ŞCOALA TEHNICĂ POSTLICEALĂ „HENRI COANDĂ” CONSTANTA CALIFICAREA PROFESIONALĂ: PROFESIONALĂ: ASISTENTI MEDICALI GENERALISTI ... FORMA DE ÎNVĂŢĂMÂNT . ZI
PROIECT DE CERTIFICARE INGRIJIREA PACIENTULUI PACIENTULUI CU HIPERTENSIUNE ARTERIALA COORDONATOR (TITLUL PROFESIONAL, NUMELE ŞI PRENUMELE)
ABSOLVENT (NUMELE ŞI PRENUMELE ABSOLVENTULUI)
CONSTANTA
1
2014 ŞCOALA TEHNICĂ POSTLICEALĂ „HENRI COANDĂ” CONSTANTA CALIFICAREA PROFESIONALĂ: PROFESIONALĂ: ASISTENTI MEDICALI GENERALISTI ... FORMA DE ÎNVĂŢĂMÂNT . ZI
PROIECT DE CERTIFICARE
COORDONATOR (TITLUL PROFESIONAL, NUMELE ŞI PRENUMELE)
ABSOLVENT (NUMELE ŞI PRENUMELE ABSOLVENTULUI)
2
2014 ŞCOALA TEHNICĂ POSTLICEALĂ „HENRI COANDĂ” CONSTANTA CALIFICAREA PROFESIONALĂ: PROFESIONALĂ: ASISTENTI MEDICALI GENERALISTI ... FORMA DE ÎNVĂŢĂMÂNT . ZI
PROIECT DE CERTIFICARE
COORDONATOR (TITLUL PROFESIONAL, NUMELE ŞI PRENUMELE)
ABSOLVENT (NUMELE ŞI PRENUMELE ABSOLVENTULUI)
2
CONSTANTA 2014 CUPRINS
I.
MOTIVATIA LUCRARII
II.
ANAT ANATOM OMIA IA SI FIZI FIZIOL OLOG OGIA IA APAR APARAT ATUL ULUI UI CARD CARDIO IOVA VASC SCUL ULAR AR
A.
I NIMA - As!"# - F$#%" s& '&%s&& - C$*&+#"&" #" " &&%&& - S##" &&%&& - V"s/"#&!"&" &&%&& - I#"&" &&%&& - P#$#&"&/ %s/& "#'&" - A&&"" %"&" " &&%&&
B.
ARBORELE CIR CIRCULATOR
1. A##/ 2. V/ 3.V"s/ /&%*"& -CIRCULATIA SANGVINA SISTEMATICA
3
-CIRCULATIA PULMONARA -CIRCULATIA LIMFATICA C. REGLAREA ACTIVITATE CARDIOVASCULARE 1. P#& %"&s% &#&s& 2. P#& %"&s% #&s& III.
EPERTENSIUNE ARTERIALA
1 .D*&&& s& /"s&*&"# 2.E&$"$+& 3.F&!&$"$/$+&" &#s&&& "##&"/ 4.A"$%&" "$/$+&" 5.D&"+$s&/ TA s& "/"# 6.F$#% /&& s& s%&"$/$+& 7.E$/& s& $%/&"&& 8. P#$+$s&/ 9.T#""%/ TA:".T#""% &+&$-'&& ;.T#""% %'&"%$s . T#""%/ #+/$# &#s& 10.P#$*&/"&" &#s&&& "##&"/ IV.
PREZENTAREA CAZURILOR STUDIATE
V.
CONCLUZII
4
VI.
BIBLIOGRAFIE
MOTIVATIA LUCRARII
'I!"#"$ %&#( !)"#"* ( %&#( +,-""' ( SENECA )
I#-$ /% & "# &s" $&'&"" " &#" &#- #&% "%&$# s& s$/&&" #;& s" &""% % s" "s#"% s"""", '"# %"& "/s % s" #"&$"% & "! ' &%;$/". C&"# '"" $'% & &"" '" %$$ " "s": « E preferabil sa te epuizezi decat sa ruginesti »
( DAVID <. SCA=ARTZ - P#" %"+&" " +"'/& ), #;& s" s&% s& #&s#& &% ";$#'"#" & "s*/ s&/ ' &"". A% "/s "s s;& # " ;$/&/ "#'&$-"s/"# $" / '&# #&%/ /$#& #&# "!/ ' %$#"/&" '& "#" $"s#". Es s& " &#s&&& ##!&" 10> '& $/"&" +#"/". I $/"&" ' s 40 ' "&, "s&" #&' 40>, &"# & $/"&" ' 55-60 ' "& %"#/ /$# #s /" 50-60>. C% s#s/ s *"$# *"$#&!" "/ &s"/"#&& TA, &"# "s"!& s *$"# #s # &#"+" $/"&, "% # " ";$#'"' "s s;& s" &" " %"& %/ 's# ""s" "*& s& 's# &%$#"" & && &/&;#"? %"& "/s s" / $ #"s%& s& /$#/"/& "s &*$#%"&&, & s&"/ /$# #'&ss& s" *"" TA.
