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ONISHAN 3G TAN, TaN NiaMogull 45: Modulul 46: Modula 47 Modula 48 Modula 4: Modul 50: Modul 54 ‘Modulul 52: Modul 53: Modul 54 Mos Modul $6: Bibiogratie Index Ginocotogle gi nursing in ginecologle Obetevies in obstetic8 Puericutr’, podiatie gi nursing specif. eur # nursing Im neurologi. Pihatrie gi nursing In si Anestezie —terapie intonsva si nursing specie Condilta in urgent medico-ch Gari fe, gorontologie gi nursing specie ‘Oncologie si nursing in oncologie a 7 109 177 197 207 307 sar 343 385 389 407 aete0q aidsep oluntoune op yaya « ‘BeIEQUILOS exdaoe 8 ap nznja) « ye eareoy2 soreseoonty 18 sjequowinda yiuBaqU 8 oxesaye 9p ep op eweraaics >) ex80)n‘BUIBeAaANA aNaAZOA WoL “vo "aunasedsip ma “eunsie ap aiezves "euyBen nes Jenn und yenssuow 2 Tpadse ‘eluepunge — oGojous mua6e ap of ~Ouny ut onsporoese9 eyunue na (gjeuiBer ojosoas) aasoono| ‘eluapuodep ap weysanueyy ‘SyuiBeAonina ut Bulsiny Innueusyed @ sojowe>ppou mauewmer, — ‘eiBojou9 jyvebe op ofouny ut ‘yoads soquoweDipaus WaweyelL — 8 “onjye0 ‘eo ‘eustned ues Benoa 20194 “wayu9‘ojunaseds) 8 "eudeA Nes JANA yenasuau eo 88 ‘eluoounde ~ 960}098 Be ep alfoury UI eNRUO;DEIED Pwevodau, "yoo mpeg siHUoY eursjd004y ‘ppfueTud ‘aedouuouD6 evossreN ‘syoUBeA ByatoupieS)ts0!e4 abo) ‘Puvspeus ‘ony ‘oroeju uabe ap asnpoud injnuen i ona sie vise -esiemocy FTIALINIDVAOATNA 9180]099u/3 us Sursinu 13 a1Sojo29ujH “sy TEINGOW+ allerarea viel sexuale ‘Surse de aieutote iolog si co rise: cde mediu: poluare, ada, noxe profesionale nore a gienel genital, varsta Obizctive Pacienta + s8 exprime + sa prezinteo siare de «si rectogumero wi micoate nog . acute + sa nu prezinte complica cronice + sa se simid in sigurants + 88 accople i s3 urmeze interes faf8 de sohimbarea stu de vag legaturd cu etiologia boli, simplomatologie, + Monitorizarea + Asigurarea con + Asigurareaigienel matelogi, evel nei ge Intervent delegate 1. Recoltari produse biologie vvaginale pentru: exemen microscopic, i secrelilor vaginale, respoctarea recomandnior madicale FIBROMUL UTERIN ‘Defiio:tumora benigna dezw Etologie: actor o sara cresteri rom, ey Simptomatotoge. = probleme in Tratament: Terapia farmacologica este simptomatice gi se adresoazé tulburéror oe insofescfibromul > antiiflamatoarele nesteoiclene ~ reduc crampole menstale si séngerarle mensivale > ier. sunt o parte impertanta in corectaraa anemiel couzate de piederea sengvina datorata fibroma > hemosiatice > uterotonice: Ergomet, Methorgin, Syntocinona > re: Adrenastazin > jee: Acid aminocaproic > progestative de sintezs (cu ral atroiant) ~ deriva de 19 nortestosteron: Lynestrenol, Orgametr ~ deriva de 17 hidroxiprogesteron: Medroxiprogesteron, Duphastone ~ deriva de 19 norprogesteron: Surgestone. logide LH- RH dotenina o menopauzé lerepeutic’ ake cre inconve- 19 In fbromul uterin stiri de dependent = durereaLoew) siedspeo ye ap sjUB WEIN 1$ eunyuoo @nujusd 1S} steed es elcoosorede, eedojsod biG ouoweodoasd amngBaid < juared eareu vein mesargy nue ajeotury9 spe, cat6oroa0u6 | sdoyq‘ojeuen ylanos ‘puun ‘aug so}es04e ap nuousexa rujiad asnpeud ap weLe|ee ‘eisdojep iver. Lugs ‘2quejund-oon ‘12201 sojeipes eau jade) ‘aveojed ‘oyu “2yyna1B u atepeas ‘a 0a & eiaGups“otvarund-oonuy“aquejounBues-o108 ayoulBen oboe ros eq 3 NIM3LN 109 3a TINYSONVD ‘op ening CEi j i ea) te despre boal ‘Surse de aficutate e de ingritre Pacienta 8 s0 almenteze Tn raport cu nevoile sale 8 nu fie deshicratats 7 teloctuala + $8 ig cecapete condita fea jeze de confor psc + Monitorizarea funcjor tale §! vegetative de doua orl pe Zi: TA, pus, T, respi 24, scaun + Asigurarea condor ce media simpto- matologie, evolute, comandéror medicale Intervent delegate 9 sange pentru: glicemie, colesterat otal, LOL, HDL, rg tice, ionograma, acid uric, VSH, + Recotarea urine pentru: examen sumar und $i sediment u + Recoltarea celulelor din coll uterin pent exarenul Papanicolaou) 2, Examen colpascopic 3, Biopsia de col gi examen fe, proteine se- a, protsinuri, wroculturs ogKe (examenul Babes Studiu de caz CULEGEREA DATELOR SI IDENTIFICAREA PROBLEMELOR (CULEGEREA DATELOR SI IDENTIFICAREA PROBLEMELOR. ™ Sox feminin romana Starea civil casatonta 48 ani ortodoxa Ocupatia muncioare Nr. copli 2 Adresa mediul urban Spitalizir anterioare ~ cu ocazia nasteior Probleme anterioare de sénatate —neaga chirurgleale —neag’s Alergii cunoseute ‘Medicament nu reactie nu te forme de alergie rwactie Tratamente Proscrise pu Unmate nu Tratamente actuale nu Alimentatia ‘petit normal Ne.de meselzi 3 principale, o qustare Ora de masa 6, 11, 18, 24 Compozitiaalimentatie! Dimineata ou fet, paine, coal rns supa de legume, came fata cu legume Cina paste Alimente nedorte Alimente pe care nu le poate consuma alums ‘Alimente interzise nu mancare cu intay Bauturi preferate ceai suc apaminoral ap plat. compot Altele ns Serveste masa singur da Supravegheat nu Ajutat ou Allele OBSERVATHofes0u96 jugis & asezotre yBesousy op sqes0u08 yes e a1eioye 2u{aBu 9p sojeuwaiqord wore: 2]eu0ss0d 03 ovony auowreey Freoreyg atwojpexaue no awoIa.aI a7ea/BunmYD juanse;) ‘gussqe = puungy - uun op vowexg qn «wuyooz9 ="1 in 22=a0L In'z= 004 ‘g6ur go't = guuneaig, ‘Gu 92 = 901n, uu zzz = HSA, soje109e op ozjeuy 19O4d op Bued Ut SHOW Bp 31d 20) 24 2612) no nu ed no nu so}onueD AD ‘fu BeAquIAsszap ep gyeiquIUD® na synuiisns ‘nu soqn|e na ep ewouoiny (easese/dop) nsiany aioe ove nu axejnamyed uureg reunou rnugd ynjoadse yeu0u ep upos od Ivawasso ru Soup ny Joooye mu yezud ru edd nu umn, ‘9p soyewnsuog ‘ieluongulsoén eresou08 wesers ung Jojaquawn9) easnyg ‘nu yeisjse nu soynfe no eunBurs oeiqual 9g nu zezade u axeoroid ui nu aoynfe n> nu sieeuBanesdns ep eanBuis eojuiz eeleo) 0 e25u u Busan GOSH SPM ereuosied eu2)6) rote} e aunisedwoo ‘ayedwo :2jeoypew yueys}se & EwUofoed ap ‘eyeye}208 ep Bie ‘eevonjaaye sane) ap pie) ‘esEon1 dso :2ailaBut ap ediyse op sie} ‘pseompodsas :jeotpew ynqueisise op Efe} tuIpmany eorenauae ezea BSTEONd SIV nuyoeues pee SO GO mY UEIOUZO sar a poepues nu nag, wou! 9p nu gueino0 nu BuEWUEP AU gANIPNE Ezoj0Nd un soy owsHIeN| Bi J9 B1ENOD eiue}2ed oudsi aremqueo ur gjeuen areso6ues 6p ai jew Ié oyfi6o.0u oenasuaW susevu 2jen0H jeusaqut ere eremoe vovezieuds ‘uulos ap sye6o} owyqoud enty ne slusjouwos nu ojuwosuy nu oiesypeusno ep affeoipaw B1p) UWS ‘10 J. (0) nuwes purmud ajuynusiqg 38 angeesaes ieuanoy ido0 no :s0qy| mindwn v ox@00N0d 2p POW pue-yeam ul ave >) eUIpe pulAud afuInUsIGO muwios-euyieo siony nu ewsiig ny eluainye|s pu ws}oSTeN, YooUn adedasuen nu 98/610 nu elueunueau) ep woueny nu yeiniy nu ezoyBoaeidng { ouneDs iN ‘nu ave0}29j00 eBund nu yuReA ep QMiewU yoadsy —yuozaxd_UNeDs ‘awargoxd any mjewey no ujd duwgo seuun yuouNpeS ‘2fouy qu aunsig nu aunieIN nu sieeunua nu elueunucsu ep wouoyny nu TeInly nu esayBenesdng qumon IN, nu 2480390109 eBung hu yourzeg ep OM jeuu0u edsy iaqul os) (eveyNUED) EULA eareujuns fenBus eu uodsuen op insoitin IMU ~ srenUES ajessynsO40]}0963 cal Postcele Sontare-Volumu3 ir = 1 = deft cin cauza hemoragiel PLAN DE INGRUJIRE: 5. durere PENTRU PERIOADA PREOPERATORIE $I POSTOPERATORIE, = gin caus ee EEE 6. teams Biagnostie ‘Obiecve Trervengi Braluare denursing steje pacienta (Gbicciveateatin a4 sBinjoieg necestatea cxmeazi pa operate lare contin pan a | Recon, |operates reahemovagie. Pecepts estes 's05 acai pene peti Tadependent | fa