[ Meaatenls De rasa ‘MUSCULO-SKELETAL | Diagnosis. [ CARE CONCERNS: Mobility: C heriplegia _. Clquathiploga Clparaplegia__ Cl paresis Magh Ea ag Muscles: D spastic Diiaccd Cltemors Cites Cl epaams Clpan__ me fi Muscle mass: Cadequate emaciated Clary others 7 Sensory detot ‘Assistance Needed: Cone C1 aria Cuil assisive dacs ) epee soints: ROM: Cul Cited Dreaness: — Dotthess__ Cartas opt SS lneebet Shisia, Ciampuistons____ onesies: ot op OE Coordination Frpared Csiowed Gat Hae Posturing Ciyphoss Clovasis Cseniose Cidecoricate Ci deoeretrate ay Cloplstiotonus ober. Totes Functional dsabifty: Diseding Dioieing i rarer Ciresing bors | Supports: oast,__- sing raion Ones | Medications. | Dxrosut l RESPIRATORY. | Dieanosis: | CARE CONCERNS Chet hepe:____Cefomiies____ 1 pahiacomfon | ANEFOR: Postar {ene Cencere yen Crogular Cagle (9) Leena Dep: Cinomal 1 sraiaw O deep Cimovtbeeating oe Quay Choma labored Cstidor Chegophory oe Eromton Cnymetial Cennreted Chaired Saad no rn Chaing Crtrctons:___ + Claoosesory musls: at OyspraatClabsent ClatRest with Actty CISOB Corthopnea eu a Ojanosis:Clabeent Cloenrd Dperinneral — Sea arctan ough: Catoent ry arch prestoive nan poducteCemopyis | “83 CSecxretons cola ‘hight swaats Reee Fronitus: CprosentCJabeent a ceiena Chest Tubestoccharantsatis). Gaygon therapy: va Pat eee ol MochNenliatr: ype, seting: Rea Afi away OETONTETT oars eee te a OX Rest ee aa CARDIOVASCULAR” | Dinos: CARE CONCERNS | ‘Dithestpah Dpatitatons nal: oo, Clakbbing capil ref_ seconds | Epa beieame | ‘Apical pulse: rate:__ Clregutar Diragular Pulse Defct: C1 No D1 Yes PM Deis ‘comfor ‘Abnormalies: Chnurmurs_ tis Conut___ Ciheaves: le ose | iynamnicprecerdum — Opedzatiatficion ofers__"____ Pv Meas. nee ‘Aveculatory areas: Aorte:_Puimoric:_ Tricuspid: _ Mitra: Osi O82 : Cardae Monitor yes Lino Pace maker: Cho yes Rhythm: regular CI ireguar eens oe eee ene oe lene Edema: Cpedal LClanike LIR Chewarlag UR Ciface Cnon-piting Cipiting Grade: a | ‘Type of IV line: Doerr fo. Dhetipharal foc. DVinfitraion cher: | | Clove leckage CVP vel Evarioostios Cistdsshunis foo eee Hemetbnisine:__petecrieo —_eccymosis __pupuwe __ hematoma UBT Type‘ cof units__ MI resetons | cae: insln yp others a Nedcaton’ Deresuts at | ‘Copyright®201 Adolescent-AduIt Assessment Tool SLUSON Page?