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Child’s physical exam

CHILD’S PHYSICAL EXAM
Date Exam Scheduled: ______________
Date Exam Performed: ______________
Child’s name: _______________________________________

Date of Birth: ________________
Height: ______________
Weight: ________________
Temperature: _________________
Blood Pressure: ___________________________________
Immunization Dates:
DPT: _________________

Measles: __________________
Polio: ________________
Rubella: __________________
Hepatitis: _____________
Small Pox: _______________
Chicken Pox: _________
Other: ___________________
_____________________________________________________________________________________
_____________________________________________________________________________________
Adenoids: _____________________________________________________________________________________
Chest:

_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
Abdomen:
_____________________________________________________________________________________
Secondary Sex Characteristics: ____________________________________________________________________
Genitals:

_____________________________________________________________________________________
Reflexes:
_____________________________________________________________________________________
Extremities: _____________________________________________________________________________________
Posture and Spine: _______________________________________________________________________________
Nutrition:

_____________________________________________________________________________________
Signs of Endocrine Imbalance: _____________________________________________________________________
Menses:

_____________________________________________________________________________________

Treatment given: _________________________________________________________________________________
__________________________________________________________________________________________________
__________________________________________________________________________________________________
__________________________________________________________________________________________________
Recommendations: _______________________________________________________________________________
__________________________________________________________________________________________________
__________________________________________________________________________________________________
__________________________________________________________________________________________________
Examining Physician Signature: _______________________________________________
Please print or type: ____________________________________________

(physician’s name)

Address:

_________________________________________________________
_________________________________________________________
I, the undersigned physician, give my permission for the foster parents to administer the following over-the-counter
medications to: ______________________________________________DOB:_______________
(Child’s name)
Type of Drug:
Examples:
__As directed on packaging
____Antacids and Acid Reducers
Tums,Rolaids;generic; or ___________________ or ___________________
Femstat 3, Gyne-Lotrimin, Mycelrx-7, Monistat

__As directed on packaging
____Anticandial
3, 7, and Vagistat-1; or ___________________
or ___________________
Actifed, Benadryl,Claritin, Chlor-Trimeton,
__As directed on packaging
____Antihistamines
Contac, Drixoral,Nyquil, Sudafed, Tavist-1, and
or ___________________
Triaminic,generic; or ___________________
Ex-Lax, Pepto-Bismol, Immodium A.D. and

__As directed on packaging
____Antidiarrheal and Laxatives
Kaopectate; or ___________________
or ___________________
____Anti-fungal
Lamisil AT, Lotramin AF, and Micatin;
__As directed on packaging
or ___________________
or ___________________
Bactine, Caldecort, Cortaid, Hydrocortisone,
____Anti-itch lotions and creams (e.g.,
and Lanacort,Calamine Lotion, Benadryl Cream, __As directed on packaging
for athletes foot, jock itch, bug
Caladryl, Cortaid,Lamisil AT, Lotramin AF, and
or ___________________
bites, poison ivy)
Micatin;
or ___________________
Robitussin, Vicks 44, Chloraseptic;

__As directed on packaging
____Cough Suppressants
or ___________________
or ___________________
Abreva Cream, Carmex; or
__As directed on packaging
____Cold Sore/Fever Blister
___________________
or ___________________
Advil Cold and Sinus, Afrin, Afrinol, Aleve Cold
and Sinus,Children’s Advil Cold, Duration,
Dristan Long Lasting,Neo-Synephrine- 12 Hour,
Orrivin, Sudafed,Tavist-D,Tylenol Cold and

____Decongestant/ Nasal
Flue, Thera-flu, Alka Seltzer Cold and Flu,
__As directed on packaging
Decongestant and Cold Remedies
Nyquil, Actidil Syrup and Capsules, Actifed,
or ___________________
Allerest,Benadryl, Claritin, Chlor-Trimeton,
Contac, Dimetane,Drixoral, Sudafed, Tavist-1,
and Triaminic;

or __________________
__As directed on packaging
____Eye Drops for Allergy/Cold Relief
Ocu Hist; or ___________________
or ___________________
Advil, Aleve, Children’s Motrin, Nuprin,
__As directed on packaging
____Internal Analgesic/antipyretic
Excedrin, Tylenol and Bayer; or
or ___________________
___________________
BenGay, Tiger Balm and Flexall; or

__As directed on packaging
____Liniments
__________________
or ___________________
Midol, Pamprin, and Premysyn PMS;
__As directed on packaging
____Menstrual Cycle Medications
or ___________________
or ___________________
____Migraine
Advil Migraine Liqui-gels, Excedrin Migraine,
__As directed on packaging
MotrinMigraine Pain, or ___________________
or ___________________
__As directed on packaging

____Pediculicide (head lice)
Nix; RID; or ___________________
or ___________________
____Toothache and teething pain
__As directed on packaging
Orajel; or ___________________
relievers
or ___________________
____Wart removal medications
Compound W; Tinamed or
__As directed on packaging
___________________
or ___________________

Physician Signature: ________________________________________________

Please print or type: ________________________________________________
(physician’s name)
Address:_________________________________________________________
Phone: __________________________________________________________

Source: http://www.bridgescpa.com/Physical%20Exam.pdf

Caso clinico psicosi f

• F. (nato nel 1996) secondogenito di due; gravidanza decorsa nella norma con parto euto• Allattamento materno sino a quattro mesi. • Non riferite ritardi o atipie nello sviluppo Nel 2008 (12 aa) ricovero per "ulcera gastrica" Ottimo rendimento scolastico da sempre. Ha completato la terza media con difficoltà per l'insorgenza della sintomatologia psicotica. Riferite lievi dif

Microsoft word - nutrition in recovery

NUTRITION IN RECOVERY Let food be your medicine. -Hippocrates noticeably improved through good nutrition.  Reduce withdraw symptoms and cravings  Detoxify the body from harmful affects of Eat artificial, processed fuel - we feel These include:  Recovery Fruits- 2-3 servings a day □ Raspberries □ Strawberries □ Watermelon  Recovery Vegetables- 4- 7 servings a day

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