prea hemoragce ~ Saseprevindakerarea | i ot i t - def generale 13 hemor 3. Poa Se prevind generate eoats | anestence ‘Sse prevind aeraea Stir generale infoemay,Pacenta [aPos ech helea ap equa as aua024 30 6 upeyeas a9| ‘sidsap waned aitanmeys - aj aptounyaisogwan ~| tip avrg aGeonau guzad ‘ees ae ad Joreadoiod up} sowed ‘nv quaoey 31071 anferowau, 16800034 uneayeas maida 18041 eues yb} einbus geasertap 35 soinle no geazyqous jauaunnsul apqeuaiews eMnBse iatgoang uns enuivas eso(3 -poureI Up seer anes euenapun ease Be Ewa ped wou Ssoienge) ap ayeue ius S69} post ugeesreoap at sedup enepy} soine no gzeaeiaous reneosansg9| ned eee sp ten onle>y ceayuaié naved axe3a13 HOU BOUp axnieng ponaid a app acamngou ons —| upornleanoies gs eoiysa2ou ge wanes ewaour eo 6 SEAS RARE Seuger nate aiem29)9 ‘uvbu, apd soreypawodsi ‘sp esunuos "Bereano) 95 3003 ec useryeo mi39go aye seuawow wo uszard 2p fgmbise 01§ ewoced agbuery ebranulap ewaned pupinb ues as vipanienguase Dojautosiod ai fetyporo sjunases eu 29 eva 21098| ur teajear 32190 erin : rear gaaounes ee ezeaesnu a aera vopiravew 8 erne> i ana §|MODULUL 46. Obstetrica si nursing in obstetric3 MODIFICARILE ORGANISMULUI IN TIMPUL SARC! fe horton gi pe contul sm santos; cng volt procesu de concept or, digestiv, endo i putin in raport cu aoesta, nu exisia cells din organismal gravidel care 88 nu sulere modifica dar care sunt reversibl > Examen bacterologie > Examen parazltlogic > Examen ciologic iopatoogic Investigatiimagistice > Ecograte >cT > RMN ‘gonerala este foarte e bine bat frecven este cobo- "ats Incét nu se poate masura, iar maxima rémane de obicei ijes en0se ove) 2)9un ut ejse6exe 1 elewiou euDtes UI gempoL ‘vowopge suo od oles oususjse1e9 uns nu "eaidet = “eases e Bunt ‘cvedynus 8 yopis € exec "epiei6 up %52 01 200 8 ae) ' aleduopns 16 19 'gSe0.} e189 eojatd — ‘respes0qo4 2p ezopi01 0 ezeafeIsu as 18 AUIBUL ezeazuoney o1eo e1euun gzeis onpaud Bg @ euduoo Op glezne9 gleeRte>-} 4 y2num 2-| no epnes6 gzeerespIUseP “aIUBLA 4 Yod BaeloersnrUAsHEN — sjowuousGes 2100) Fzeasaroqu (§ ao00aid gze=le\Su Bs B1e> UeDYpOW RIUZAIE imeiedy jedsos rupunu someon: us grmawe® euIoIeS wh — ‘ussed 2} 18 8 9p eumsone easeoon ezeainén o8 « wH 28s UP F09 &p lexquaau0d peas — vaBx0 ap ‘ovede ‘wo p ajewrxaide Aeu6 juein eueS OP ny YO 2-72 | pugOu faynoseie Joyanad @ asewin &9 e1¥8|SU00 af Ur PnpupCurcuH In MuexeNp earzodus 92% ro feunu ongoe few yuns FURL @ QuEIROseR # euEUER -ou sjezeoidepe 0s (hae s1eyoroxa gunisardied 16 prauou eareojen a0 no Keedap pu ‘eipre0 mugep eigen ‘HSA ai6a.o "gzoquon e] sundsipasd 93 ‘1anosnus sopgy eidnge 1 up ‘nusoun SEEee 9 utero serie de modifica, mugchi repli abdominal sunt deparal baal, prolactina pul galben oe sareina Inaouieste copul galoen menstrual, find s principald a secrejo de folcuin si progesteron le pretuatt de placenta care secret, ‘armele el uni de sarin, apa pe lng8 cet hormoni ‘ulburd neurologice: compresiunea pe ner pelvic! deter ‘apoi seade progres; se modifies: metabo 8 din cauea frdore mai les in utile 1 se asociaza ou fefeiantrioare a toracolu,retea ce cu noasa Haller, A ‘pare o zond pi Glandele sebacee ale arcoelp de 10-12), se hipertofiaza, so prezinta ea rise proem ‘umte tuberoul Montgomery. Din tuna a 3-8 apare sec secrefa lclata find e colosiy, ca urmare a ints ce caire estrogen s) rogesteron, produgi de a secrete lactate In evolu croste, ajungan vers: 2¢ em dala 4 om: ante = capacitatea creste de ls 4-8 mia 4-5, far in cazunpatologice putnd ejunge la 10-151 19 15009 15 mm la 19 mm, pentru ca apoi s cauza distensiel; forma: Inceputu sarcni, devine steric ince- ‘cu luna a 3a pana in luna a S-3~ 6-a $i oveidé pans la stars sarc sau poate avea forma unetinimi de carte de joc, jologice constay Tnnoo we 83 wuazeid "genp ap woyéeu uguinu nu nes Usis “ea\6o.0o6u ee H4aEqo awuEpaDaIUE Joun earEAyNUEpH a1p nes Joon 2p areojeuNs400 8 nydnopojvoreseo :26u 9p u eveuun, YIVIVNSue SuivIINSNOD Pied s7ouuias ‘saupesed Jo} soues ap noysoubeig ‘oworduls # auwes 734 pad ap en gsuens xesogej09 ro OpenesB (rjonu 18 apmes8 oje0) ruled puepuens ion 1 8} Boyde os eoiaiaro # eeioyheu nued got ‘aenejeus ves © pjeaipew maveyBenesdns jreyeuaid asoysaneidng, vewerdes Ly ednp aedop uowior ap ax 252 esnyewrd 0 VIVWHON VNIDNVS JSoneidns @ 6 pwew e2eonIA £9 HOU ide wumies @ nas eaiajoeds tes0U06 (eoipeu jnuowexa injdne ounep inauved ‘eden e2aexcj1 06 rosea y260q 2129 uber SEive; cresterea in greutate nu trebuie 88 depageasca, imea gravidei cu ajutorltaiometru- ical. Slarea aparatulul carclovascuar. isiunes trebule $3 raméné 130/80 mmMg fara 68 depageasca limitele maximo adrise, se efectuesza examen stomatologc, ‘Examene de laborator i paractnice se efectueaz6 la inceput gi pe parcursul supraveghe- J catre mei n funcie de evolu sa rea singel 30.32, determinarea grupel cu sof Rh poai, tr de ecografe, event $1pe parcursul 2 (se poste face incapind cu sépiam joldeauna s2 practied sub contol ecogr 80 efectueazd cu ajutorul ammioscopul repetate din 2 In 2 PRIMUL TRIMESTRU: li LLuatea fn evident a gravide trebule tBcuta cat mal precoce, nade amenocee, rea vérsteisor- jterulu ge pune IFU se cerceteaza prin palpare sau na pulang $8 ajunga la 300 de 2 patologica ‘Amenoroea este menstuat (ou mai este 3 de marimea unel mands C8 sau portocala deforma seria, la f und! vteruli se poate palpa deasupr ‘se adaug’ alte seme: jaloree), pirozols,balonéri sau meteorism, con- vin mai ales dimineata, fra efor, pe nemancate, se rep tino inante de luna a Va, orcare arf abundenta lor inal prezenta| lor dupa acest interval poate arta olezlune organic, gasticé sau veziculara cau poate sd arate 0 cisgravcio, ~ somne neuropshicice ~ somnolenté, astenie, bi te emofionala, irascibltate,faiga- (HCG) prezent in urns gin plasma sani Testele de sarcind deceleazd prezenfa in urina de HCG gi bela-HCG tncd din prima zi do intarziere 9 scurgerlor monstrusle, Dozat sarcina de laa 7-2 ~ a 10-2 2i de la fecundate: bezeaza pe utlizarea ant -2$1a 12 saplamang de ameno- poste detecta actviatea carciaca1d 117NaLLSAWRAL NI YIVIION YNID€VS nD GIVES TNONISUNN ‘21294 a4e250 op eu oun Beseyneo Mau ‘paide 18 enjowwadorpe: — rynuauiay Beseidoxde ‘ouxoy eeserosc nijuad "YoU! 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Pragaltea gravidol pentru Intemare gi nastere const In prmirea gravid a servic de Interna, progatirea psitica a acestola~ nformares gravidei ssupra star ei de sénata coopersaza cu gravida Invayand-o s8 pat al cdi se sole a camera de ga cul pentru exarinerea gravidelg stable diagn ‘magazie). Se Indeparteaz lacul de pe u \c, 90 efoctueaza toaleta rquroasa a din rogiune pubo- feazd cisma evacuatoare, se efoc- saza datele de identtate in a, lnsiune arterial, omy ci ATENTIE! 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Se vor evita con mancatunle grase, cond care, prin continutl de asindu-se urme de ‘tancl,pot determina mod ‘Se evita constipaia pria mise . Se va acorda o atentie mare gravidelor care muncese, care au nevole oalimentalie cu vB loare caloricé superioara gravide casnice in cos mai mare pate p lucozate i vitamine, In laurie, e 2. Ponty ecare 100 g late matean fematuce, malformati congenitale. Macicata in primele'3 toni de tH mn cazuri cu (oll just NTA, infect grave, lepsie etc, respectand posologa $c ie. 