5
ANATOMIA SI FIZIOLOGIA APARATULUI CARDIO/VASCULAR
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10
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12
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14
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15
CIRCULATIA LIMFATICA C/"&" /&%*"&" s $ "/ '#&"" " %"#&& /"&&, #& "# #&#" & $ "# '& /&&'/ &#s&&"/. S&%&/"# /"&& s"+&, /"&" /&%*"&" "# /$ & "'#/ & s&s% "s/"# &&s, "# & '& s#&, #& "&/"# &&s, s $/"!" "$& & "s '& & %"& %"#&, s&, & *&"/, *$#%"!" '$" $/$"# /&%*"& %"#&, "# s 's"&' & / s;/"&/"#.
C.REGLAREA ACTIVITATII CARDIOVASCULARE R+/"#" "&&"&& &&%&& s *" #& %"&s% &#&s& s& #&s&. 1. R&4"&" %)
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16
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20
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21
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22
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23
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24
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25
-/ $;&&#& "/&%"# &'&&'"/ s& *"%&/&"/ ($s% ' s"#, ' '/&#&), *%"/ s& $s%/ ' "/$$/, -#$*&// #$*s&$"/, +#"'/ ' s$/&&"# #$*s&$"/" $%&&&"" s& *&"&"" s$&"/" " ;$/"/&, -&s" $# s&%$% "# $ s+#" $ TA s'"#" (#&! s'$#"/ &s$& ' "/&"&&, "&" s& "/$"#, "s& %s/"#", "#s!&&, %&"/+&&, "#"/&!&& &#%&, $/&#&, ...), -#!" $# s&%$% s+#"!" &s" $# $%/&"&& "s/"# (/&s #;#"/, /"'&"& &#%&", #&! ' "+&" $#"/") ... ;) PREGATIREA SI ASISTAREA EJAMINARILOR CLINICE C$/";$#"#" /" "%&"#" /&&" " ;$/"/& s " '& s"#&&/ &%$#" "/ "s&s&. A$#/ "#'" %'&/& s& ;$/"/& & #s/ "%&"#&& /&& '+#"!" ""s" '& #%" ' *$##& *&!&, && #& $ s#& ' s*#& &&/, $#&;& /" #"#" & /&%" *"$#";&/ &# ;$/" s& %'&, *" "s&;&/" %'&/& /$#"#" #$# #+&/$# $#+"&s%/&, s#&'-1 &s%"#/ s"#, $" "s" &#&' # s#"#" &%/& #&& ;$/"/& & s"# +#"" /" "%&"#&/ /&& s &'&ss";&/ & "!/ ;$/"&/$# & s"# +#"": "s&&, "'&"%&&, s$%$/&, &$s&&, &%$;&/&!"&, ... s& *$"# &/" & "!/ #$# ;$/"&/$# S"#&&/ "s&s& & #+"" s& "s&s"#" & "% /&& %&"/ s #%"$"#/: -#+"" s&&" " ;$/"/&, -"'"#", #&*&"#" s& #+"" &s#%/& s"#, -'!;#""#" s& &;#""#" ;$/"/&, -"'#" ;$/"/& & $!&&&/ "'" "%&"$#&/$#,
26
-"s&+#"#" &/%&"&& s"# /" "%&"#&/ "&"&/$# "#"/, -'s#" %'&/& &s#%, -*#" ;$/"/& ' #"%"&s% s& #""/", -"s!"#" ;$/"/& & " '" "%&"# s& *"#" "/&. P#+"" s&&" " ;$/"/& s &"'#"!" & %" ' '"& s& ' /&&s "# "s&s" $ ' ;$/"/ '& %$%/ #&%&& /& & s&. A&'&" & *"" ' ;$/" #;& s" #*/ '$#&" #%"" ' "-1 ""? #"#" /&%"/& *"$#";&/, "&'& #&"s", $s&& *"$#&& &%$#"& "& & ; #+"& s&&. I #"%" "%&"#&/$# ' $#& "#", "s&s" #;& s" /"%#"s" ;$/"/ "s#" "#"#/& &$*s& "/ "%&"#&/$#, ""' s" s #'" /" %&&%% '##&/ "# "/ $# *& #$$" #& / %"$# s&%/, ": "%&"#" & "#&/"&& &*/"%", "/"#" & ";'$% '##$s, ... B$/"/ #;& &&$'"" &'s & #$"# "& "s*/ " &#' &#'#" & $&. D"" &s" $"s s" s& &%$#"" "%&"#&/$#, #& &#'#" "# &-"% &s*/"-$, " s$#" %/ %"& s$# s*#&/ "!" ' '&#s /$#"#&, $;&"' $$#"#" /& "&" & #s&" s& $#"&&"" "%&"#&/$#. T&"' s"%" ' s&%/ '$#&&, "s&s" " &!