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Individual Treatment Record (Itr) For Patient With Fever/Rashes

This document contains an individual treatment record for a patient presenting with fever and rashes. It includes the patient's personal information, vital signs, chief complaint, signs and symptoms, impression/diagnosis, treatment plan, and plans for follow up. The record tracks whether the patient has dengue fever without or with warning signs, and allows for noting other potential issues like cough, skin lesions, or runny nose.

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Concepcion RHU
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430 views1 page

Individual Treatment Record (Itr) For Patient With Fever/Rashes

This document contains an individual treatment record for a patient presenting with fever and rashes. It includes the patient's personal information, vital signs, chief complaint, signs and symptoms, impression/diagnosis, treatment plan, and plans for follow up. The record tracks whether the patient has dengue fever without or with warning signs, and allows for noting other potential issues like cough, skin lesions, or runny nose.

Uploaded by

Concepcion RHU
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
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MUNICIPALITY OF CONCEPCION

CONCEPCION RURAL HEALTH UNIT

INDIVIDUAL TREATMENT RECORD (ITR) FOR PATIENT WITH FEVER/RASHES

Date: _______________

Time admitted: _______________

Name: ______________________________Birthday: _____________Age:______Sex:______Status:________

Address: _________________________________School (if student): _________________________________

Parents: ______________________NHTS(Yes): _________(No): ________Philhealth No. ________________

Occupation: __________________

VITAL SIGNS: BP: __________TEMP.__________PR__________RR_________WT________HT_________

S: Chief Compliant: (please check if present)

A. Dengue without warning sign

DATE SIGN AND SYMPTOMS PLEASE


STARTED & N0. OF DAYS CHECK IF Impression/Diagnosis:
PRESENT _________________________________________________
Fever _________________________________________________
Headache
Myalgia (body pains)
Retro-orbital pain
(behind eyes)
Plans/Treatment:
Nausea (kasukaon)
Diarrhea (LBM) _________________________________________________
Rash (petechial _________________________________________________
Hermann’s rash) _________________________________________________
Body malaise _________________________________________________
(palamuypuy) _________________________________________________
Arthralgia (joint pains) _________________________________________________
Anorexia (wala gana _________________________________________________
magkaon) _________________________________________________
Vomiting _________________________________________________
Flushed skin (gapamula) _________________________________________________
Decrease WBC
Decrease Platelet count Follow-UP:
NS1 (+)
IgM test (+) optional Date Platelet WBC Hematocrit
Tourniquet test Count
B. Dengue with warning signs

Abdominal pain or
tenderness
Persisten vomiting
(sige-sige suka)
Clinical signs of fluid
accumulation
Mucosal (gum, nose)
bleeding
Lethargy (palangluya)
Restlessness
Increase in hematocrit
Decrease Platelet count
C. Others

Cough
Skin lesionss
Runny nose

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