Dagbog for semi-ambulante patienter

Kontakt os altid på telefon 97 66 38 33 (hverdage) eller 97 66 38 01 (aften, nat, weekend), hvis du får følgende symptomer:

• Temperatur over 38,5 grader
• Andre tegn på infektion
• Blødning.

Har du spørgsmål, er du velkommen til at kontakte os.

Dato
Temperatur morgen (grader celsius)
Temperatur aften (grader celsius)
Vægt 2 gange ugentligt (kg)

Notér symptomer på infektion, nyopståede problemer, ændringer i appetit, humør, motion eller andet:

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Notér, hvis du mangler medicin, udstyr til skift af forbinding eller udstyr til blodprøvetagning i eget hjem:

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____________________________________________________________________________________________________________________________________________________________________________________

____________________________________________________________________________________________________________________________________________________________________________________

Dato
Temperatur morgen (grader celsius)
Temperatur aften (grader celsius)
Vægt 2 gange ugentligt (kg)

Notér symptomer på infektion, nyopståede problemer, ændringer i appetit, humør, motion eller andet:

__________________________________________________________________________________________
__________________________________________________________________________________________

__________________________________________________________________________________________
__________________________________________________________________________________________

__________________________________________________________________________________________
__________________________________________________________________________________________

__________________________________________________________________________________________
__________________________________________________________________________________________

Notér, hvis du mangler medicin, udstyr til skift af forbinding eller udstyr til blodprøvetagning i eget hjem:

__________________________________________________________________________________________
__________________________________________________________________________________________

____________________________________________________________________________________________________________________________________________________________________________________

____________________________________________________________________________________________________________________________________________________________________________________

____________________________________________________________________________________________________________________________________________________________________________________

Dato
Temperatur morgen (grader celsius)
Temperatur aften (grader celsius)
Vægt 2 gange ugentligt (kg)

Notér symptomer på infektion, nyopståede problemer, ændringer i appetit, humør, motion eller andet:

____________________________________________________________________________________________________________________________________________________________________________________

____________________________________________________________________________________________________________________________________________________________________________________

____________________________________________________________________________________________________________________________________________________________________________________

____________________________________________________________________________________________________________________________________________________________________________________

Notér, hvis du mangler medicin, udstyr til skift af forbinding eller udstyr til blodprøvetagning i eget hjem:

____________________________________________________________________________________________________________________________________________________________________________________

____________________________________________________________________________________________________________________________________________________________________________________

____________________________________________________________________________________________________________________________________________________________________________________

____________________________________________________________________________________________________________________________________________________________________________________

Dato
Temperatur morgen (grader celsius)
Temperatur aften (grader celsius)
Vægt 2 gange ugentligt (kg)

Notér symptomer på infektion, nyopståede problemer, ændringer i appetit, humør, motion eller andet:

____________________________________________________________________________________________________________________________________________________________________________________

____________________________________________________________________________________________________________________________________________________________________________________

____________________________________________________________________________________________________________________________________________________________________________________

____________________________________________________________________________________________________________________________________________________________________________________

Notér, hvis du mangler medicin, udstyr til skift af forbinding eller udstyr til blodprøvetagning i eget hjem:

____________________________________________________________________________________________________________________________________________________________________________________

____________________________________________________________________________________________________________________________________________________________________________________

____________________________________________________________________________________________________________________________________________________________________________________

____________________________________________________________________________________________________________________________________________________________________________________

Dato
Temperatur morgen (grader celcius)
Temperatur aften (grader celcius)
Vægt 2 gange ugentligt (kg)

Notér symptomer på infektion, nyopståede problemer, ændringer i appetit, humør, motion eller andet:

____________________________________________________________________________________________________________________________________________________________________________________

____________________________________________________________________________________________________________________________________________________________________________________

____________________________________________________________________________________________________________________________________________________________________________________

____________________________________________________________________________________________________________________________________________________________________________________

Notér, hvis du mangler medicin, udstyr til skift af forbinding eller udstyr til blodprøvetagning i eget hjem:

____________________________________________________________________________________________________________________________________________________________________________________

____________________________________________________________________________________________________________________________________________________________________________________

____________________________________________________________________________________________________________________________________________________________________________________

____________________________________________________________________________________________________________________________________________________________________________________

Dato
Temperatur morgen (grader celcius)
Temperatur aften (grader celcius)
Vægt 2 gange ugentligt (kg)

Notér symptomer på infektion, nyopståede problemer, ændringer i appetit, humør, motion eller andet:

____________________________________________________________________________________________________________________________________________________________________________________

____________________________________________________________________________________________________________________________________________________________________________________

____________________________________________________________________________________________________________________________________________________________________________________

____________________________________________________________________________________________________________________________________________________________________________________

Notér, hvis du mangler medicin, udstyr til skift af forbinding eller udstyr til blodprøvetagning i eget hjem:

____________________________________________________________________________________________________________________________________________________________________________________

____________________________________________________________________________________________________________________________________________________________________________________

____________________________________________________________________________________________________________________________________________________________________________________

____________________________________________________________________________________________________________________________________________________________________________________

Dato
Temperatur morgen (grader celcius)
Temperatur aften (grader celcius)'
Vægt 2 gange ugentligt (kg)

Notér symptomer på infektion, nyopståede problemer, ændringer i appetit, humør, motion eller andet:

____________________________________________________________________________________________________________________________________________________________________________________

____________________________________________________________________________________________________________________________________________________________________________________

____________________________________________________________________________________________________________________________________________________________________________________

____________________________________________________________________________________________________________________________________________________________________________________