$/" "/ ;$/"/& (& s&"/ /" #&%" "%&"#), 's"#&'-/ "#"" ' //"/ "#&, " /&&ss %/& ;$/"&. EXAMENU C!N!C
D#%&"#" #s&&& "##&"/ s *" $# #& %$'" "s/"&" s" " /#$&", %"s#"' TA /" "%;/ ;#", & /&$s"&s% s& $#$s"&s%, '"" s $s&;&/ '&%&"", '" #"s *&!& s& &/"/. E"%/ /&& &"#" s" '/! "!/ s" /!&&/ +#"$"# ' TA, #% s& s"'&/ $/& s& #"s/ "s#" &#+/& $#+"&s%. S"'#" &$#"" " /s/& /" "##/ *%#"/ s" ";$/" s" $" $ s$!" " s&s%/& "$#& "# s $*%" /" "/"#" "##/$# &#$s"/ $#"/ $s#&$#, #& "s/"&" &&%&& (s*/ s&s$/& "#"#;#"/ s"+) s& ' #"'&$+#"*&" $#"/& (#$!&& $s"/). S$!" & "## #"/ $" '#%&" $#& s*/ #&;&/ "#"$%;&/&"/ s& & #+&" /$%;"#". P"/"#" /$/$# #"/ $" &'&" $ %$"# #"/" s" *#$%+"/& ;&/"#"/", s+#"' $/&&s$!" #"/". Ts/
27
#"/ /" ;"#;" s& / "+&"/ /" *%& s "s%" s"#. E"%/ /&& +#"/ $" & &'" s& s%/ & "*&& '$#& s" %";$/&, ss&;&/ ' " #$' TA s'"#" (&#$&'&s%, ;$"/" Cs&+, "#$%+"/&, %"&*s"#& "" "/ & '&"! +$"s s" '&s/&$#&%&&). A#&#" #"s/& &s#"/ "/ TA: "' ;$/"/ s%"/"!" '&s /" *$##& ;& $/#" "#&$#, &"# "%/ $;&& '/"!" s*/ s&s$/& s& "#'&$%+"/& ($*%"" #"'&$/$+&, EG, $+#"*&), s $#"!" s#"s$/&&"#" $#'/&? s%"/"#" & $/&#&& $#, #, *"#" '&s#&, $;/&+" /" ss&&$"#" #"/&!"#&& TA. D"s%", s"'#" ""&"&& ' /#, /&s #;#"/, "% ' *' ' $& %$'&*&" (+#"'/ IIIII) ss& *"/ " TA " #$'s "*"#" "s/$# #;#"/. ) RECOLTAREA PRODUSELOR BIOLOGICE SI PATOLOGICE PENTRU EJAMENELE PARACLINICE I+#&" ;$/"&/$# &%/&" s";&/" '&"+$s&/& #&s &#- &% " %"& s# $s&;&/, # " s " "$#'" &+#&&/ s& #""%/ "'". U "$# #&$s -' %/ $#& &'&ss";&/- & ""s" %"-1 $s&& #$;/ ' /";$#"$#, "# #&%" & %$' $;&& %$'&*&"#&/ s#& & %$#*$/$+&", *&" s& ;&$&%&" $#+"&s%/& s& &'&"!" "+&& "+#s&&, *"$#&& &$/$+&& "& &%;$/"&/$#. U&/&"" #!/"/$# ' /";$#"$# '&' ' & '$& *"$#& ' ;"!": #$/"#" $#" " #$'s/$# ss ""/&!/$# s& *"#" ""/&!/$# #$#& !&s. E*"#" ""/&!/$# "' "#$" /s& & s"#&" #s$"//& ' /";$#"$#, %"$#&"" #$/"#&/$# &s", *" "# '& s"#&&/ #s$"//& "# /#"!" %&/$& /" "/ ;$/"/&, '& "s %$&, "s&s" #;& s" "&;" $s& #&s s& %""/&" $#s!"$"#. I%$#"" "%&"#&/$# ' /";$#"$# s $#&!"!" & #%"$"#/: -&%;$+"s s&%$%"$/$+&" ;$/&/$# %#$"s /% $;&&, -$*%" s" &*%" '&"+$s&/ /&&, -/"#&*&" '&"+$s&/ '&*#&"/ *"" ' ";/$#& /&& s&%&/"# s& '&*#&"!" *$#%/ /&& "/ "/"s& &%;$/"&, -s";&/s *"$#/ &$/$+& & %#$"s "!#&,
28
-&*$#%"!" "s#" +#"&"&& "!/& , #*/" $;&& $/&" $/&" ;$/&& s& "" /" s";&/" #$+$s&/&, -$#&;& /" "#&#" *&"&"&&#""%/&, -#ss &s"/"#" $# $%/&"&&, -$*%" &'"#" /&&" s& &$/$+&" " ;$/"/&, -$#&;& /" #$*&/"#" ;$/&/$# &*$-$"+&$"s, #& '&s"# #$ " s#s/$# ' &*&, ;$/"&& s& #"$#&& ' +#%&. EXAMENE "A#AC!N!CE