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PREGATIREA PROPRIU-ZISA PENTRU NASTERE o unele sere apa. ntnstatea, eeveia: | acd do de SEMNELE DECLANSARII TRAVALIULUI ermnele = Contac } | | | | |"208 -syoo0u6 eseul ad “gzese 05 ‘arzinda 9p ees ul euodsueN as eURDed ‘anzndea yioesuCO sewud \dx9 op nes enop v epeoused 2 ipunoes oy gs eed 24 Zh 89 epeouod oop gla) a}eyENOW ap EeyeyaEAaId EzeaIQND 2g x=Yos ‘onpaid 28 guox0 2p Heues ou aun eavBaigaeap 2 ‘pune 805 njeueo 9 equ ut BHI ese MR BENZOZD fop eoseu 8 a8 ode 'pze=LnOS 2s ‘aIEOUU a (00) UBM ro 2100018 8p giep ajs0 ose paw espe y en 09 & Haus “201 youweup eeseoyypoyy ang 916094 gdp seUD uoouT sop leu nase 98 Ofna ul dra es ojouexquaw 20 ec 1590 mo}pow an “BA DEI uid 808; 38 ‘80 » gosEatedop os BS GAR] 'al0 ez B) .ed8e jruunion gzetoaide 98 wD 9 0p onde "BIGOU -YoweZa.d new eojadns:nrico raerenp exnjone owe & gyessueB-e610)¢ 0) stefan (0m) sazos sade fara ment 81 sounee8 andop eerene) oj niga Beroroaide: 198 “eseaxeinp us Bun} feu “9s@p Yeu :,89 UL 99 UP arequiog ‘soune} InjAdop eaxeuNS ‘uUaIR IMHO BFE UEaYEPOU ra IE aysasBoud 13,2019 ro "slemeweIss Suuoin eyiequCD uns weysou ryndsoL! elunue 29 eoUID sjeuWES ‘yoo goulpout a9 ‘sjezieu 2198 "(aN9) aseorainp aupeinsojoenu09 eivede no elepo edaaut sf-nuda “grequnas 05 yu 28 ynjeo “usin ryNpuRJuBIOqCo Fe YeyNZa! eo 'eoHN suNLap YoUIE) elles y2naxduy "guejvOds ojee ea.opIaiy “SIO pyo snvatdacyade ound exc) jeuerqurou ening = ‘9x2 enoqeo e| urd unjoud ayeod as yeniu 3808 Jp ‘siveut 910 ensiga no nyenes u:eovesi speneud eo wos “aGueS Op UNIS no esEOUyESE Pofioade de extulze a fatului dureazé 20-46 tute Ia primipare si 16.20 minute fa mul prezentaia(eaboara in medie eu 1 cmiora Ia aborata pe plangeul peliperinea, cu sau fir8 rupe- 8 de produsul de conceptie,preznta: strémtoa ‘excavatia (sau conduc ISA) - 62a mai tree permite nasteres pe cale joasa, dar este mai delcata si mai se depisteazd la con 8 preze n genoral nastorea pe cale joss, ne $e succed la 2-3 mi inal, combina cu fora con rviperineat induce relexul de screamal(ducnd la ex se deflecteaza dodesubtul sim tall, umeni se vor plasa inp ‘coboar capul posterior ‘al spec satu pa au mai multe comprese, a0 f- xeaza 2 aplica pe bortul om ical un pansament steril uscat peste cae tragem ofas8. Asistentul medical ve control rec- 1 ombical pentru a depistala timp o eventuala hemoragie. 50 are gr ca aceasta sA verifice vax Se stabileste identitatea, se pune 0 Identic eu cet dat mame, namele mamel, data, ora nast evita contuzil Je acctasi sex. se efeclueaza complet si rapid, este de prferat ca nasterea, se cerceteazs into entra ice bune, scot 7 80 poate astra, iar Sconul 3, 2,1 8a apreciazajIHOOM asuod z "Beaz8n youd ‘ngasnyi esusd z “luip no gauoreue esued ‘sn0}4 “oie| yeh :epuuda aie ‘efsse ap ajueuinnsu no esr rudd sojendse & omoneo 9p epuos 280806 es 6180 Ut IEA) BLEUILEO! op “ynnyenen ealeyp navad syuewearpous ec}Do20U08 wyuReyo eBi\tOAaxErulued ‘reyoyeu 'Bawqus0 muopI09 Muyuad Ble ‘sjUels No}e0) “acuad ‘alaejuZOp oP 9 vols Snug '9iuays unduugo :e2y8eu o|elvzisse nuusd evesso0U ojeuaieU: !9qe ued ex20)r» 9p 1jUROYPOU Bada mmyeraduss “evans oj21Pou oiduosaid uojue0 RSROjNALLEIPA ©9:6130) 81 Sluseyns 'gatUeU ap URANgI) euoUtouD} soUn co gzeonieas jeuesqwow ea1Es Impyoo easeoypO ulus ge }ode nde0u e| sinus pO ap feet ye} INpAON OHARA PZeAUBAneiCNE — >on: 499 sqeOWpOW nes EULaIN gORUEUAP ep oplewoUE MmaIpaU!YepeU EZEDIEUWES ‘ajiewasqo 2p etm} us ano eare ue) yesBoooioypie9 no equn-40 ¢ EUONT eonUUp eiSezEUL eres etnjons axsaxguun os nyoron ap eles U4 “Ic 2} 95 puodsuea "PopUN oIpeWw goeD Aen uwexe rulued Yed Ul Nes gorGojoDoUIO eseul ad azake Os RS EILaUTLeN einly ‘uneos giuzoud nu goep “aeojenser9 eulsip 16 umjuods aonpoad 98 nu oIzaA e2atO6 2ep re0/zanfepuos ezean9j9 nynejpaw iene “Sun w eUNES BUR “eunyeladuim qieosgui ‘922)e “ewesrUy no YnzEAeNE BlUeLiMES nad fed njeworsue} ‘aieunsenin no nes jeowreysqo ndoosojeys ‘soqdasiue ‘Knueus:eouiIsqo MLewiaxa naued 103000u [nee ‘eu aybo}eB0i¢ "ueOUIaIEGo Mojpow nes eSEOw elunuy 1M /§ PUABURS edrUb 1 EIUT -guv8In BORLEUP op UEoyIpoU BtUIZoNd NU gS — “218 eymewaxd araiseU “uops00 Bp exeyNcua aye JES B NES 408 PereayIpow Yojeuerquew & avooeid eavedns -21% al aymomue ap eaves azanuaye gS "axpau # eseoueD TrRUaISISE no BzaIOqeRD eS — gjugey 0 30 eurayga1s B -{e cove nos mene abinaap ea wno pow no gan}g69} Ut EatSUFaL eWeD eLUCAO res — Fasoibeu e| 9p myo}O ‘9p eypanes exezid3 ‘eaioiseu asosancud 90 oued op sjouins e970\Se0unS0! — 9p Bienes yqisod aS WS 180d ajoyunyswaid — lesionsuen nes eo4go aiewezosd — uopi0o ap ejuaprood ‘aBevoway POU! YB.o}09 IHONUWE HILO “eer EluLOINS :oIENNEID 9p BjoULUOS BAIOSGO Os — ‘yojauesqueus eased Bop suns nd) — \w guoves nes grewoUe afeuaz01d ‘atuspovesd Worse| | | i t Psz ancildevnsng peti elena ace curt Hagedorn, porta; a ster gros pentru legerea cordonului ombiical sau lem subjie sau medie,calgul, sor de cauciuc gi casoleté cu halat si cAmpur rebuie 68 mai existe in sala gi casolele cu compress, tampoane de v2- simanus stele, sering® ster, septazo, alcool, tinctura de iad, apé oxgenats, substants ‘analgezice pont anesteze ocala xllna, novocaina (ase face test de tolerant In sale trebuie 68 mai existe: stetosoop obstetrical, plosca plat, iigator prevazut cu tub de cauclue gi canula steia, 3 perl stone sau soluje antiseptic pentru asepsizares mainlor i, sonda de aspirate a mucozititlor (iszepam); opiacee ( «, vitaine (8, B,, ©). [De asemenea,insiaiaia de O, Tnexpuize asistontu medi care per, prime folosind- pan a dous laturi de deget de pli tatea antebratu mana. Va avea gif sd nu se ating’ de obiec- 3 pulernic penta stropi mana ster lar apa ‘se sourga spre cots nu invers. Dupd aceasta, maine se fteacd cu o solule sca stoi, iiologice indicate le asisla numa sub supravegherea mediculi, respecting in tocmal cele mai gus mentionate. nou-rscutului,imeiat dupa expulzie tebuiereanimat, stabilzat din punct nctilor vale gi examinat sumer, Respiratia NN sanatos este arp cu un itm penseaz’, sectioneaza, ligatures, ‘deserise mal sus In momentul cind asteapté declirea placentei supravegheazS atent parurerts, urma- rind starea gene a de sange pierdut este de maxim 300 mi find pragatta pants © eventuald extractic manual a placente Observa semne de dezipre a placentel prin apasare cu mana deasupra sinfiel pubiene mil de sange, contrac uterine slabe, caborsrea Mn jurcontractat, apisarea deasupra sine! pubione Prinde placenta cu paimete facute caus, résucepte membranele pentru evitarea ruperi si ramanerl avostora in cov se prinde imu recipient stoi \eriica integitatea placente! pe ambele fete, acorda atentie deosebits cotledoanetor abe- rant, ven integrate 5), calaboreaza cu medicul tn Jn uterotonic: Ergomet, Matnergin, ind. Se controleaza séngerarea prin on = | feciveaz’ toaleta vuvo-vaginala cu apa ster, cu sau opt 2a epiziorafei cu Rivano’, Mercuracrom, s@ fixeax vulvo-perineul cu un torgan sleri. Lauza este alata 8 coboare de pe mase ginecologcd, ise schims eventual e&maaa, se acoperd cu o patura, este supravegheatd per poste prezenta: © fesle mama. Se masoaré pull, tens imp, 8 saptsiani, dupa exoubia placental n care se sistemice produse de sarcina pi e conceptie, practic lucia este apt pentu a relua un now ely gr media: duteazd 10-12 zie, Cup {8} perioada @ pata sau de postpartum ») auziaimeciata proprv-28, care dureaza 2. Lauzia tardive: dureaza din za 10 pan apsraiote cardiovascular, joc, care rovine Is normal aptamas Penioads a patra sau de post-partum data cu terminarea pericadei «Wa ast imole 24 ora de fe nagtere 2. 