Notér, hvis du mangler medicin, udstyr til skift af forbinding eller udstyr til blodprøvetagning i eget hjem:

____________________________________________________________________________________________________________________________________________________________________________________

____________________________________________________________________________________________________________________________________________________________________________________

____________________________________________________________________________________________________________________________________________________________________________________

____________________________________________________________________________________________________________________________________________________________________________________

Dato
Temperatur morgen (grader celcius)
Temperatur aften (grader celcius)
Vægt 2 gange ugentligt (kg)

Notér symptomer på infektion, nyopståede problemer, ændringer i appetit, humør, motion eller andet:

__________________________________________________________________________________________
__________________________________________________________________________________________

__________________________________________________________________________________________
__________________________________________________________________________________________

__________________________________________________________________________________________
__________________________________________________________________________________________

__________________________________________________________________________________________
__________________________________________________________________________________________

Notér, hvis du mangler medicin, udstyr til skift af forbinding eller udstyr til blodprøvetagning i eget hjem:

__________________________________________________________________________________________
__________________________________________________________________________________________

__________________________________________________________________________________________
__________________________________________________________________________________________

__________________________________________________________________________________________
__________________________________________________________________________________________

__________________________________________________________________________________________
__________________________________________________________________________________________

Dato
Temperatur morgen (grader celcius)
Temperatur aften (grader celcius)
Vægt 2 gange ugentligt (kg)

Notér symptomer på infektion, nyopståede problemer, ændringer i appetit, humør, motion eller andet:

__________________________________________________________________________________________
__________________________________________________________________________________________

__________________________________________________________________________________________
__________________________________________________________________________________________

__________________________________________________________________________________________
__________________________________________________________________________________________

__________________________________________________________________________________________
__________________________________________________________________________________________

Notér, hvis du mangler medicin, udstyr til skift af forbinding eller udstyr til blodprøvetagning i eget hjem:

__________________________________________________________________________________________
__________________________________________________________________________________________

__________________________________________________________________________________________
__________________________________________________________________________________________

__________________________________________________________________________________________
__________________________________________________________________________________________

__________________________________________________________________________________________
__________________________________________________________________________________________

Dato
Temperatur morgen (grader celcius)
Temperatur aften (grader celcius)
Vægt 2 gange ugentligt (kg)

Notér symptomer på infektion, nyopståede problemer, ændringer i appetit, humør, motion eller andet:

__________________________________________________________________________________________
__________________________________________________________________________________________

__________________________________________________________________________________________
__________________________________________________________________________________________

__________________________________________________________________________________________
__________________________________________________________________________________________

__________________________________________________________________________________________
__________________________________________________________________________________________

Notér, hvis du mangler medicin, udstyr til skift af forbinding eller udstyr til blodprøvetagning i eget hjem:

__________________________________________________________________________________________
__________________________________________________________________________________________

__________________________________________________________________________________________
__________________________________________________________________________________________

__________________________________________________________________________________________
__________________________________________________________________________________________

__________________________________________________________________________________________
__________________________________________________________________________________________

Dato
Temperatur morgen (grader celcius)
Temperatur aften (grader celcius)
Vægt 2 gange ugentligt (kg)

Notér symptomer på infektion, nyopståede problemer, ændringer i appetit, humør, motion eller andet:

__________________________________________________________________________________________
__________________________________________________________________________________________

__________________________________________________________________________________________
__________________________________________________________________________________________

__________________________________________________________________________________________
__________________________________________________________________________________________

__________________________________________________________________________________________
__________________________________________________________________________________________

Notér, hvis du mangler medicin, udstyr til skift af forbinding eller udstyr til blodprøvetagning i eget hjem:

__________________________________________________________________________________________
__________________________________________________________________________________________

__________________________________________________________________________________________
__________________________________________________________________________________________

__________________________________________________________________________________________
__________________________________________________________________________________________

__________________________________________________________________________________________
__________________________________________________________________________________________

Dato
Temperatur morgen (grader celcius)
Temperatur aften (grader celcius)
Vægt 2 gange ugentligt (kg)

Notér symptomer på infektion, nyopståede problemer, ændringer i appetit, humør, motion eller andet:

__________________________________________________________________________________________
__________________________________________________________________________________________

__________________________________________________________________________________________
__________________________________________________________________________________________

__________________________________________________________________________________________
__________________________________________________________________________________________

__________________________________________________________________________________________
__________________________________________________________________________________________

Notér, hvis du mangler medicin, udstyr til skift af forbinding eller udstyr til blodprøvetagning i eget hjem:

__________________________________________________________________________________________
__________________________________________________________________________________________

__________________________________________________________________________________________
__________________________________________________________________________________________

__________________________________________________________________________________________
__________________________________________________________________________________________

__________________________________________________________________________________________
__________________________________________________________________________________________

Dato
Temperatur morgen (grader celcius)
Temperatur aften (grader celcius)
Vægt 2 gange ugentligt (kg)

Notér symptomer på infektion, nyopståede problemer, ændringer i appetit, humør, motion eller andet:

__________________________________________________________________________________________
__________________________________________________________________________________________

__________________________________________________________________________________________
__________________________________________________________________________________________

__________________________________________________________________________________________
__________________________________________________________________________________________

__________________________________________________________________________________________
__________________________________________________________________________________________

Notér, hvis du mangler medicin, udstyr til skift af forbinding eller udstyr til blodprøvetagning i eget hjem:

__________________________________________________________________________________________
__________________________________________________________________________________________

__________________________________________________________________________________________
__________________________________________________________________________________________

__________________________________________________________________________________________
__________________________________________________________________________________________

__________________________________________________________________________________________
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