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29
F$#ME C!N!CE %! %!M"&$MA&$$'!E
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30
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31
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32
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34
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"##&"/"). S%/ &s*&&& "#'&" s $s s& &s&s"% '" "s#" $# "%": -s" $" *& 's&s" ' $ &s*&" #&/"#" s"+", &s"/"" ;#s? - &#s& ""# $%s" $" ''" /" #&%" #&!" ' '% /%$"# "? -%"&*s"#&/ '&s& "#$&s& ("s% "#'&", '% /%$"# ") "" '/"s"#" &s*&&& "#'&" $+s&. I ""s" #&$"'" ""# s*/#& '/" "#&$#: ' &s*&&" %&#"/" *&$"/", %"& #"# ' &s*&&" "$#&". V"/$#&/ s&$"/ #&'&", "'s$#&, $# s"'" '" &s"/"#" &s*&&& #&/"# s"+&. E"%/ #"'&$/$+& "#"" &##$*&" $#'/& (#&/ s"+, "#& '# s& "#& s"+, & *&"/ #&/ '#), #% s& s% ' s"!" /%$"#". I $/&, #$ "#&";&/ ' &#s&& $# '& "+&$s& s" $# *" &*"# ' %&$"#'. C. C-$%),"#))& &"& "& HTA A#&#" *&& #"/ #s *"#" $# "% ' #&": #$&#&" 24 ' $#, s/ A''&s s" S"s*/'-=;;, '$!"#" #& s& &"# /"#-/ s; 40%/H%&.
35
"#"" '*&& *&$"/ #"/, #$;" ' $#"# V$/"#', /&%&"#" #"/" " *$/s/*$*"/&& ($#%"/ 15> /" 15 %&. 55-70> /" 70 %&.). C$%/&"&" #"/" " TA s &s*&&" #"/" #& *#$"+&$s#/$!". TA ' "!" #"/" ##!&" 15> '& $"// &#s&&/$# s& s s'"#. TA #$"#&%"$"s" ""# /" 60> '& ;$/"&& &/$*#&" #$&". S #!&" /&& s%/ /"s& "/ &/$*#&&: &#&, $/&#&, s&'#$% &s&&, s&'#$% ;&$/$+& ' &*& #&"#" (/$&#&, &/&'#&& /$&"#&, #$/#& $!&&), s&'#$% ' ; '&s"/ (s"'#" ""&"&& ' $#"# " #&&, *&/#"#" #"%" $#%"/"). T"#'&, ""# s% ' &s*&" #"/". B$"/" $/&&s&" #"/" s $ "*& ;&/"#"/", "#"# *"%&/&"/, #!" /" &#&. E"%/ /&& '/"!": *#$%+"/& ;&/"#"/" (#&&& ;$;/"&), %"#&, '##& /$%;"#. U#$+#"*&" $*%" '&"+$s&/: #&&& %"#&, $/& "/+& "s ' "!" ' "&". G/$%#/$*#&" #$&" #!&" TA "s$&"" s% #"/ ("/;%&#&, %"#&, s"'#" &%$#"" " *&/#"/& +/$%#/"#). TA #$-"s/"#" s ;"&s /" ;$/" s; 40 ' "&, TA *"#" "!" ""#", $s&;&/ '; '" #"%"&s% /$%;"#:? #!&" s*/ ";'$%&"/, &+"s#& s" & /$" #"/". S '/"!" '&#s "$%"/&& #$+#"*& "/ *#$+#"%& &!$$&, s&&+#"%& #"/, "##&$+#"*&& #"/. A/ "! $s&;&/ "/ TA #"/ $ *& ;#/$!" #"/", "/"!&&/ s& "#$*&&/ #"/ &/"#"/ $+&"/.Is&+"&& ' s&"/&" #&!"!" '&"+$s&/. PROGNOSTICUL -'&' ' *$#" /&&" ;&+" s" %"/&+", ' #'&", ' &// s&&& '&"s$/& s& ;"!"/, ' "#s" (&#&& *" *$#% %"& +#"), ' #s"#" #""%/&, ' %$'/ ' &"" #$%"'" s&, & s*"#s&, ' ""#&&&" $%/&"&&/$#. P#$+$s&/ s *"$#";&/ & #&%/ s"'& ' ;$"/", *&&' %"& #!#" & s"'&/ "/ '$&/" s& %"& "/s & "/ #&/". M$"#" s '"$#"!" &'$s;& $%/&"&&/$# "#'&", #;#"/ s& #"/. S; &*/" #""%/& ""/, #$+$s&/ s-" &%;""&.
