valoracion 14 necesidades v. henderson 2

VALORACIN 14 NECESIDADES V

Valoracin 14 Necesidades Virginia Henderson

E.C. Salud Mlaga

Departamento Enfermera Valoracin 14 necesidades V. Henderson1.- RESPIRACIN - CIRCULACIN

RESPIRACIN:

Va Area: Permeable __. No Permeable __. Intubacin: No.__ S.___ Traqueotoma: No.__ S.___

Obstruccin: Parcial.__ Total.__ Nariz. __ Boca. ___ Bronquial. __ Pulmonar. __ Causa: __________

_____________________________________________________________________________________Cnula Tipo: No. __ S__.: Naso traqueal. __ Oro traqueal. __ Traqueal. __.Tipo: _____________ N.__

Mascarilla: No. __ S. __ Gafa Nasal: No. __ S. __ % O2: _______

Frecuencia: Respiraciones: ____ por mto. SO2: ___ %.

Tipo: Eupnea. __ Taquipnea. __ Bradipnea. __ Ortopnea. __ Cheyne-stokes. __ Apnea. __Aleteo Nasal.

__ Tiraje: __ Supra esternal. __ Infra esternal. __Amplitud: Normal __ Profunda. __ Superficial __

Movimiento: Torcica. __ Abdominal. __

Secreciones: Ausente. __Escasa. __Abundante. __Boca. __ Nariz. __ Color________ Olor:__________

Volumen: Normal.___ Hiperventilacin.___ Hipo ventilacin.___ Ruidos: Normal __ Crepitaciones.__

Estertores. __ Silbido. __ Gorgoteo. __ Estridor. __ Otros: _____________________________________ Dificultad Respiratoria: No. __ Si. ___ Tos: __ Seca. __ Hmeda. __ Quintosa. __Ronquera.__

Afona. __Disfona. ___Estornudo. ___ Ronquido. ___Obesidad. ___ Ansiedad. ___Estrs.___

Cianosis: No. __ S.__ Central: No.__ S.__ Perifrica: No.__ S.__ Localizacin: __________________Dolor: No. __ Si. __: Garganta. __ Trax. __ Abdomen. __ Otros:______________________________Deformaciones: No. __ S__:. __ Nariz. __ Boca. __ Trax. __ Abdomen. ___ Otros:_______________Fumador: No. __ Si. __ N Cigarrillos da: _____ Alergias: No ___ Si. __ Tipo:__________________

Intoxicacin: No. __Si. __: Respiratoria. __ Metablica. ___ Medicamentosa. __ Txico:____________

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Otras manifestaciones de Independencia: _________________________________________________ _____________________________________________________________________________________

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Otras manifestaciones de Dependencia: __________________________________________________

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Datos a Considerar: __________________________________________________________________ __________________________________________________________________________________________________________________________________________________________________________

Otros: ______________________________________________________________________________

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1.- RESPIRACIN - CIRCULACIN

CIRCULACIN:

F.C.: ____ X. Pulsos: Si _____ No___ Localizacin: ____________________ Tipo: _______________

T/A.: Sistlica. _______ Diastlica. _______ P.V.C: ____________cm/H2OECG: No ____ Si. ____ Alteraciones: ____ No ____ Si. Tipo: _________________________________Dolor: No. _____ S. ____ Torcico: ____ No. ____ S. Localizacin:___________________________Edemas.: No. ____ Si. ____ Localizacin: ________________________________________________Heridas: No ____ Si. ___ Tipo:____________________ Localizacin: __________________________Hemorragia.: No. _____ S. ____ Localizacin: ____________________________________________

Color piel y tegumentos: Normal. __ Cianosis ___ Equimosis __ Localizacin:____________________Cambios Temperatura: No ____ Si. ____ Localizacin: ______________________________________Otras manifestaciones de Independencia: _________________________________________________ _____________________________________________________________________________________

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Otras manifestaciones de Dependencia: _____________________________________________________________________________________

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Datos a Considerar: __________________________________________________________________________________________________________________________________________________________________________ _______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

Otros: ________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

2.- BEBER Y COMER, ALIMENTARSE

Vmitos: No.__ S.__ N veces _________ Cantidad:________ Contenido:______________________

Estado de la boca: Normal. ____ Deficiente. ____ Causas: ___________________________________

Denticin Suficiente: S. _____ No. ____ Prtesis. ____ No. ____ S. Ajustada: _____ Si. ____ No.