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Poziia in gezut pe scaun..Furia laptelu” poate fl rezolvata prin a- rinistrarea de anaigezice, comprese rec, retenfe hideca, iar pentru golrea sdnului se adim- ium. sau sandopat procesul de mamogenez®, glanda mamara se dezvoté mull n sarcing. La glande mamara secreté doar vaginale, la fer ‘sexual se poate relua dupa Jo cole fra epiiorfi a 6 saptiméni, Femela rebule avertizaa asuprafaptlui cd alaptarea, dtermindnd 0 supresieprelungia a secrete de estrogeni, conereazs derea lubrfie vaginae INGRIJIRI ACORDATE CULEGEREA DATELOR: luz’ es PROBLEME: = eisconfortul cauzal de cor ore2e, 33 Injeleaga ci somnul produce retaxarea musculaturi uterine favorizeaza hemoragia, zen primele 2 ore dupa nesters: imele 2 ore dupa nastere ~ evilarea accidentelor cauzate de starea de lipotimie. grave. De. ‘parea la vl ‘e poate instala o anomie grava nee 198 ab In vedere: iv, deoarece poate exista go rupturé vaginalé necunoscut consistenfa sa, exormind utotu cu mana ~ cur am apasa Unb ~ globut de securtate, de siguranta edule @ formeze 0 masa regulaté dura, de dimen sunea unui pepene mic, su fe cheaguri exteriorizats prin manevra de exprimare. lu, expulzia sbundenta de choagun, samnaloazé o dint medic, tr favorizarea retract gl formal globu- In cazu In cere este crescuts gi nu apare glo }comportamental eral este bund werirea sti de NURSING iN LAUZIA FIZIOLOGICA Jn culegerea informati piziotomie, operate cezariana sav instaléri care urmeaza dupa nastere; i cu prvire la capacitiie ei de a putea avea gra de cop de singe, (evioare, limes ti post-partum: in petioada lauzie, alo‘eojolaiue ezesrisiupe inpompaw “aypaus 3p Hlenpu wioyu00 gzeauotie ‘ezne| oxtoseed m ‘pow plunue jeoipew muetsise “guUOINelieu! ap “evejUaDRId Unjsai op syezneD WDeIOUleN — ‘luspuadso ep uejsapuey VOID0T0LVd VIZNVT NE jado no rezng east ue lop ulind je eurozes gnoU o 249 BS e> euEYEZSD aiosado no ezne| oy + e108) ‘sues und eunuye 9s seun eoate9op gfeo)pausrepueUicoe! gp ALsEDIpaU Bn Es — upweides vio-eses ojerxos unyodes ayaa 2 — ‘pois erex)na auzadusey goseesoj0) gS 'gI290| ue Pung o puluaL IE-e8 ‘1eU8}x9@| ezngl eos) Bie 190 9p innuoys e2reyr9 riwad ejwouuad sopuntze| nze0 UL axcy na BiUOURye uUNsuOD Na eS — ‘suoiniey ofo1 -‘Vouuye eine es 800 ‘08280 ‘E}eIo000 ‘Bojes) oWEYOX “eoyoODFe UraNeg auINsuCD MBs — ‘ezng] ezeauoluaty lunjeredusa earsisan ‘jes9;200 “unp ‘ievoysodueo jugs :=feo ‘BpUB of2 €-7 oyoun ‘ojope6e1 aiede ezv0Ne nu B uiued iymdns BayBuma "gunnoyoy no wenBun un nes PuyeseA ‘uetuedag ‘gUOUR? no dns ales dos ecnp 18 auiey, azarn9pUZ—p ates urluaw ps wr eqns! 3789 22m— a ‘a1op0u! uns :nsouy 6 OD L-00P aip=w “atuedsip | eued myeyjues anpas as ‘asoySeu e ap 1uRweides ¢ Bdnp nag UAap 2-01 een 9 242 Ul aseares weweIdes oud rusiels 8] auiA5UeSoINS ‘Uo}oUAEUES Nz FZ ajay uiseI6‘unBEoLD "eonpeD Bp jas ‘a6ues -eiyzodoo) lagen 2eainp “suabeu edp see 220 ut rospeusgiuntry ONY} seuodis 9209) equa6 mymesedevatinjona eeaueun # womeby eanfsbuy we ‘eds ejs0 eeudsa: !souebi0 tunooye eisxe eOEP UU goylpow es armEU fednp a1o eaaigo e}jeuuoU e} auie1 EleveLe eoun|sue)“>ieae) eunap sind “amadiand oyu nes eo jeaydiuco ap zeo U Ime aug ‘nue 2}89‘empejpeig exeosn eu smyzuen ‘equge, aunsusase 0 _ezeons|6o1u 28 9jz sjaulud ul ~ryH0 gnop op eieradwia ezeoI0U 1S GuBOSPLI ‘elected ‘upd mjvayninsnuo ‘ebues ap so}ensaK! us H BaleyIUED — seAA rjuOWesuIE’ FoyHn — eyeiosuod jnzeo UW njnauuad vasesi ‘osname onions anni onsen PRIMELE INGRIJIRI ACORDATE NOU-NASCUTULUI IN SALA DE NASTERE ups expulze, now néscutul este ayezat pe un cp sel cl, inte coapsle mame i este acopet cu un alt mp eal Prime ingilit oe se 2608 rounds buco-faringiana 0 uma 8 eau 10, cu balonag; se as- fle scorului Apgar, notindu-se cu 2er0, un eau doua puncte: imal cardiac, res rhusul muscular, ofenai de 3, culoarea togumentelor si mucoaselor Nou-na cu scorul sub, 7 necesita masuri de reanimare (sume cifelar acordate pentru lecare tom = scor Agar) ~ profaxia oftaimite! gonococico: se indepaitoazd secroile palpobrale gi oculare cu autor! . ‘umezite ou infuzie de musafel: se metieaza in tundurle de sac conjunc- ‘compreselor st tivalo,picatur de soluje proaspatd d re, plecapele sunt jumele mame) Ingres tegurnentoor: se usucd tegumentale prin tarmpanarea cu un cémp sterical, pen- de vernix caseosa, aensta avin evelg protector impo- lor gla pierderior de caldurd infSgarea: 60 de protecto ter- STUDIU DE CAZ CULEGEREA INFORMATIILOR INFORMATH SOCIALE Nume: M Prenume: G Varsta: 25 985 Jud. Arges Bl, ~ Se. = Apt- ia Farmacia Catena 60 4 ani gi un nou-ndscut: trun apariament v3 ca = catea: da; 100 mii drogut: nu 12.08.2011; ora: 21.15 30 nundente, facies crisps ners greoi, ez iand pigmentata gi prezenja smamare la nivell sarilor; tic I nternare: sareina de 39 s8pt., prezentap craniand (pr. cr.), membrane intacte coapse Diaar (M4. Diagnostica extemare: Medicul care tngrieste: BM. Istorcul boli: Pacienta MG., sa In evident a mecicu defo fama: 47 ani; preg 4; slarea sana Ww sénatoasa 49 ani; preg, prot.: 12 clase; ocupatia:saariat la Arpachim: starea sBnaai: s8inatos un fale; 27 ani; prog. prof, 12 clase; ccupabia: munctor; starea sanéiafi afi. SIDA, rata 45 2, fx mo- nedureros; sarin ‘ntacedente personale - patoogice: je a aconueise os aueonsy ind 8820 wena. exten ep solu ep sewn ‘ne6o1¢p re sfu6ul op ued Lt suasep jee WowIel, o|Usd eave ap sy263) waged Prez ENAS euEOSiod e/a 9uBeW 'e-L #O '/1 03 sBRZIENdS sTvoiaaw LvWao4N! ‘uyzyeyds epecued od pzeoteunouy 01 gine 0 'pzBaH2IA 0 :ABuINg aD Be} fue} BOUDRY ‘gues rauposiad eaurpry ye ro Inu inBurs ay eS BOE -sdoo0 18 gaeatinuco auy 0 aise euaped :=1e0 vareney AL ‘eoranu gunose indoo oy “NWOS aNIaRtd FAN133180 1208 ot ~ yeInueD ~ ‘ey 00g 4 :axeyueo — ‘ysuapere9 “som — ploy ssa — sou, uages :as89jno — styouy :as29)R0 — ng i2adse — sn spodse = 2y6-9 siuen20y— ——_ogegyuneds 4 sejusnoy — on nes STRIVNINITS ND YANLYOT NI RINIBoIEO ep spDeqz00 9 — ‘ep "eomquit 96 — ep ape 08 — ep ceueiderd 25 — ‘ep silup ad gieds 28 ~ mu eale ‘ep ants “ep e120, YW IWNOSNad YNSIDI 3d RINISOIEO ‘nu 2980u ap ees Ul 1ep :uoIes ul ‘ep :eseu Buss exdones ep :yeuun “ep -sayalu 80) eux Jounin ‘edn90 “210894 "22784 nuysei8 "eunsuco ayRod a nu aleD ad BUBUNY ‘wareq "gjeunjou unons :ajroye1d umine nsqop 18 unary 's}any -o1e11d owvoUy nee} fs exeyezouoK wi ep wer} auLVANaWny 30 34NaW3TS, fp seyoeip nu “DeCUEIS ‘mu ynesous no eum 1 2u}405e ny seine ep :anBurs pleoos 6S !gung soem eainiaon gues easn pedse "gst4our e720) ‘ploleoe SoM ‘ep EyuneDs | ‘afeOisU0O 'PUIES 0 sjuad jEULOU ‘wiMIOA Ul SulSep YewOpde “Tea, jeogseus "yaased Wade ‘oxaUe OURS If AISOEIP pou eur "wjon uy es eowuRW: Rie}sUa2 28 yjnUOLUOPGE IyONWU Ej Je eleWeLL jE! Bose, “ould gieistaa 28 so9ues mjaadsue} !2120}69 eULOU “sojqueLunG, easeoRa 8 pedsy THONTRL UW 2anpNe BWC aca soz ivwao3nt SEahionee Dispre, doris auedion manesiaa pin evep/mn. ahianee, 22 respi i emen monies In tormen de 3 or. termen de 1 2 Resurse: ~ ale paciontul: persoand cu dependent’ major’; ANALIZA SITUATIEI PE NEVO! FUNDAMENTALE asiaaeso = cahipnes| bund ercusye Nevolafundamentala | Manifestareade | Maniestarea de Sursa de Independent ‘dependent® ifcultate Tae ~ contact uterine 2. comunica| persoanele apropiate | mess deformat, rte ia = geste les ~ Siegen ameter pert A ctiuna, 8c 29 abunderte, ~ orar mocicat ~ stare de acetate = ure TAactona conform proprio conven practical, nu poate merge la basen ~ saiamentsim. sv TZARpreccupat veeres veal Sbhicd Ta Aserecies S.A se miseagiaaveao = ones 0 bans pasture = ae = marca mi = cboseak ~ sara termen, > efortl a nese = epee = drei 1 Ainwita,cur sh ~ sesh pastren sardinia > ances = nastere = spiaivatea,AER ‘esaoe vid ioan ae Shared mmo, ‘teas se ‘Swadtenou9 es | iow sitios | wee nials exes onsadare Sai *emcte a | amon saat ol uss eet patty | somesitass ayoun| snipe’ leans weccg] anata winger! | Stem] unge tare] coer! | suman] ankees tassano =| aims] “ada! “eit | Soeasrietaetze| Ma asa oe ped fow>ersnapy| a syersonsece| rmmacay enon - | sch woo) oes son) Ment agncn et] eneouscoen fa - | mosetns| Maurie nn] tana sot ese | ates] "St ne ate PIN] 12s VOETAIK TNO | sBBoSoWa TIEN, Bee tacit wos] or nmoseienp | ‘eeui|“neoae dion ea] aptonos eivenuous ‘wibx] 2IZtDP ¥escan| popu eeu Saget HMO CLL] adnan ed wenayrued wee ab nL 2a poe seeedaeS P9042 euoioy| ssa0 OSWE ULOD S03] aizod oss ztas ‘essa ono 3 urete ameiniznz| wai vetnaNie| ——_vonysaedes { aeeoing SoyaueowG| Zyi'svemeues] —_ rwoooomnbees sausnbemes coven Suibosracuai a) :gnpor pure names ao} “Uiaeesajuea) assay eseone wexeus] réuno. auionnip| —" puparmunrep | gapuswmusaina| syeenaccageo| auanisencs -| gee oy | _wacrtony| “nari sun] ganusieannpnac -| simadmunitou) maspama) egccutensy ~ “yinaanaaaa} anawyaven| ——_ulvousannt ua teatoeoateal suv) SIVDTFOHINGAWNT] —_muaowa nlwanains ees -aiuataersonra “| Sh snuzsiwo! _ousonova IOAN (4.99-¢p)gieio eluspuaden no puBosiod = py (482 ~ 61) nevepow giuepuedop no euscared = 2N (29-62) goto eluspuadep no puBosiod = EN (apy) ewopusdepu gueosied = (N suvnwag ag vd ze | 7 rie = ad =a" 3 ad | ak tie ale leet ele } o/s a alee 8 (Ele (e 1EeE |e *D VEIEIVE IEMA AEE BaP 4 UPIEIE US STEER [Ed a]a 0/3 [2Adem ave lost aso nso, ares ‘nde sna, iret xin [enn agit en resets fac. ence de formate n oma Jaezate, ‘Set sal gia, 5.50 pe nape Scere rogram Geodhns corsouaator ‘rang oe nus anes |- ceezosenaye deine SSMS, pimctecue Sptetetic dengrie rent necesre abt Stik ate a) Sern ssh ‘nemourprpus, heme > Sen seunelor Sean | ccna elece | peki 85 meh eres non sna ‘monte pun sana seaueloe rave e193 Fe gahaukaina aeoce limite yeas Irsdecaa canta ie metas pn poskune, 3m ern reciente de sh rus eine [pasate intern de ete Tobie rosin frecvera yeonssten ‘uno sauna isa apex 00 onssteryusc8 as feciod cues nena | ecetminge mc. scent deena, | Sables rere cu Mu era regubt de hrvars inte ctv ere deter eke sbumeses Sherine Feo, tserogeabi | absense natin FO cantatas cattes ‘uinagoakicie 89 mey eu olben ne {ecowe ms ‘ates 150) = fecnine blag smasuandingest vce | tear ina pare ‘iamene cherie ieee me pean Iie noma teman! ae oe ema! ~ verse Sond ores stents etl ae din Sepalaen Brno suncente MG sr maipresie rahe de TP igwowmeaa cas edsound promot a ‘erceiies chemarie scent ~ Ssgurigers coed ‘owas, + amb enor de pte ‘Sep oft ce ee | ejezpaciana ssi exorme inaute Setimene siege Eaptema - Sis oen de inate Spacer |- Sura mente cequmenee ries cust nate |. estesoneres once | ~ Schiblenerade cop: |e mening gcd ctor spi irene = aur iorimnte ons ee + cits eindee, ‘otat pace she En Goma Fans in temend prepa. Ia Reape panes loss cree epi tance 86 iti iaarearim lara 9 chevapa, [trea der, arent rin ps jsncorse ssa TG prem ple mee oresi interme loons obser mio grate ‘active nF. AY ‘arromnts > educpacena 5 pane imbrdimore lees Gres rusinorencs eheulalasangeu - Sintpesate srnenape began, ~ Seine mecca reseed de meses liste efelacees -aename | resp "een prow usoracy} 9 pow saith ona “AL ap uguomw'neme era apne wise asavenausd sue | sips igncenes Insoune =| venue mea | meer Mane te pep ene — ory "ie Peco suttelowrsnsen “| “Sesyuetttty| Metgemeye) een wetqasmorsonve -| ‘ona seunqauseseane easpabcneoary = ‘iba 92 onauinmworaapen Sis 9 20 ae O eucce aya enue Ses gwansenise - paibunju ios: wie soundoud un yore - vata uremic ‘yi e metus haved 5 eneauad aes nso weneasd germina] Nous ques eojeaes Si] UeIeD eau vptaue tas aon] tae -| oats ~ nod una] eneezenurey § qaante po sapyeouts puns ‘uasrved tue nes a “aizod 6 snEise y | 4 pune 4 8 adeoUL ant we aaaser ug spunuai wales] gnu opine peaDauEedE oH) AoE wussa) vaya causa ze “anichet Ten sed ampe ina oqo ‘emt ap a -enters: uate be SPITALUL JUDETEAN ARGES * SECTIA: OBSTETRICA ~ GINECOLOGIE NR.FO. 12743 SCRISOARE MEDICALA NUME:MPRENUME: G \VARSTA: 25 ani SEX: leminin ADRESA: Loc. Pitesti, Jud. Arges, Str. ~ Bl. ~ Se. -, Apt ~ DIAGNOSTIC LA EXTERNARE: lehuziefaiologica Doomne M.G., in vars de 25 ani, néseuld la data de \QOmgial; Hemoleucograma completa: (WBC; 14.7 “O/u, MONO: 0.560, EOS: 0.018, BASO: 0.055, RBC: 5.23 Po, MCHC: 28.6 gia, ROW: 5, NEUM%: 843%, LYMM: BASO%: 0.372%); Ure serica: 18 mg, ‘S-a etectuat urmatorltratament: Glucozs 10% . acon: Onitoi = toaleta sénior ~ eutarea traumatizari regiuni geitale cu s8punus tar: vitamine: ior $i contact cu persoanele bolnave; Recomandti fa externare Fe S-au asigurat ing necesare corespunztoare 9 se declaré mull: ‘Aa fost atinse scopurie: da, pacianta se extemeaza cu stare generalé bund. EVALUAREA CAZULUI FPacienta M.G., in vrsta do 25 an, de sex feminin, ndscut la data de 17.10.1985, pita. zala dela data 12.06.2010 pana la 17.08.2010, pentru urmatoarele motive: jr 8-9 micy2,tahipnee 22 resp/min nts, facies crispat, gemete, pete, mers greoi, amet Volum ou lnia medians pigmentata si prezenta vergetur steoleimamare la nivel Snir; Pe baza examenula clinic gene pe Coase gi lancu, pigment iminares dopuiul gelatinos, CUD, nelinite, polekive spiral abundente, faces crispal, gomet, pate, frecvente, abdomen main volum cu linia mediand pigmentata ‘amare la nv sAnior sha Icograma com- 124, LYM: 1.68, MONO: 0.560, EOS: 0,018, BASO: 0.055, HT: 98.8%, MCV: 74.11, MCH: 21.2 pg, MCHC: 28.8 gt PV 8.60 f, PCT: 0.231%, POW: 18.6, NEU%: 84.3%, LYMM: 1%, BASO%: 0.372% 18 mgi, s-acon- ‘raniand (pr. cx), membrane in REC: 5.25 10, HB: ROW: 11.7% PLT: 268, , MONO: 3.80% fiemat siegnosteul mat cH urine dureroase, ise! ce ingjire manifesta prin tise de complica. 