36
TRATAMENTUL HTA . C& #;& s" ;*&&! ' #""% "&&#s& T$#& #"ss/ s s$# ' '". T$& & "# " &*# s&$"/ s 160H95%%+ /" %"& %/ "%&"#& %'&"/ s s"# s" *& &"'#"& & #$+#"%/ #"& "&&#s&. P#"& #$;/%" s %"& '&*&&/", '$"# #. &#s&&/$# (s";&/&& '" "s /&%& #$%"'" ' OMS) s %"#. I /s, %"$#&"" "s$# ;$/"& s "s&%$%"&& s&, " #%"#, $%/&"" /$# /" #""% s %&", ' "s%", "'%&&s#"#" &'*&&" " $# '#$+#& "&&#s& "# * s'"# '$#&, +# "" ' "&&. C $" "s" & %"& %/& '&# "$#& s "&%& & " #$%"'" #""% #$# &#s&&/$# *& s; *$#%" #+&%/& &+&$-'&& *& " /& %'&"%$s. A#+%/ & *"$"#" /& ' '# #s& s *#&!", ' $ "#, ' s$&"&/ ' "s&+#"#& "/ "#$# s"&s&& "#"" " TA s $ "!" %"$#" ' #s# " %$#;&'&"&& s& ' s"'# " /$+&"&&, &"# ' "/" "#, ' #!/"/ $# s'&& #"& $#$/" "# '%$s#"!" " s"'#" s; #""% " TA %&s$#"!" %$#;&'&"" s& %$#"/&"" /" &#s&&. R"$#"' &#;"#" s" /" &, s $" s ", &'&*# ' &"'#"#" &#-$ /"s&*&"# s" "/", $& &#s&&& #;& #""&. D"" "&'&" #"&" *"" ' ;$/"/ &#s& TA160H95%%+ s #/"& /"#", "/"s& /# s &"%/" &#s&&& /" /&%&" (;$#'#/& #s&$ TA S 140-159, TA ' 90-94%%+). O#&"#" %/$# "$#& "s#" #""%/& TA /" /&%&" s /&", #&#&&/ ' /"# & #""% *&&' "#;&#"# s& "#&";&/. U /# #&s #+"" '& s'&&/ #&&' /$+&"" s& "% " s#"" ' &"" " "s$# "&& s %"& %&" '" " $#%$s&&/$#. C$s&'#"% " s& ""s" "+$#& ' ;$/"& #;& &"'#"" &#- #$+#"% #"&. O$#&"" /& " *& "#&"" %"& '" &*#" s&$"/", & s& & *& ' "/& *"$#&: #&s/ +&, "#s", / $;&s& "/&%"#, s#ss/ s&$-s$&"/, "// "s$&"&& %$#;&' ('&s/&&'%&&, &##&%&, $;!&", '&";, *#$"&, '&#s ). C$s%/ '
37
"&$&$"/ $#"/, !$" ' #s'&" (#"/" TA s %"& %"# & / #+&& '" & "//), . U &'&&' ""#, &#$'#"/, #$& '&#-$ *"%&/& ' &#s&&, ss & s#ss s&$s$&"/ &s, "# "/ $s%" s& s"# %/" s" s '&s/&&'%&, "# $" s"s/ " & #%"$#&& "& '& %& &#s& s" '&" %"# &#s&. D "" s &/ " #""%/ s" &" & "s s"'& "/ ;$/&&, & "# s& *&&" $" *& %"&%". T#""%/ TA /" /&%&" #;& s" *& %"&'" %'&"%$s. A's$#& $#"#" $;!&"&&, #+&%/ s"#" & s$'& s& ;$+" & $"s& s" #"&"#" s$#/& ' "+#% s s*&& # " #"/&!" #" /" $#%"/ " TA. T#""%/ TA #;& s" &!! "%& $;&& s& & #&%/# #"' $#%"/&!"#" "/$#&/$# s&$"/. E/ #;& s" &" s"%" ' "%& #&&&& s& $#&"#&: -/$#"#" #;& ;& *"" '$"# s &#s&& "# ;*&&"!" ' #""% #+&"/ (&#s&&/ #$-"s/"#)? -#""%/ #;& s" *& $%/ &+&&$-'&&, %'&"%$s ? -#""%/ #;& &'&&'"/&!" s& s";&/& & $'&&& ' "%;/"$#, ' s&"/? -'#$+#&/ &$s& $# *& "'%&&s#" /" & & "&"& %"& %&& s& %"#& "$& #$+#s&, "" /" $#%"/&!"#" TA. Es ;& " '#$+#&/ &$s& s" *& "s$&" s& /" &/ #""%/& "s$&#" s" #&'" &$s& '&#& &"!&'&? -#;& & s"%" ' "#$s#/$!" "s$&"", ' "&& (%"& "/s /" "#s&&) '#+"' #'", # " #&&" "&'/ "s/"# #;#"/, $#$$#& s& #&*#& (&&$'"" s " & '$! %"#&, ;#"/)? -'$"# %/ &#s&& s $s&" s" s "s$&" "#$s#/$!&, #+&%/ s& #""%/ $# *& "'"" "s&" '& #%". S $# $%;" $;!&"", +" '&";/ !""#", &#/&$#$&%&&/ ? -#"s/ #;& s" *& ";s$/. E#&&&/ *&!&, %#s/ $s s& +&%"s&" %'&"/", *" "# '& #""%. E*$#/ *&!& " *& '$!" s& "'"" $s&;&/&"&/$# ;$/"/&? -s'"&/ s& #"&/&!"/ s ' %/ $#& s"#? -'&" " *& s"#"" & $/s#$/ s& +#"s&%& s"#"? -s ;& " #""%/ s" *& s& "s$'&/""$# #$"#&", '$"# "s$&"&" "#'&$"& &s%&"