Mucosa oral rosada: Si.___ No. ___ Color: _________ Encas rosadas: __ S. __ No. Color: ________

Lengua rosada: S. ____ No. ____ Color________________ Hmeda: S. ____ No. _____

Heridas: No.___ S. ___ Tipo:________________ Localizacin: _______________________________

Masticacin: lenta. ____ rpida.___ Reflejo deglucin: S. ___ No. ___ Causa:___________________

Apetito: Si. ____ No. ____ Saciedad: S.____ No.____ Causas:_______________________________

Horario Comidas: Maana. _______ Tarde. ________ Noche. ______

Toma entre comidas: No. _____ S. ____ Tipo y Cantidad: _____________________ Hora:________

Cantidad de slidos da: Mucho, _______Normal, ________ Escaso. _____ grms./da. _________

Cantidad de liquidos da: Mucho, _______Normal, ________ Escaso. _____ cm3./da _________

Digestin: Ligera, ____ Lenta, ____ Pesada. ____ Alimentos indigestos: ________________________

Alimentos Preferidos: Verduras. ___ Carnes. ___ Pescados. ___ Frutas. __ Otros: ________________

Alimentos No Deseados: _______________________________________________________________

Restricciones: ________________________________________________________________________

Otras manifestaciones de Independencia: _________________________________________________ _______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

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Datos a Considerar: __________________________________________________________________ ____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

Otros: ______________________________________________________________________________

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3.- ELIMINACIN

ELIMNACIN URINARIA:

Cantidad: ___________ cm3/da. ________ cm3/hora. Satisfactoria: Si: ____ No: ____

Frecuencia: _____ veces da. Cantidad por miccin: ________ cm3

Dolor: No. _____ S. _____ Coloracin: Trigo ___ mbar. ___ Transparente. ____ Olor: No.____ Si. _____ Dbil. ______ Fuerte. ______ Semejanza a: ___________________________Contenido: No: ____ S: ___ Tipo y caractersticas:_________________________________________

PH: _____ Densidad: ___________ Urea: _____________ Creatinna: ______________

Va Uretral: Permeable ____. No Permeable ____.

Obstruccin: Total.__ Parcial: __ Causa:_________________________________________________Sonda Vesical: No. ___ S. ___ Permanente : S. ___ No. ___ Tipo: ___________________ N ______

Caractersticas y/o dificultad del Sondje: ________________________________________________ ____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

Otras manifestaciones de Independencia: _________________________________________________ ____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

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Otros: ______________________________________________________________________________

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3.- ELIMINACIN

ELIMNACIN FECAL:

Frecuencia: _____ veces da. Satisfactoria: Si. ____ No. ____

Estreimiento: No.___ Si.___ Diarrea: No. ___ S. ___ Habitual: No.___ S.___

Coloracin Marrn: S. __ No. __ Otro color:_____________________________________________Cantidad: Normal. ___ Escasa.___ Abundante. ___ Peso: _______ gms/deposicin. ________ gms/da.

Olor: Dbil. ______ Fuerte. ______ Semejanza: ____________________________________________Consistencia: Dura. ___ Blanda. ____ Liquida. ____ Otros Contenidos: ________________________

Obstruccin: Total.__ Parcial: __ Causa:_________________________________________________Toma Laxantes: No. ___ S. ___ Tipo: ____________________________________________________

Sonda Rectal: No. ___ S. ___ Permanente: S. ___ No. ___ Tipo: ___________________ N ______

Caractersticas y/o dificultad del Sondje: ________________________________________________ _________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

Otras manifestaciones de Independencia: _________________________________________________ ____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

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Datos a Considerar: __________________________________________________________________ _________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

Otros: ______________________________________________________________________________

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3.- ELIMINACIN

ELIMNACIN SUDOR:

S: __ No: ___

Cantidad: Normal. ___ Escasa.___ Abundante. ___ Valoracin. _______________________cm3/da. Olor: No.___ Si. ___ Dbil. ______ Fuerte. ______ Semejanza a: ______________________________Otras Fuentes de Eliminacin y Caractersticas: __________________________________________________________________________________________________________________________________________________________________________ __________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

Otras manifestaciones de Independencia: _________________________________________________ ______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

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Datos a Considerar: __________________________________________________________________ ______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

Otros: ______________________________________________________________________________

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4.- MOVIMIENTO: MANTENER POSTURA ADECUADA

D ambulacin: S.___ No.____ Silln. S.___ No.____ Cama. S.___ No.____

Mantiene posicin adecuada: S.___ No.___ Dificultad: _____________________________________