3. Insomnia, datos stride anviet torts efortulu fie ain timput napteri, manifesta p 7, Ailraroa tiimulul cardiac sia circulate, datorta dureri, manifesta 286 batimin spiral abundente. ul tahicardc, hipnee, 22 resp.lmin td prin mers greo si ametel otorts spitlizari gi tratamentukai admins: ‘rai, manitestata prin inactvitate,‘orpoyg2undsa100| ‘owe soqugs ei ~ uewerdes gjenxes 1b ay snedos — ‘uepuewcoas seseoreuun ezeozyeoi 9 ‘AL 9p ugue ‘2100816 sanpoud woind se exe amteasoo: ae wooed eaves nasq0 ~ 8208U 99019 720 | 25BAI96 0 ‘OHA | — igs © pj0U06 eases mesqo lueindis -npuueyo ‘eronou axe exe ap agooyeousd ojuce jo it iueuned Due} es — Ea © aso ¢5 S)¥4 2d usa}ap 0 ~ (99 “poHeD9) sos "FIEDEN iorIsUCD 'B ODL node peneea ‘feo neds | sOjuneDs eueiisueD # eluanoey 0:4 U 70} 18 NEGO eysyes Sp wes ul ap }uye) ands — ‘euNd ojnosip uud “O'¥ In| UNG ap afezuas 0 29019 — imenue ezneo ynvepr 1 jusuebi0 sojezundsei09 guNIpO op ulBGoNd Un oseuDOUUE — ed a0 9-¢ YeNbe uuios smuawos n2=q0 — roquauned e gjesoue6 eareis wosqa ~ So1exe)a1 9p fquye) ienul o — 16 auloenuoa zezyoquow — ‘nputigo sauBaid aouo ey zafeunouy 0 noo 2| i ; i i MODULUL 47. Puericuttura, pediatrie si nursing specific INGRIJIREA NOU-NASCUTULUI $I A SUGARULUI Caractere antropometrice. Groutatos media normals la nastere este de 3000-3500 g, nasculi cu o grautate intro 2500 gi 3000 g se numese not iatea de 2500 g la naptere se sueaza premeatuti $i disme tru varsta de sarciné la care au ajuns). Poste 40 raster in medio de 48-52 em, Sub 47 de et Je corpului se masoara cu un es sto In madie de 24 em, cline cele dou In Gecursul primal an de viata aceasta ferenta se micgoreazétreplal, ase Incat la varsta de 1 an cole dovd perimetve devin ege Usterior, permet oracle va creste minun ars aco pipseimmgcsnod asm] Blentaou any anita pu gu2sgo a6 feroci 86op usu yuo. 09 arwetynsoy 5p aes cpu am | ean 0 uny ans 3p spuos esnponu ee 9 reo 2otaundo eo99| "gordues g2MsoWeL o nBisR a atuedue’ 99 dop” u _Barejduioo 25 8 po =p eamouy na ereusfos ejeyescns ezesucd uns eunye6y 0 einoe} ngan eaep fBesoway foun jnzzo uexesen9U “piueInGis ep ElUeIsP 0 aisa BiseaDy oreKd lus We BoD BIS Ble 10 yuog esryeo g220ULI 156 suas e001n08 no jew 9p e86180 ose ‘gyeroepe au ap onsed -idse vud gzeazyee! 96 Bsea9y 2120 es UoIPian epuos 0 no gino 91 Jour weleniisqozep ro ad20U] 2g "| ‘SuaLE¥N yang Amani soLyHys Nama YTINIAINOSYN NON ava¥ODY I TYON| sad .90 95 1un} 6-9 89 esIeN sISad a9 SnUIp e0UN ejuar + ,0un eayeyra}sod eojpur eIeIeUooU EpEOUeK uy mio 16 equed ‘esdeoo ezeayay injnosgu-nou ‘eweyd 9p 40én yo ajfoeas gidut ap ymeayas — ‘ow sed un ozeiyps Bs w aged op inxayey ~ nysuewyp n> "e>IgwUOL 18009 96 NUEID EY 9 208) sojsaid se:6 nya esd "reofumos ayso gzneD eIseede UIP I aWSEID Op eng ‘uizaid 2189 ila} mdoaxo no “}eyoATEp Sur BIse nu yeueYrOANS sealpe-ojan nse. ‘iz 2% unGuis ezeatejap oe 16 oBnue| asawnu 9s 2129 Uy ued nyeaeio © gresiop eaun 2s 6 od 10, _enoigo p sundep ur enbus oquoos ‘euuorep vagy |Z €-z edag ‘ee:29I0d jf 9} 2 ‘erBOIOIE sfeoyuws ove GZOUED 99 avOZ 0UN eiuEZeIs "gaqesou nes gzo1 yndaou)e| aise mold esseaing ‘aaIBolorzy 14 ap asa inyndeo w geo} gaunbum (prose) ereau 9266 ap S301 2 avorzigu) aieouayn soxysdosneu ‘Pogues ow eaxd ueWED lp yoq sour e ssewin 23 (gutare funcional foarte cd, fd a exclude tlusi posbltile de rosusctr 8. Sub aceasta valoare, nou-nas 4.Se face pansament de 70° =! daasupra s 12 Poe roma pert sin. "cit penttus se proven’ sperfia elem produsd de scaune numeroase gi acide). Prima bale generalé se va face insé do aba a 26 do ote dupa detagarea bon 4.In primeie 2le ce viata se face vaccinarea Impot Engerix). 5. Iainte de externares din materntate se face vaccinarea B.C.G. (bi a tubereuleze entatia nowsnascutulul Find vorba de un nou-nascut fara probleme, alimenttia se incape precoce, la 3-6 ore du 8 nagtere. Exista mai mul a) Alimer tip B (vaccin ‘almete- Guerin) Daca Slint-un az 9 ma 2 lcrescfind rep 88 se dea gintrun incepand cu 1-2 mi ia saptaméné un supts& dureze 15.20 minute fiecare supt si s8 se schimbe cu ceiat s8n la su lactets la ambi i 88 nu se produc va spala sénul cu apa gf s8pun gi apoi la s&n sa sug, el va la a Vil-Xa 2hds lanastere) cu greulatea la naglare sub 3250 9 ) Dac mama nu are deloe I ‘adic exctusiv cu ata Indicate: ~ peparate industiale de lapte adaptat: Si pent nou-nascut 2e poate e epte in iupe Milumi, Miupa Apteml, Morinaga, se au cate o masuré de plastic in ambala, se reconstituie in ap firth i adaos, conform instructunlor de pe aichets, Numarul de mese este ia zinica -200 milkgcorp. Mai poate f ullizat laptele pr ins8 praparatint-o concentrate mai slab si anume 8% si cu un adaos de 5% zahsr. Deci pent o pore de 200 q se folosese 190 ml apa fata gi rac, 3 zanar (10 9), ‘vaca nu est in umarul de mese este de 7 in 24 or, lar cantitatea znicd te dvat este do 150-180 mkgcorpsna eu ood meu : pyaaioa ees {1 njups & gua: ap syne: copy en ‘azapajse [28 10 asad cnyranosgusnou @ (2a -nBuy)jnvoseqyg no nes ues e| eiewwow! sy GIeObE;Sep 95 wo Apo BaNARIN — !ajpewn ojufuSu, esreuuuel ednp inpyneseU-oU ealeszyN ~ ‘jeuod uous iownseu 1 eanueI—D — nmrasgu-nou sojsjaUnBey Balen — was 2s eoseuoises "easesued — unoueus Joun Berenyoara ‘2 -2udoo na yy wosesued ouay ‘ye=3)qWUO MNuODYOD eam -rosgu-nou eoveoynuep! n:3uad eroUnY no Ouse RUAN WP Nes YOLED ap cinDe|d — ( mminosgu-nou earségyul nod ees soeinas — ‘elUssoo} pwn ep ave no muUew e1z0H 2p elussoN) lun ap uLas — ‘arearBinayp #feupul — ‘uepunoes no seen "goyBuvd-njawiues ‘nsawoxped ‘ueBns nUsd JeNED — ojpoa0u06 Jauujeyo eeyjoud MUOM % | UIE Op eR ap a nuod ses909u nfuewvouIsUl 1 ‘loi wepodur ap yee waweU! YSe0e Wy ojdMUL HAS UY SOLWNYS INIALNOSYN-NON 3UYS3OIN YOTLINON| VAUVOYODY N| 3TVDIGRW ISINSISISY 1NTOM gseaisojui ezne> pugrean, ‘Buns 9p ‘Daf | Pued gata) eunisuadse o- \youros soe a1soq 942 12 90 2150 aGo}O7Zy 19 NUad Esme e feeasartir areo gcnp "gueweIdes 0 op +1e8 wlesojco wud e=-npugisejuew ‘asaiSeu e| op of gz B| a1€CE OIOOIOIZIS INURL! (> ‘8952 Bunt ewud w pugoaseD IURISvOO pow U UFZ O10.0 FIED "Bane up eanpaid 88 31Yi NAD ‘szovonda 96 es indsouy @ eBord pues ‘210 9p +2 © no jnapeeid ezann e-8 e0~p) 01 9p joore UL aise asaxdusoo n> -upesap 2 ued IMBUIS apuudsap 9s aoeleoap in| esdnseyurfoen ap f8) un fqU AyDIEKD Ul gzeotejop as jeuy UL oid ap oredos inp TuBau suinap iuOR e2UEInOSEA aise nu adesedep (eDtdase e7O0aU coum) eMs00e e ojeId92 INEOSN GIAOIED BIS WO!TIEINO IVIMINOE WLM IOAN¢} Riscut legate de actu obstetric fo sindrom Langdon-Down (tisomia 21) estry de sarcina: rise de cardiopatie congental, surd- ‘care se comport ca geaman ransfuzor, 2 ‘erirocte gi Hb normalé find geaménu ransfuzal cu nagtere prolungit, Iaborioasd, cu adminis ‘anaigezice mame: sc oe hipoxe neonatala (encefalopatia hipoxicischemicd & nou-nas- de g0¢ neo-natal gate de slarea now nascar ‘sor Apgar mic: isc da encefalopatiehipoxic — ischemic8, de h ngeala prematuttate rise de crze de apnee gi cianozs, de boal = dismatuniate (nou ‘men sau In apropierea trrerul = racirea extromitafior sau hipotermis (scBderea temperat corporate sub 26"); = palcaree tagumentelor sia mucoaselor (conjunctive, buze) = absenta migesiior sav diminusres lor vi i anormale: contrac muscular repat ‘minime la exctati exteroare, la un memoru izale sau la un singur mambo Ca i edlatle Sinursing speciic are ar la nastore greutatea egal eu sau ub 2500 g ingimea depigeste 47 cm Clasiticarea promat ramaturtale gradul sau ugoard: coplul are a Prematuntategradul I! sau medie: greviatea la gradu! 