38
-TA s *$"# *#"? - $#& TA #%"!" s" #&%"s" #""% &$s&. As*/ & *$#%/ /";&/ ' +#'. I, s s*&& #+&%/ '&&, "/ #"&/&!" s& s'"&. A. TRATAMENTUL IGIENO-DIETETIC T#""%/ &+&&$-'&& #%"#s s";&/" #+&%/& "/&%"# ('&" s& #+/%"#" "&&"&& *&!& s& &/"/). I%$#"" "s& #""% #!/" s& '& *"/ " %/ ;$/& s $ &'" %"& #& '&" s& #"s (/ #$$/& ", / *#& ), "// "'-s %& & s"# ' $%s"# ("*&& "#'&", "&, #"/). D&&" s" "/&%"&" #"&" s $" "/&%"&" $%/& ;$/". A"s" &/&!"" $#, /&%&"!" &#;&"#" %'&"%/$#,
&"' "s*/ $;&s&"
$#+"&s%/& %'&"%/. D"#, '&&" $"" #$/ &%$#" s& & #$*&/"&" &s$"'/$# ", " $%/&"&&/$# s& " '$%s"#&/$# (&s*&&" "#'&"", TA, '&"; !""#", $/&s&, ;$"/" /#$"s" ). R+&%/ '&& #;& &$'"" &'&&'"/&!", "'"" *"!& ' $/& " ;$/&& s& " %"& "#&", # " #$$" #/s&, '& $$#"#" ;$/"/&. L" s";&/" & #+&% #;& #&!" "/&%/ #%&s, "&"" s& "/&"" /$#, $#"#/ s& #"#&!"#" %s/$#, '#"" "/&"#&&. S #$%"'", $#& *$& ' #+&%. P#&$'&, ;$/"/ #;& ""#&, # " "#&" ss/ s" &*&&" %$'&.
R-( "s&s& %'&"/ & "/&"#" #""%/& &+&$-'&& s *$"# &%$#", " $#&;&' /" $" *$#%/ s& *"!/ "s& #""%, #%"#&' #s"#" "s&", "#&&' #!/"/ *"$#";&/ s" '&s"' /;#"#&/ s'"#.
R&4)$( ")$&#" ) HTA ALIMENTE PERMISE: -s: ' !"#!"" s&%/ s" "'"$s *"&$s, ;$#s ' !"#!"" s" "#$*&, s ' /+%, s ' #$s&&, $" *"#" s"#?
39
-*"&$"s: & "&" /&%&"", +#&s, $#!, */+& ' $"!, *&'", $" *&# *"#" s"# -$" &"&" #'s" (1-2 s""%""), *"#" +"/;s? -"# & "&" #'s", '3 $#& s""%"", ' &", &&, +"&", &, s/";", *&"#" " #"s$/, *#&", "#/, "#$*&, %$#$&, $#!, #&s$"# *&# & ";#& s" "", $" *"#" s"#, s s/"; (/&, s"/", s&", #", "s#") *&#, #"s$/, *#& s" $ & #+"% (& !&// "# s '" s s& &#s)? -+#"s&%& #', +"/, /& ' $#%;, */$"#" s$"#/&, %"#+"#&" s"#"". T$/ s '" #' /" s"/", "% 50+H!&. -"&: "/;" s" &#%'&"#", *"#" s"#, ' $ !& s" #"&"? -/+% s& !"#!""#&: #' s" *&#, # #& s&", &##&, s##", &*/ ' !"#!"", "#$*& $&, %$#$&, '$/&, *"s$/ #', %"!"# #', s*/", s"/"" #', #$s&&, &, "#'& +#"s&, "#!" #'" s& %#"", *"#" s"#, $ #"s %"# s& "'%&&s#" " s"/", s" *&# " s$#& s" ;'&& ' /+%? -/" s& ;#"!#&: /" '/, &"#, /" ;", ;#"!" ' "&, "s, #'" s"#"", /" "*"? -*# s; $#& *$#%": #', $", &##&, $%$#&? -'/&#&: #"#" *"#" ;&"#;$" s& s"#, '& "/" *&#, s", ;#"!" '
40
"&, *# s" +/"&" ' *#, /", &"#, /", s"/"" ' *#, %&# s& *#&s", %"#%/"'", "#&, '/"", !""#? -;"#&: /" s&%/ '+#s", /" ;" s" &"#, s#& ' *# s" !"#!""#&, "&#& ' /"? -$'&%: s$s ' #$s&&, s$s#& '&& (*"#" +#"s&% #"&") *"&" #%&" s", !"%" ' !"#!"" (s"#" & "&" #'s"), #'#& $" ("#/, %"#"#, /&", /s", &%;#), !"%" ' /"%"& s& s"# /&%&"".