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Lesin: No.____ S.____ Cabeza: ____ Cuello: ___ Tronco:____ Extremidades: ___

Tipo: _______________________________________________________________________________ __________________________________________________________________________________________________________________________________________________________________________

Deformacin: No. __ S__ Tipo: _________________________________________________________Dolor: No __ S __ Localizacin y Tipo: ____________________________________________________Realiza ejercicio: Activo: S.___ No.___ Pasivo: S.___ No.___ Tipo: ____________________________

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Fuerza muscular: Normal. S.__ No.__ Disminuida: No.__ S.__ dificultad:_________________________________________________________________________________________________________________________________________________________________________________________________

Posibilidad de movimientos:

Levantarse: S.___ No.____ Caminar S.___ No.___ Inclinarse: S.___ No.__ Sentarse: S.___ No.___

Acostarse: S.___ No.___ Correr: S.___ No.___ Agacharse: S.___ No.___ Arrodillarse: S.___ No.___

Levantar Peso: S.___ No.___ Estirarse: S.___ No.___ Coger objetos: S.___ No.___

Alcanzar objetos: S.___ No.___ Dificultad: ________________________________________________ Prtesis: S.___ No.____ Tipo:___________________________________________________________Utiliza medios mecnicos: S.___ No.____ Tipo:____________________________________________Otras manifestaciones de Independencia: _________________________________________________ _____________________________________________________________________________________

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Datos a Considerar: __________________________________________________________________ _______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

Otros: ______________________________________________________________________________

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5.- NECESIDAD DE DORMIR Y DESCANSAR

SUEO:

Nocturno: S.___ No.___ Duracin: __________h. Diurno: S.___ No.___ Duracin: ________h. Normal: ___ Profundo: ___ Ligero: ____ Satisfactorio: S.___ No.___

Caractersticas: ______________________________________________________________________

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Hbitos ligados al sueo: Bao: No.___ S.___ ducha: No.___ S.___ Infusin: No.___ S.___

Leche: S.___ No.___ Lectura: S.___ No.___ Medicacin: No.__ S.__ Tipo: ______________________

Otros hbitos de reposo/sueo: _____________________________________________________________________________________

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Otras manifestaciones de Independencia: _________________________________________________ _________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

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Otros: ______________________________________________________________________________

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6.- VESTIRSE Y DESVESTIRSE

Capacidad: S.___ No.___ Dificultad: No.___ S.___ Tipo: ___________________________________

__________________________________________________________________________________________________________________________________________________________________________Utiliza ropa y/o calzado adecuado al: Fro: S.___ No.___Calor: S.___ No.___ Humedad: S.___

No.___ Movimiento: S.___ No.___ Actividad fsica: S.___ No.___ Trabajo: S.___ No.___ Evitar

peligros: S.___ No.___ Creencias y/o cultura: S.___ No.___ Esttica y/o gustos: S.___ No.___

Limpieza: S.___ No.___ Objetos Significativos: S.___ No.___ Gusto: S.___ No.___ Otras manifestaciones de Independencia: __________________________________________________________________________________________________________________________________________________________________________

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Otros: ______________________________________________________________________________

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7.- MANTENER LA TEMPERATURA CORPORAL DENTRO DE LIMITES NORMALES

Temperatura: _________ g/c. Axilar: S.___ No.___ Oral: S.___ No.___ Rectal S.___ No.___

Homeotermia: S.___ No.___ Hipertermia: No.___ S.___ Hipotermia: No.___ S.__ Duracin: ______h. Sensacin de: Fri: No.___ S.___Calor: No.___ S.___ Escalofros: No.___ S.__ Sudor: S.__ No.__

Piel Rosada: S.___ No.___ Cianosis: No.___ S.___ Perifrica: S.___ No.___ Central: S.___ No.___Otras manifestaciones de Independencia: _________________________________________________ _____________________________________________________________________________________

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Otros: ______________________________________________________________________________

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8.- HIGIENE

Estado de la Piel:

Limpia. S. __ No. __ Hidratada: S. __ No. __ Integra: S. __ No. __ Color Rosada: S. __ No. __

Pigmentacin: No.__ S. __Tipo: _____________________Turgencia: S. __ No. __ Lisa: S. __ No.__

Suavidad: S. __ No. __ Flexibilidad: S. __ No. __ Transpiracin: No. __ S. __ Olor: No. __ S. __

Frecuencia de lavado: _________________ Productos usados: _________________________________Bao: S. ___ No. ___ Ducha: S. ___ No. ___ Frecuencia: _______________ Duracin: ___________