1Y: grevtatea la nagtere sub 1000 0 romaturitafil se casted In 4 ma grupe: 1. Couze mecanice, de pe urma efora se nase prematul .s8nato reruperee In 8) Caz comprest 5; ruperea procoee a membrancior. ©) Cauze mecanice ovulare (fetal): sareina gemelara: prez unele matformati conga 2, Cauize morbide, de pe urna cérora rezuité prematur suferinc| ss ') Cauze morbide matere: 3m, tabagism, saluenism (intoxiala eronicd ‘marfinomanie, cocainomanie sate consumuri de drogun. ») Gauze morbide anexiale: leziuni degenerative placentae: infarcio placentae. ©) Gauze motbide feiale: nanism intrauterin; tisamie 21 (sindromul Langdon Dow somie 18 (i s@ nase mai ales dsmater ‘a mamel; carene protece favorzant gnu determinant al prematurtai gl dismaturtai: ‘arietuancay mimidoo v gio -owand 2 36 les uozwes 1oun quo oyu wud 909} 98 jumyewoud 2 nu eounrogasn ud ajeudsoy ‘eeuin 0 9p s1oxeu axe ya seo ops EU doo yez9be 1 eleod eIs0Ie ‘od 200) 2 nes8 arjeusd une ejoeieo Beals, ‘sseorruee 1oaped juns goep se1y9 ‘meward no ye|uCO UL UA si jouUEDSied ee} RaLOd ALCIeEIGO 2388 ley ad ngeusveun jnyod se oes ut insaa0e rajuad ofese0es e1erey eso 10 "ir ‘28 9p venesbop JeyLes Loszed no 0] ads UOFES UN eae gS nJEWONd > exNged] ‘mypanjauid efor ooued ut au 1 od aves eyeuctouny aluoyep oe ezastens Bs PUL UNE BIzOOY _ya0s8 urmeuseud 8 yuesqe HIND “sonIO=pe ‘yuasge sep 1836 mnyeuard 8 ‘nsebip mnyezede oje ejeuojoury eyeusiasoc 8 yde> evenness — (Soumnsel @ pseon9jop sieuebe.0 0 puusessu 29 EasD ySNpA! EZEUOLINA ojendsay mnyesede aye ejeuojouns jeluory5a -2iuo} o}Bournu as 1 guejUBUNIY eu ave eise=D% 'esiu2sep elouEjuy exe VS EU: EGY ‘eSIUDS—D 6. i i | ' ionda, Le siégit introduce putin solupe glucozs 8% pentru a nu i Sande! gi se pune capacelul ca s8 nu reguriteze din aplefnapot fn 52 schimbs sonda g1 nara pe are a fst inirodusa, pent ca 68 nu ‘ale mucoase’ nazale ior inoope la 6-12 ore de la naglere cu adminstratea de soluie de cu seringa,troptat, ramane iapte pe pe lari. La 24-48 de. ‘un prematur nascut cu 2.000 g, cu reflex de sup insuficient dar ou 0 1d, va prim in a 8-8 2i de vats o canthate lotala de lpte de 0,02 x8 x 2.000 = 320g. Acoast® ‘cantitate se imparte la 8 mese fa cite 3 ore interval, revenind la fecare masa 40 9, adminis- PPrematuti, calegorie de nou-nascu) cu rss crescut, pot croa adevBrate surprize in evoltia Jor, prin para brused sau weptata a unortuburB care tebuie cunoscute, 1. Cael de apne ¢ cianozé aper in special promatutl grav, Se caracterizeaz prin opr tei, oprive care poate dura de la cAteva secunde pan la un minut acd este o cauzs organi, eriza Se ‘Tratamentul de urgent consta din ugoare stimula (exci oxigen pe masca, adminisrat cu 0 2. Hemoragia cerebro-meningealé este cauzata de tagitates capi’ a premalurl, desi de traumatismul obstaticl a care ~ puncha lombara care poate extragelchid cefalo-ahigian sangvinolent sau xentocrom (gal- Dui) La mieroscap se consiataprezenta de numeroase hemati vec, modticate: ~ ecografatransfontenelard d3 date imagistice despre focarul hemoregic ~ tomogratia computerizaté (CT) este cel mai sigur examen, ardtind sedi! sl marimea foce ru ic endocranian, ment hemoragieicerebro-meningeele a prematuruui este complex $i df, cu re- esigure 5) medicate hemestaie: Adrenostazin gEtamsilat iv, plasma proaspaté congeat in per fuzie; .) Mani! solujie 10% Lv. pentru combaterea edemului cerebral care insoleste de regula fo- carul hemoragic 2) vorticasteroizihemisusctinat de hidrecortizon iv. i perioada inal, apo prednison per hhematom endoeranian poate f necesar8interventia neurochiurgicala va infectitorintercurente care compic8 boale, (etrsa respratorie) const in formarea unei membrane care aplugeste bronhile terminal si alveolele pulmonare, Impiedicand schimburie gazoase Rezuta 0 insuficient respratore acuta prin tu 0 reprezinta dec de surfactant, defick caracte favorizante: hipotermia, hipoxis, acoza, ‘Manifestarie bolt ncep la 2-4 ore dela nastere gi constau in spree cu polpnee, elano- chiar dact prematurul respira in atmostora de oxigen pur, alterarea ste generale. Lets: ialea este risicats. Tralamentul este da urgent si const din i dar boala are gi cauzejezeby yuauewuod jezvoyuous inde: reads uy Yumewaid 'aygns iow fe seu (8 p2oue! 8 eoude op sojeRu3 jos) pueIshe — mynuooew @ axeuus@ euyUd i Uno fd }HO}ENZI yMsBODe EoRsENL eA — ‘ateIo9juZ0p aipaned (7p ingen e282 vabHo nhuod sereroneg UP ateRsP ede @eiuandey eoNeqUILDS — IMOSeu-noU N7ED UL IPORP as faniiut oqumeusard rze9 Up uo rMNIVId TIYS3OIN Iueuecul 9p ngesoap ay ‘otusondas ‘sjeusajuO|se6 uesng ‘ewvoWINaLdaYvory sreiNoo visa} “ez0!00N 9 GU ejno unjze| aonpaud ayeod njDeG 99 Hao ANUad see 201 yeUOSiod ajuets ad op "uodK0 nu}ued ejalecioqiEg UP ereqnOUN 1d Guaisod 9180 faved eq) esoujinuee seuoWOpNasy no e32/41 9 001 81804 vosun aeudijod no gsusiut eaudsIp und eysejUEU! Bg “7p yooun fo evexéeu cp yejpaus axed mu nse Tueweides Bnsigo op o 818 Bje0g " eMn7EOs eseOze)uNIVE elussiza: Ro OJoUISIUEBIO Od EzeRIOIB 2s esE> Is0 pz80I018 ag “Pduoo {ouq.0) 124990 eH EUTEL ap eauZOD fy aang aieo puemnoo aunioaje 0 sise (nrumjeward eredoue)) giemeanar siredoanty 298) 25 een sIULIDY ou jase ezBaINO|eD 9s ez0N 1 oie 9D fan y od) awe rs opezs euGueseacool 89 ales el 0 pubes Sansone ‘gugweydes ad tio ¢ 99 dioofiyn oor ap ezop UI 1 nes ss ezearsINWINE as oxeo (odINHL) BIUBUIQUIOD®: 3 9 waweIeN ap ailecsput DMO} © gIeveYE glezed eaunsseid‘ua6m0 UL ‘unBues i “U0Rse 2 mnuobixo eovensiuuune 2220) ue eeiued eaunisoidpe care se evacues- aceasta trebuie 84 fe ‘nur valor a temperaturi 2. Interventie pring almantata prematutlor sunt deosebit de importante, data fing tehnica rematutiar grav: i de degli, allmentatia fe unica flosingS,schimbatd la 24-48 de ore, = asisentut mei ‘ceput, va admit ‘invajata mama sé faca aceasté cperatuno, te pant flecare masa si manipularea in condi do de solujie glucozs 5% pentru curatarea sondel ‘or cu cépacelul care impiedica regurgtarea lapel din slomac: ‘sau chiar accigente 4. Intervent pregattoae inaintea naster: = progitrea din timp a tuturor mateialetr sinstrumentelor necesare Tn momentul nag- ~ verificarea bunel tunctionari a incubetoruiu sa instal do oxigen; SUGARULUI = secfonarea cordonulu Inte cole dous pense ~ efectuaree igatur fa 2 cm de inserja abdominals ~ secfionarea cordonuluila em distants de igaturd tuarea nodull) (2a unui pansament ster peste bontul ombiical ~ evaluarea str lnice (scor APGAR) cardiac espirae = tonus muscular = inftarea ranspot In sectia de nou al ~ agezarea nou-nascutuul in pat respunzator(temperaturs, umiditate, luminozitate) scutulu Lor sinlome care deol sncom rewrovascular, boas hem respirator, digestive i ~ Bindi céderee bri orb! tegumentle or spate zhi tata pari) ‘si spun, apoi uscate prin. " Pasa) ova ~ In primete 12 are ceal > dupa 12 ore este pus a si terndnd sani ~ esigurarea conciilor de glen’ = Progattea fica a mame (halal de protectie, masca, spalarea mamelonut ~ asigurarea pozitl pentru alaptae (la incepul in pat, apal seztind pe un son do aléptara la a valu dintre mese, durata suptuluig a = Seat oma red roma be peronda ot Je po poten ait, importa sien nara ant dears copaatctta aac sone Asigurarea condiilor de medi: = camerd separatd, calduroasa, mo respunzatoare, temperaturé opi = Alimostatis: ~ 88 50 fact la aceleasi oe a necesttile copii, lumind co '# ind bberonul, apoi cana, sé bea singur dia 88 foloseasca lingurita8 ereyonzep “aitans 9p Inp216 mmudea @ eyeypups an eaves azontere es — | imuBul so}se0e eiuevodus szaniow es | ‘1bee00u Jone “uu, wenysyo eosopon ws ewews gosenasu es — ‘amqea fe2IG0UL NIUEISTSE nue 18 mminosgu-nou pagauop eo} eze20 > WUoUye "gieAsepe ajizod ul evepaes ns fpup20n SSW 2p wyaeis repuaiED 2B sng.09 — ‘enjoe ajueziunun, ~ ‘sai601d oo "gjeuozuEs eteyonzap “ereuop.0%0 UDa¢s Bun SuHepoR Mn ahd 4 INOW. fase 9-5 ap eseA ea sojarapuus BSseoNP3 reoig9 eu “ou red exxoueul op on — nop Wen — 2p evalua, — eaIUNweDeAaL edn ‘vo eearene ge1osap aveoyno ap ‘equng Up aeezieul ‘iene ‘sugtd euninejap ayeod asta ayBian ub ‘al s1ereues 9p eoveis ‘es red ap aoa eu es nga — elev ap ruby pow nun eoveindise ~ 49n 9p etauny u yezyenpNu y 2A jsnoe nes onde fueioxo ey wadeou earSLSe: ISIE 90 of 108 9p soju0 eauerpadsas — rues {104 9p aueodwer no wena Jon 