ALIMENTE INTERZISE: -/" &+#"/, ;#"!#& s"#" s& +#"s? -"# +#"s", &s#, "", s +#"s s" s"#", $s# ' s s" "#, "*%"#&? -$" & "&" #s" (%"& "/s +"/;s#&), $" "#&, $%/", %"#&, %"&$!"? -+#"s&%& "&%"/ & "&" #s" (, #", *#&s", s%""", s, s/"&"), +#"s&%& #"&? -"& s"# s& "& "+#"? -*"&$"s #"#" s"# s& & "&" %"#? -;#"!#&: +#"s, s"#", *#%"? -s$s#&: +#"s&%& #"&, !"%" ' "#, %s"# s" %"&$!"?
41
-/+% s& !"#!""#& "# $& %/ s$'& (/&", s"", "#!" "#", %#"#&)? -'/&#& #"#" ;&"#;$", s& +"/;s ' $, &$$/"" s" ""$: -;"#& "/$$/&, "*", "& "#, /&&' & s? -$'&%: s"# %"& %/ '" s #s#&s, &#, "#'& &, ;$&" ' "#'&, #", %s"#, "", s#$&.
RECOMANDAM: -&"" $#'$"", *"#" *$##&, *"#" *%", *"#" s#ss, *"#" "/$$/? -%s %&& s& *#"&$", /" $# #+/". U/&%" %"s" 2 $# &"& ' /"#? -&$'"" s " $%;" $;!&"" ("' &s").
REGIMUL DE VIATA C$s" & /&%&"#" *$##&/$# *&!&, /# ' 6-8 $#H!&, '" "!, #s"#" $#/$# ' s$% s& " $#/$# ' %"s". A $ %"# &%$#"" %&/$"/ s&$#"&, $%;"#" "&"&& s& &"#" s&"&&/$# $*&'&"/ '& %'&/ ' &"" s" ' %". V$# *& "" s& I#"" /%/ ' s"&s*"& '& #$*s&" ;$/"/&, $# *& /&" #$"#&/ "# #$' #/""#" (/&%;"#&, /#", %!&", "#). B. TRATAMENTUL MEDICAMENTOS P#&&&& +#"/ "/ #""%/& %'&"%$s
42
T#""%/ TA " *& #%", &"# "& "' &*#/ s&$"/ s-" $#%"/&!". I ""s" s&"& s " s";&/& #& "$"# '$!" %&&%" *&&", "# s " $&" "$& #""%/. Es $;/&+"$#& " "" #+&%/ &+&$-'&&, " s& %'&"&" "&&#s&" s" *& "'%&&s#" & %$' $&. R"#" /" #""%, $'"" $#%"/&!"#" TA, ' /" #s#" &*#/$# TA "" /" "/$#&/ ##"& (& "" /&) /" s 70> '& "!#&. N s " #" /" %'&"% s" /" $ s%" #"&" '" '" "s" " *$s "'%&&s#" s*&& &%, # "-s& *" #$;" *&"&"&& s" &*&"&"&& /$#. D $;&&, &%/ %'& ' "#&# " *&"&"&& & s% #"& s ' 4-6 s""%"& ( $'&&" " %'&"%/ s" *& "'%&&s#" & '$! *&&). I "!/ ""#&&& */$# "'#s /" %'&"%, s " %&s$#" '$!" s" "s" " *& &/$&, '" "!, "/ %'&"%, '"# s " #" /" $&&"" #""%/&. N s #$%"'" "'%&&s#"#" '&s$&" " & %'&"% "&&#s& &#" s &*&&". & "'#/ $&&"&& #""%/& & *& ' $/&" ;$/&&, s " "" & '# "/&"#" /& #"", *&&" #""%/$# "#&$"# s& "// * "'#s "/ $# s% #"&. I #""%/ TA s $# &#;&" " %"& & %'&"%. L" %"$#&"" ;$/"&/$#, TA s $#$/"" 1-2 %'&"% s "/+ & *& ' #$*&// *&!&$"$/$+& "/ ;$/&&, "#&/"#&"&/ /&&$-$/&, #&" #s$"/" " %'&/& s& '&s$&;&/&"" ' %'&"%. A#$" & $"" /%" s #*#" "!& '&#&/ &"!&'& s& -;/$"/, s&+# s" & "s$&"&. I" ' /"#+" &/&!"# s #!#&&/ s& &'#"/"!&". F$/$s" "s$&"&&/$# ' 34 s" %"& %/ "&&#s& $s&& $ & s& s "/&";&/" /" %"# #s#"s ' ;$/"&. P$s$/$+&" " *& #s"" # *&"# %'&"%. B$/"&& $# *& "&!"& ' /" & "s#" */$# s'"# "/ %'&"&& "&&#s& s";&/&, &"# "##s/ $;s#"&& %'&"/ $# *& s&$"& & "s ss. P " $s&;&/ s " *" #$*&/"&" /$# (' . "$# $+ ' $"s& & "!/ s"/#&/$#), &"# $'"" ""# $# *& $#" &%'&". U$#& * s'"# %&$# ($;s#&" "!"/" '" #!#&&, s$%$/", s"&" %$"s/$#'" /$&'&"? "s&" *&!&" s$"#" '"
43
s"/#&) '#""!" %/ ;$/"&, '#%&"'-& "'s", '"" s "&!"& s& #+"&& s&$/$+& ' %'& ("s&s" %'&"/"), s" ";"'$! #""%/, &"# "' "s" #" *&&. L" ;"#;"& s " &" "'%&&s#"#" & #&$"'" "&&"&& +&"/ ' '#$+#& "&&#s& "# " " * s'"# /;#"#& ' '&"%&" s"/", # " & %$' s&+# "s&" &s& $# "$&##&' #""%/.