Productos Usados: ____________________________________________________________________

Lesin Tipo y localizacin: ___________________________________________________________________________________________________________________________________________________

Nariz: Limpia S. __ No. __ Mucosa Integra: S. __ No. __ Humedad mucosa S. __ No. __ Ojos: Limpios: S. __ No. __ ntegros: S. __ No. __ Humedad mucosa S. __ No. __ Prtesis No __ S.__

Orejas: Limpia S. __ No. __ Integra: S. __ No. __ Configuracin _____________________Genitales: Limpios S. __ No. __ Mucosa Integra: S. __ No. __ Humedad mucosa S. __ No. __ Ano: Limpio S. __ No. __ Mucosa Integra: S. __ No. __ Lesin No.__ S__ Tipo: _________________Cabello: Limpio: S. __ No. __ Integro: S. __ No. __Longitud: ______________ Aspecto____________ Frecuencia de lavado: _________________ Productos usados: _________________________________Vellos: Escaso: S. __ No. __ Medio: S. __ No. __ Abundante: S. __ No. __Uas: Limpias S. __ No. __ Integras: S. __ No. __ Configuracin _____________________________

Boca: Limpia S. __ No. __ Mucosa Integra: S. __ No. __ Humedad mucosa S. __ No. __ Dientes: Limpios S.__ No __ Prtesis: No.__ S.__ Faltas: S. __ No. __ Tipo:_____________________

Frecuencia de lavado: _________________ Productos usados: _________________________________

Otras manifestaciones de Independencia: _________________________________________________ _____________________________________________________________________________________

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Otros: ______________________________________________________________________________

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9.- SEGURIDADMantiene seguridad fsica: S. __ No. __ Riesgo: ____________________________________________

Mantiene seguridad biolgica: S. __ No. __ Riesgo: ________________________________________

Mantiene seguridad psicolgica o emocional: S. __ No. __ Riesgo: ____________________________Mantiene entorno social: S. __ No. __ Riesgo: _____________________________________________Mantiene estrs: No. __ S. __ Tipo:______________________________________________________

Mantiene Entorno familiar seguro: S. __ No. __ Riesgo: ____________________________________Mantiene medio ambiente seguro: S. __ No. __ Riesgo: _____________________________________Mantiene inmunidad segura. S. __ No. __ Riesgo: __________________________________________

Vacunas: S. __ No. __ Necesidad de: ____________________________________________________Mantiene Trabajo seguro: S. __ No. __ Riesgo: ___________________________________________Mantiene medidas preventivas: S. __ No. __ Necesidad de: __________________________________

Mantiene factores hereditarios de riesgo: S. __ No. __ Riesgo: _______________________________Conoce los peligros: S. __ No. __ Tipo: ___________________________________________________Mantiene medidas de proteccin: S. __ No. __ Tipo: ________________________________________Mantiene Entorno sano: Temp. ambiental 18.3 a 25 c. S. __ No. __ Riesgo: ____________________Humedad 30 y 60 %: S. __ No. __ Riesgo: __________________________________________________

Iluminacin oscura o brillante: S. __ No. __ Riesgo: _________________________________________Ruido 120 decibelios: S. __ No. __ Riesgo: ________________________________________________Aire con humos, polvo, microorganismos productos qumicos: S. __ No. __ Riesgo: ______________Aparatos y/o artefactos posibles accidentes: S. __ No. __ Riesgo: _____________________________Conoce y sabe los mecanismos de proteccin: S. __ No. __ Riesgo: ____________________________Conoce normativas legales: S. __ No. __ Riesgo: ___________________________________________Factores Culturales /religioso /sociales. S. __ No. __ Tipo: ___________________________________Mantiene rgimen teraputico: S. __ No. __ Riesgo: ________________________________________Riego de accidente: S. __ No. __ Riesgo: __________________________________________________Riesgo de infeccin: S. __ No. __ Riesgo: __________________________________________________Riesgo de agresin: S. __ No. __ Riesgo: __________________________________________________Otras manifestaciones de Independencia: _________________________________________________ __________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

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Datos a Considerar: __________________________________________________________________ _______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

Otros: _______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

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10.- COMUNICACINComunicacin verbal: S. __ No. __ Fcil: S. __ No. __ Moderado: S. __ No. ___ Claro: S. __ No. __

Preciso S.__ No. __ Asertivo S. __ No.__ Agresivo: No. __ S. __ Voluntad de comunicar: S. __ No. __Limitaciones: No. __ S. __ Tipo: _________________________________________________________

