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  • Travelling Dialysis Patient Questionare: Laborat/ Laboratory Value: Terlampir

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    Adiyanto
    16 просмотров3 страницы
    This document contains three travelling dialysis patient questionnaires. Each questionnaire provides information about a patient's name, age, address, medical diagnosis of chronic kidney disease, date of last dialysis treatment, vascular access method, dialysis machine and dialyzer used, dialysate composition, blood and dialysate flow rates, heparinization levels, blood pressure, pulse, and attached laboratory results. The questionnaires are signed by the treating physician.

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    TRAVELLING CETAK.docx

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    This document contains three travelling dialysis patient questionnaires. Each questionnaire provides information about a patient's name, age, address, medical diagnosis of chronic kidney disease, date of last dialysis treatment, vascular access method, dialysis machine and dialyzer used, dialysate composition, blood and dialysate flow rates, heparinization levels, blood pressure, pulse, and attached laboratory results. The questionnaires are signed by the treating physician.

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    © All Rights Reserved
    Скачайте в формате DOCX, PDF, TXT или читайте онлайн в Scribd
    Отметить как неприемлемый контент
    16 просмотров3 страницы

    Travelling Dialysis Patient Questionare: Laborat/ Laboratory Value: Terlampir

    Загружено:

    Adiyanto
    This document contains three travelling dialysis patient questionnaires. Each questionnaire provides information about a patient's name, age, address, medical diagnosis of chronic kidney disease, date of last dialysis treatment, vascular access method, dialysis machine and dialyzer used, dialysate composition, blood and dialysate flow rates, heparinization levels, blood pressure, pulse, and attached laboratory results. The questionnaires are signed by the treating physician.

    Авторское право:

    © All Rights Reserved
    Скачайте в формате DOCX, PDF, TXT или читайте онлайн в Scribd
    Отметить как неприемлемый контент
    из 3

    TRAVELLING DIALYSIS PATIENT QUESTIONARE

    Nama pasien/ Patient’n name : Tn. Siwan

    Umur/ Age : 62 Tahun

    Alamat/ Recent addres : Karangsari 6/3,Kalimanah,kab. Purbalingga

    Diagnosis Medis/ Medical Diagnosis : CKD

    HD terakhir/ Last of dyalisis : 6 Juli 2018

    BB kering/ Patient dry weigh : Belum diketahui

    Frekuensi/ Number of run per week :-

    Lama HD/ How long per run : 3 jam (inisiasi)

    Akses Vaskuler/ Vasculair acces : Femoral

    Mesin/ Machine : Nipro Surdial 55 Plus

    Dialiser/ Dializer : Elisio 13 H

    Dialisat/ Composition of dialisate : Bicarbonat

    QB : 190 ml/mnt

    QD : 500 ml/mnt

    Heparinisasi/ type of heparinization used : 500-1000 iu

    TD/ Blood Pressure : 150/100 mmHg

    Nadi/ Pulse : 94 x/mnt

    Laborat/ Laboratory value : Terlampir

    Purbalingga, 06 Juli 2018

    dr. Indra Adhi Nugraha, Sp.PD


    TRAVELLING DIALYSIS PATIENT QUESTIONARE
    Nama pasien/ Patient’n name : Ny.Sri Mulyani

    Umur/ Age : 59 Tahun

    Alamat/ Recent addres : Gemuruh 1/3, Padamara,kab. Purbalingga

    Diagnosis Medis/ Medical Diagnosis : CKD

    HD terakhir/ Last of dyalisis : 2 Juli 2018

    BB kering/ Patient dry weigh : Belum diketahui

    Frekuensi/ Number of run per week :-

    Lama HD/ How long per run : 3 jam (inisiasi)

    Akses Vaskuler/ Vasculair acces : Femoral

    Mesin/ Machine : Nipro Surdial 55 Plus

    Dialiser/ Dializer : Elisio 13 H

    Dialisat/ Composition of dialisate : Bicarbonat

    QB : 180 ml/mnt

    QD : 500 ml/mnt

    Heparinisasi/ type of heparinization used : 500-1000 iu

    TD/ Blood Pressure : 160/90 mmHg

    Nadi/ Pulse : 87 x/mnt

    Laborat/ Laboratory value : Terlampir

    Purbalingga, 03 Juli 2018

    dr. Indra Adhi Nugraha, Sp.PD


    TRAVELLING DIALYSIS PATIENT QUESTIONARE
    Nama pasien/ Patient’n name : Ny. Wartini

    Umur/ Age : 60 Tahun

    Alamat/ Recent addres : Kedunglegok 11/06 Kemangkon kab. Purbalingga

    Diagnosis Medis/ Medical Diagnosis : CKD

    HD terakhir/ Last of dyalisis : 14 Juli 2018

    BB kering/ Patient dry weigh : Belum diketahui

    Frekuensi/ Number of run per week :-

    Lama HD/ How long per run : 3 jam (inisiasi)

    Akses Vaskuler/ Vasculair acces : Femoral

    Mesin/ Machine : Nipro Surdial 55 Plus

    Dialiser/ Dializer : Elisio 13 H

    Dialisat/ Composition of dialisate : Bicarbonat

    QB : 180 ml/mnt

    QD : 500 ml/mnt

    Heparinisasi/ type of heparinization used : 500-1000 iu

    TD/ Blood Pressure : 150/100 mmHg

    Nadi/ Pulse : 88 x/mnt

    Laborat/ Laboratory value : Terlampir

    Purbalingga, 14 Juli 2018

    dr. Indra Adhi Nugraha, Sp.PD

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