96 sane 6 ajezeu apoUO — f2 81s s9u61 jRRJSUM BSS eNOS BSBNCINED CMO BBE] BABS JOHLO PDIOEIE — ‘teuodwer ud 208 en 25 sjeiuawnBs; eaxeasn areq edap — ‘ayese0a 520 aug6eid i Jon epeo 288, — eoseosedap nu gs ode mont: — ‘6s edep es nu eieinp — ‘ede ade 2p "gio Neaeae e} "09 — ges0d.00 BUSI, (nnsebip roueseio) ueulpaaaia havi Guinan enue PIES éASTMUL BRONSIC INFANTIL Este 0 afectune respiratoie de natur® alergic8, manifastta prin crize de dis- ic Apare informa tpio& dupa varsta de 2 ani, la cop sub aceasta forma recurenti dint-un pneumoalorgen: praful de cas particule arf, produse cosmetice. Un foomela de nor} an oganis pert aroxstice uo dura de 12-48 ore, se ‘end nu epare nie! un este brusc, deseo in timpul nop, cu dispnes de tin expr rigid in gezut $I se sprina in mini expiata este insopts de wheezing percept stan. ‘Seacd la Inceput, apol devine productiva; cop = Bronhodistatoare simgaticomimetice cu scjiune bata? selectva, sub forma inhalatonie sau, pentru copil de varsta mics, comprimate sau suspersi orale ‘caz de infect acute sau cronice reactivare ~ Desensibizare specific la alerganulllergeni ta care copia fost gait sensibil — Asanarea fovarelor de infectie: vegetapi adenoige, amigdale hipertofiste, otté medie re- ‘aivanta ~ Psinotorapio cu = Baineofzt are (heliaterpe) savin staun proflate pe afectune: Govora, Slanic Moidova, Slane Prahova, a LUnele cazurl de astm bronsle chiar rebele la ratamentele efectuate, s-au vindecat spon- {an odatd cu instalarea pubertai BRONHOPNEUMONIA, Jara gi, cel Etiologi Cauza determinant: infect pulmonar® aerogens Haemophilus influenzae, Kiebsiola pneumoniae, sau, ma Cauze favorizanta: sezonul Simptomatologie na sandtate sau tn urs unel infec acute @ c&foraeriene superioare: 8, uneor poste 40 grade Celsius: = Starea generat a supa priviea anxioasd, facies Investigail paraclinice: examenc! sangvind, examen bacteriologie din secretia vaheal,urmal de entiiograma, moattea copiuiul. Sub precooe, sunt multe sanse de vindecare, cu 0 dural a be- uncle de sediu de producer: ~ insuficienya cadaea stanga; Weresdnd ambole par ale ini icarite exudative sau constrictive: avansate de evoluie: b. Cauze vasculare: ~ hipertensiunea arterialé din clomeruionetitele severe: ~ fistuelearteiowencase periferice «Gauze pulmonare si pleurale: ~ preunopal grave: tronhgnaurtonie, areumeni ies severe, neu be| aye unvoy 1 eure op ues “weoy6us ie oye ‘810 uneos‘unons gpHovos ‘eu 998 cesigsn ooo 'ezien slut oirin “e600 ‘zon ees “sad ude rio “ned .98 0" jiueue 9p eases epuPlioo: en ‘een du op specu oa 9 eos op veces Hel SaFEMIU|AT yExa/G} 28 BISBIE WND In|NPoU BaIUEULN 1S NjMUOWEFE PALEMIDaI3 “¢ aheoen "e901 ls Uno 1 uBokeeap os eieace ave Uy usu o.repyes ap aseoueNopLe rane um tleey6 no sen uy eseo8s uud yop) ‘pe FwUOzaE UI IS BIEMSIP ede ro JOI0q)eG UM 21200 vad Yeoypuun aingen [oUeBO “SURFS 10400 ‘fezEU JOLOIED 'BOSBW Bd EP 3 "20d 05 -osUsju Suto aaudp [ew z9UeN fljuede zed u; ezeansIALIpE As (MLAGIKO 'S Wwe un iwesoun4 ‘oyadns jan un e 0 25 yrEeD YOU OR lusfins 27 ‘upwlld ang eBues ep yneny eopeDs © pupuipie aseouaju ajaiqulsut ro i eiendsos ezeomén aseo "epurzagias ea esa euindo eizod ‘ied e} ious snedoys "| jteunzos eaveasibanu 18 Jou Jo}e1038| 9p 0}eqox eareo09%4 “¢ (ropes ewesBovoy"guwesBowsy ‘em | Powe UES, (one) eenv20 eseoven eounrsard ~ POU BORK sBope9003 ~ foqunigsven sojeuneas mgodse 16 jupwinw auesBorpse2010013 — -oiaque nes gyyaiuseqse6 m9 seu PworCus fat}sede eounsacons 19129010 eoeinuea sjuotaunsup ‘eUEYE NUTISUa BO;0pHS — ‘ane Bui 981989 Und soresoae pee ~ ‘nb "este oys0soyeseeonus ojNuOUINES | ‘eunbijo ~ eeungosn fou injdoo 86s eco atueUt [ew eee ereiepusep ap suwiag ~ | Suma — ‘ane ofa, U1 esecioaUI ezneD pv oRiajonodky Ud SAIOD — | :(eans06uco aueBawo.adeu) areded e| eseazainp ayebawoiedoy ~ operseyuew sjeinp #8 eajeysues ednp ‘ayeInesB ul e20nz0.4 ~ | 4 ‘peraye puryoid y 91804 on se 1 ones6 ejowics ul “wisi ejeyue6 JojpUebLo Bfe 1 yoeUN (equIED ei) anIpeD awope - yn jou elusasobin; ~ 9p earopecs ud ‘UNBI ~ ‘jsuOUE juTIsUD) 829p—OS ~ ‘ef872U0,0U0d @Z0UEID — {eoeipieo asm) gavanpoid yode "g22es sn ~ ‘2audouo e| neUyog od se yanoep ut 1 arede rode ‘oye 2p eugs poeipueo eiuerynsuy ‘e018 9p foun ut eee uojouuBuesconu HoOUN “spy NES EpUcMUeS ‘a ‘0u avenysuatu 8p 2249 ap FULD} a ViNOV VINODOUSINA VANOV VLRISUNSOULSVS ND TVW INTINUGOD VSSICIYON] ‘aunBues ezneg 0 1 gud yesuene jusiposyediy = ‘eusnopua ezneg p pz0an010% 2 Up UA aren ojuapunae 20 2 ee ‘ievownd eueye sunisuovedy P IS Bangeys no “osquoU ued 9j80 eat Jat B ojuoepe! ‘seu eine yesueNes nun ae we HMUeD Ut Ija6ugs © pseoven esiocieciy eaipariu es B1eD unose6 ap eateund ‘{awionto ems vengene :xe.ojounaud "pi ap eqURLodusl guiueD no oje}nED Siew ap wesnerd — Sooo ae Suis iaviebad rnoLenae ca8 de vecinatate; joadele de acullzare, putdnd fi ricicata gi prolungita. In peroadele de fie in reglunea lombarf, fe abdominal, necaracteristic. Ele sunt iensitale, uneor devin eclcative. gl cop mic, gestive (anorexie, varsitun, dareo) la suger gi con = Fenomenale vezicale:ustutim! i mictiune polakiure, tonesme vezicale = trina astetubure, uneor cu flocoane care sugereaza prezenta puroiulul ‘pare hematurie macroscopics. Mai rar terulu vezical = examen de uring = Probele de numavare a elemental = Urocutura este proba cheie ca = Hemoleucograma, = VsH = Ecogratia de risichi sci urinare poate pune in evident rate cin urna (Addls-Hamburge I Stanstelé Webb). gormenele cauza ase ale tractuuiurinar (cist) pot ute gl bale Dorbint de gezut, cu 0 ‘de potas, dar numai sear nainte de culeare, pentry 8 p> GLOMERULONEFRITA ACUTA DIFUZA POSTSTREPTOCOCICA Definite, Este o afectine in care streptococul beta-hemoltic acioneaza de la distant de infecie, de obicei amigdatian) prin antgene gi toxine asupetinichiiu, de- jun dtp glomonutar = de i un exiape ~ ups seariating ~ Supa pneumonie sau pleurezie purulent cy streptocoe: ~ in cursul une septicomi streptococie, + Cauze favorizante ~ copii se scoala dimineata cu edeme pelpebrale si ale gambelor; ~ urna are aspect spaiatur de came (hematuria macroscopic ~ urinesz8 in canttate mic la itervale rar (igure) = uneor acuza cofalee, grejur gi durerlombare: erie ara hipertensiune, uneori mult peste valoile normale. orator -dinurin (probaAddls- Hamburger siproba tansfeld-Webb} Streplococul ramane cantonat la sediul infec (amigdale, focar ‘actiondnd ce ia disiana = Urocultura este Feziuni cut ~ Hemeleucoarama \ respiraie aciotica iatee) gi modifica im- pulmonar aeut. Apare (3 cv secre, sputa aorat ro Tratament 1. Repaus la pat pe loaté perioada cét se men repausul va fi menfinut in casa, Se va evita figul 2. Diets de crutare renal, desodata, cu realentare progresivd esl ~ primele 2-92ileregim hidrazahara (cea, mere, dulceala), cu restric chidelor tn caz Ue hipertensiune artenala important ~ uimeaza inttoducorea fuctelor gia zarzavaturor: salala verde, ros (tomate), more, ‘strugus. pepene; supe de zarzavat respite Incarca- Gane, senate de sutocate, ce si ureea crescute. Apo!‘o1us ew 2189 moo ig9 no ye10909 lew Ie no O}s9 WWBASINALCD yx “POH ASIEN uns smsinnuco ef aqueziones afozne9 ‘ondoyd oprsmaucg “2 ‘ere nel nes siezope1d yewuopIoe o}nae epieonH4 ‘mveseo ys na aySunyaid yore ‘708 aiByesPIUs90 Bp wOIpUIS MD prEID RYDE goRze onosye sn ‘2)u2}98109 jun @ -POVPOU! 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