ ...........༛ ...........༛ ...........༛ ...........༛ ...........༛ ...........
5.༛การพูด༛(ชัด/เม຋ชัด)༛ ...........༛ ...........༛ ...........༛ ...........༛ ...........༛ ...........༛ ...........༛ ...........
จับการ฼ดินของชีพจรมือ฽ละ฼ทຌา༛(ขຌางทีไ฼ปຓน)༛...........༛ ...........༛ ...........༛ ...........༛ ...........༛ ...........༛ ...........༛ ...........
วัดสຌน฼ทຌา༛(ระบุ฼ปຓน฼ซนติ฼มตร)༛ ...........༛ ...........༛ ...........༛ ...........༛ ...........༛ ...........༛ ...........༛ ...........
องศาการ฼คลืไอนเหวของขຌอ༛ ...........༛ ...........༛ ...........༛ ...........༛ ...........༛ ...........༛ ...........༛ ...........
1.༛กระดกขຌอ฼ทຌา༛ ...........༛ ...........༛ ...........༛ ...........༛ ...........༛ ...........༛ ...........༛ ...........
2.༛กระดิกนิๅว฼ทຌา༛ ...........༛ ...........༛ ...........༛ ...........༛ ...........༛ ...........༛ ...........༛ ...........
3.༛ตัๅงขาชัน฼ข຋า༛ ...........༛ ...........༛ ...........༛ ...........༛ ...........༛ ...........༛ ...........༛ ...........
4.༛กระดกขຌอมือ༛ ...........༛ ...........༛ ...........༛ ...........༛ ...........༛ ...........༛ ...........༛ ...........
5.༛กระดิกนิๅวมือ༛ ...........༛ ...........༛ ...........༛ ...........༛ ...........༛ ...........༛ ...........༛ ...........
6.༛การก้ามือ༛฽บมือ༛ ...........༛ ...........༛ ...........༛ ...........༛ ...........༛ ...........༛ ...........༛ ...........
7.༛คว้ไามือ-หงายมือ༛ ...........༛ ...........༛ ...........༛ ...........༛ ...........༛ ...........༛ ...........༛ ...........

90 คู຋มือ฽นวทาง฼วชฏิบัติ༛(Clinical༛Practice༛Guideline)༛การดู฽ลผูຌปຆวยระยะกลาง༛(Intermediate༛Care)༛
ดຌานการ฽พทยຏ฽ผนเทย฽ละการ฽พทยຏทาง฼ลือก