CONDUITA TERAPEUTICA IN FUNCTIE DE TIPUL HTA HTA (+-"" s &" *$#%" ' ""# &#;"#" $$#&"&& & #"&& "&. U&& "$#& #$%"'" s#"+#" s& #s#&#" s'"&/$#. A/&& #$%"'" %$$#"&" '&#& s" P-;/$".
HTA +)+#-),". L" &#& s '#%&"" ' &#$&" s&%"&", #$%"'"'-s '& P-;/$". L" "#s&& s '"$#"!" #'#&& $%/&"& "##&"/ s& s #$%"'" '#$+#& "& '" "s#" #/& "##&"/. IDRALAZINA-P.O.HI.V. ? NICERGOLINA
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'&#& (NICERGOLINA), &"# & "! ' s, s "s$&"!" s& &'#"/"!&" s" %&/'$". S" s "'%&&s#"!" "s$&#": CLONIDINA .$. ALFAMETTLDOPA .$. DIURETIC.
HTA +&!&" , '*&&" #&#-$ '&"s$/&" s 120%%+, ;*&&"!" ' &$s$"# %"$#, s"/#&, s$$/"$", &/&!"" s&s%"&. D"" &s" / $%/&"&&, #"&" TA s %"& """. I HTA ,( )+(7),)&#" ,"6)"," s "s$&"!" $&"#'&". S ' &" P ;/$"/. S *$/$ss s"/#& (N*#& .$., F#$s%&' .$.H &.., A&' "#&&) & "s$&# S$$/"$" .$. "s$'&/""$"#. S #$%"'" &'#"/"!&" 50-100%+H!& "s$&"" '#&"& &#&& "& #/+&" (Is$) 20-40%+ 3H!& s"#" s" P#"!$s&% .$. /-2%+ 3H!& #s"' #$+#s& "" /" 10-20%+ 3H!&, *& E"/"#&/ .$. & '$!" &". I HTA ,( )+(7),)&#" ,--")"" s&Hs" "#&-+,&-8" ,&&5"" s #$%"'" s"/#& & '$! %$'#", -;/$", $-%&/'$", "&"/& (A'$/"), &#&& "&
44
#/+&" (Is$) s& & "+$#/ ' ';&, $#, ""/"s%" #&&#&" -+/ 15-30%+, "/&" $#" s"#" /" /"#. L" & s*#&" #;#"/" "s/"#" s #$%"'" " s "s$&" S"'"%&, J"&$/, P#"&/, T#"/, P$&*&/&", C$s"/'$. D &" s"'#" ;#s" " TA I H#" ,( )+(7),)&#" &"" s ' #*#" '#$+#& "# s"' *// s"+& #"/: &'#"/"!&", "-%&/'$", C/$&'&", C"$#&/. S "s$&"!" '&#&: F#$s%&', "&' E"#&&. C" "&" #"&", s #$%"'" %&#" $#$//& #"& "/ TA &"# '"" ""# $ '#&$#"# " *&& #"/, $s&;&/" /" &/ #""%/&, '"# "s"+#". I *$#%/ s# s ' &/&!" &&;&$#&& s&s%/& #&$-"+&$s&".
HTA $")4". C" #""% ' "" s *$/$ss D&"!$&' &.. 5%+H+ $#, "s$&" F#$s%&'
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CAPITOLUL III PREZENTAREA CAZURILOR
A+ Culegerea datelor Nume : S. Prenume V. Vârsta: 49 ani Ocupaţia:pensionară Naţionalitate:#$mân Stare civilă: sătorită Data internării / externării: 9 %"#& 2014H15 %"#& 2014 Dianostic: !la internare : TA s'. II, s !la externare: '&s/&&'%& %&, &s*&& "#'&" #$& /s. II, N@A, '&"; !""#" & II
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