Mantiene Lenguaje No verbal: S. __ No. __ Smbolos No. __ S. __ Otros:_____________________

Expresa movimientos significativos: No. __ S. __ Tipo: ____________________________________ Expresa Gestos significativos: No. __ S. __ Tipo: ___________________________________________Mirada significativa: No. __ S. __ Tipo: __________________________________________________Manifiesta necesidades: S. __ No. __ Tipo: ________________________________________________

Manifiesta opiniones / ideas: S. __ No. __ Tipo: ____________________________________________

Manifiesta Sentimientos / experiencias: S. __ No. __ Tipo: ___________________________________Solicita informacin: S. __ No. __ Tipo: __________________________________________________

Presenta alteracin, intelectual, psicolgica, sociolgica: No. __ S. __ Tipo: _______________

Mantiene Todos los sentidos: S. __ No. __

Odo: Agudeza: S. __ No. __ Limitacin No. __ S. __ Tipo: ___________________________________

Vista: Agudeza: S. __ No. __ Limitacin No. __ S. __ Tipo: ___________________________________

Olfato: Fineza: S. __ No. __ Limitacin No. __ S. __ Tipo: ___________________________________

Gusto: Fineza: S. __ No. __ Limitacin No. __ S. __ Tipo: ___________________________________

Tacto: sensibilidad: S.___ No.___ Limitacin No. __ S. __ Tipo: ______________________________Utiliza Prtesis: No.___ S.___ Tipo: ______________________________________________________Mantiene: Silencio: S.___ No.___ lloros: S.___ No.___ Risas.___ S.__ No.__ Otros: _____________Manifiesta Perfeccin objetiva de mensaje recibido: S.___ No.___

Mantiene capacidad de verificar sus percepciones: S.___ No.___

Busca atencin de afecto de los dems: S. ___ No. ___

Manifiesta Reacciones Particulares : No.___ S.___ Tipo: ____________________________________Manifiesta actitud receptiva y/o confianza: S. ___ No. ___ Tipo:______________________________

Otras manifestaciones de Independencia: _________________________________________________ _______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

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Datos a Considerar: __________________________________________________________________ _______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

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11.- CREENCIAS Y VALORESSolicita ayuda religiosa: No.___ S.___ Tipo: ______________________________________________Mantiene limitaciones religiosas: No.___ S.___ Tipo: _______________________________________Mantiene limitaciones morales y/o culturales: No.___ S.___ Tipo: _____________________________Utiliza objetos religiosos y/o culturales: No.___ S.___ Tipo: __________________________________Otras manifestaciones de Independencia: _________________________________________________ ______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________


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12.- REALIZACIN: Ocuparse de Algo til 13.- OCIO RECREARSE

Solicita medios o actividad de realizacin o recreativa: No.___ S.___ Tipo: _______________________________________________________________________________________________________________________________________________________________________________________________

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Mantiene limitaciones para su actividad recreativa o de realizacin : No.___ S.___ Tipo: _________

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_____________________________________________________________________________________Utiliza objetos particulares de actividad recreativa o de realizacin : No.___ S.___ Tipo: _________

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_____________________________________________________________________________________Lectura: No.__ S.__ Msica: No.___ S.__ Bricolaje: No.__ S.__ Arte: No.__ S.__Deporte: No.__ S._

Tipo:__________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

Otras consideraciones: _________________________________________________________________

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Otros: ____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

14.- APRENDER

Conoce su estado de salud: S. __ No. __ Conoce sus diagnsticos S. __ No. __ Tipo: _____________

Conoce los medios teraputicos S. __ No. __ Tipo: _________________________________________

Conoce los frmacos, horarios y vas de administracin: S. __ No. __ Tipo: _____________________

Manifiesta necesidad de aprender S. __ No. __ Tipo: _______________________________________

Manifiesta capacidad receptiva o memoria S. __ No. __ Limitacin :___________________________

Existen factores que limitan su aprendizaje: No. __ S. __ Tipo: _______________________________

Necesita medios de apoyo para el aprendizaje: No. __ S. __ Tipo ______________________________

Otras consideraciones: _________________________________________________________________

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Otras manifestaciones de Independencia: _________________________________________________ _______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________


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PAGE 1Antonio Bentez Leiva. Enfermero Prof. Asociado Medico Quirrgica II. Enfermera U.M.A Mlaga febrero 2.002

valoracion 14 necesidades v. henderson 2

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