lucrare de diploma :pleurezia

8/12/2019 lucrare de diploma :pleurezia

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COALA POSTLICEAL LOUIS PASTEUR , CMPINA

-PROIECT DE DIPLOM -NGRIJIRI SPECIFICE ASISTENTEI MEDICALE,

ACORDATEPACIENTULUI CU PLEUREZIE

COORDONATOR: ABSOLVENT:

- PROMOIA !"#-

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Ingrijiri specifice

asistentei medicale

acordate pacientilor cu

$%&'(&)*&

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PLANUL PROIECTULUI

ARGUMENT

Rolul esenial al asistentei medicale const n a ajuta persoanabolnav sau sntoas sa-i mentin sau rectige sntatea (sau s-l asiste nultimile sale clipe) prin ndeplinirea sarcinilor pe care le-ar i ndeplinitsingur dac ar i avut or! voin sau cunotinele necesare"

#sistenta medical trebuie s ndeplineasc aceste uncii! astel nctpacientul sa-i rectige independenta ct mai repede posibil"$

%irginia &euderson

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CAPITOLUL I

*R+,+R+ ./0++0/ #+//+ 3/4+0#5/ #06R4#/.#0+/ +56R 07 .5/7R/8+/"

1"1 o iuni de anatomie i i9iologie a aparatului respirator: 1"2 4eini ie" /timologie" 0lasiicare:1"' /valuarea unor semne! simptome! probleme ale pacien ilor cu

pleure9ie:1"; .articiparea asistentei medicale la acte de investiga ii:1"< .articiparea asistentei medicale la interven ii autonome i

delegate:1"= /valuarea (/volu ie! 0omplica ii! .rognostic):

1"> /duca ie pentru sntate:1"? 3suri de securitate a muncii n domeniul sanitar"

CAPITOLUL II

2"1 0ulegerea datelor:2"2 #nali9a i interpretarea datelor:2"' .laniicarea ngrijirilor:

2"; #plicarea ngrijirilor:2"< /@ternarea bolnavului"

CAPITOLUL III

/valuarea inal"

CAPITOLUL IV

#ne@e bibliograice"

;


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CAPITOLUL I

NGRIJIRI SPECIFICE ASISTENTEI MEDICALE

ACORDATE PACIEN ILOR CU PLEUREZIE

"+" NOIUNI DE ANATOMIE I FIZIOLOGIE AAPARATULUI RESPIRATOR

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2;


25/69

L/ >23&$' &'6/'% && .04*% * 2*&%'% 8' && /(*/4*% 3' >23%*28(*%&40%2/'%'*, (&3'(1&. %/ /3&& ./2&(& /'23* 323%*28. .'% 40%2/'%+ A$&3'%%'* && /(*/4*%, $0/& $(&)&2/ '.4(& 6& 3026&2/(& /&%/3*38 /' *27%/./0/(&, >2

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2


26/69

I++ PARTICIPAREA ASISTENTEI MEDICALE LAINTERVENII AUTONOME I DELEGATE

2 3/)'% *2&(&2 **%0( /'020.& /. >2 &6&(&:- 8 /&(*&3 3/.&(/- 8 '.&)&3 /&('% >2 >238$&(&- 8 35*.4 6& %&2?&(*/ 6& $/ /' 6& 30($- .02*0(*)&) 7'23@**%& */%& =* &1&/*& 9&2*'2& /(&(*/%8, $'%,

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6*&&*3

2=


27/69

- 04&( &7&3'% .&6*3/.&2&%0( /'$(/ 0(1/2*.'%'*+

T(//.&2'% /(*/)8 >2 (/$0( 3' /6*'% /7&3 *'2**: $&(*0/6/ 6& 6&78 '(/(& / $%&'(&)*&*, $&(*0/6/ 3/(& '(.&/)8 (&0(4 *&* %*35*6'%'*, (&6'3&(&/ /3**8 **

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2>


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*26*3/ ** $&3*/%&: 2' & 7/3& 0(/303&2&)8 3


29/69

I++ EDUCAIE PENTRU SNTATE PRIVINDPREVENIREA BOLII

P(07*%/*/ $(*./(8P(07*%/*/ $(*./(8 3028 >2:"+ E*/(&/ 3026* **%0( 6& .&6*' $(&6*$0)/2&, 3'. /( 7*:

- &$'2&(* $(&%'21*& %/ 7(*1 * '.&)&/%8- *25/%/(&/ 6& $(/7 /' 6& /%& '4/2 & *(*/2&- &*%*.- /4/1*.- &$'*)/(& 7*)*38+

+ S& 0( 6&$*/ * 2&'(/%*)/ '(&%& 6& *27&3 *&+ + S& 0( /$%*3/ .8'(* 6& &%*.*2/(& / '(&* 6& (/2.*&(& $(*2

'4&(3'%0/*3&+#+ E*/(&/ /1%0.&(/ **%0( 6& 38(& 48(2 3'*$80/(& - 8 2' (0$&38 >2 ?'( - 8 3'(& & .'30// 4'3/%8 * 6*2 ** 3' /.$0/2& &(*%&+

P(07*%/*/ &( */(8

P(*2 $(07*%/*/ &( */(8 & '(.8(& &: - (&*2&1(/(&/ 03*/%8 * 7/.*%*/%8 - (&$&3/(&/ $%/2'%'* 6& (&3'$&(/(& - 302(0% $&(*06*3 %/ .&6*3'% 6& 7/.*%*& - &*/(&/ 7(*1'%'* * '.&)&%** - (&$&3/(&/ '2'* (&1*. 6& */ 8 &35*%*4(/ - (&$&3/(&/ .8'(*%0( 6& *1*&28 $&(02/%8 /%*.&2/(8 * 6& */ 8 - &*/(&/ &70('(*%0( ./(* 9$(&%'21*&;+

2C


30/69

'D


31/69

CAPITOLUL II STUDIU DE CAZ

CULEGEREA DATELOR

PACIENT " PACIENT PACIENT ume iprenume

E"0 4"%" *""

%rsta 2= ani cm

*rupsanguin

E+++ E+++ #++

3otiveleinternrii

+napetenta! tuse seac! scdere

ponderal! durere(jungHi toracic)!

+napeten! tuse seac! scdere ngreutate! durere (jungHi toracic)!ebr(I'C!2J0! depresii!

+napetenta! tuse seac! scdereponderal! stare ebril(I'?!


32/69

ebr moderat(I'?J0)! depresii!

transpiraii nocturne"

transpiraii nocturne! insomnie!astenie i9ic marcant"

marcant! transpiraii nocturne!insomnie"

+storiculbolii

.acienta se pre9intG pe data de2D"D'"2D1;! la ora 11GDD lapitalul 3unicipal 0mpina! laecia de Eoli +nterne! cuurmtoarele simptomeG -inapeten! tuse seac! scdereponderal! durere! ebr '?J 0"e internea9 de urgen cudiagnosticulG .leure9ie ba9alstnga"

.acientul se pre9intG pe data de1C"D


33/69

ANALIZA NEVOILOR FUNDAMENTALE NESATISFCUTE

PACIENT " PACIENT PACIENT N&0*/7'26/.&2/%82&/*783'8

1" N&0*/ 6& / (&$*(/ =* 6& /&/ 0 4'283*(3'%/@*&

1" N&0*/ 6& / (&$*(/ =* 6& /&/0 4'28 3*(3'%/@*&

1" N&0*/ 6& / (&$*(/ =* 6&/&/ 0 4'28 3*(3'%/@*&

P(04%&./ 6&6&$&26&2@8

- 4ispnee- 6bstrucia cilor respiratorii

- 4ispnee- use- 6bstrucia cilor respiratorii

- 4ispnee

E*0%01*/ - 5ipsa cunoaterii mijloacelor eicace dedegajare i e@pectoraie- .re9ena secreiilor

- .roces inlamator- .re9ena secreiilor

- .roces inlamator

M/2*7&/(&/ 6&6&$&26&2@8

- Eradipnee- 0iano9a bu9elor! ungHiilor! tegumentelor- 8gomot respirator modiicat- 3uco9iti- useG uscat! persistent"

- Eradipnee- 0iano9a bu9elor! ungHiilor!tegumentelor- 8gomot respirator modiicat- 3uco9iti- useG uscat! neproductiv!persistent! Kuinoas"

- Eradipnee- 0iano9a bu9elor! ungHiilor!tegumentelor- 8gomot respirator modiicat- useG uscat! persistent"

''


34/69

PACIENT " PACIENT PACIENT N&0*/7'26/.&2/%82&/*7/3'8

2" N&0*/ 6& / 4&/ =* 6& / .


35/69

N&0*/7'26/.&2/%82&/*7/3'8

'" N&0*/ 6& / &%*.*2/ '" N&0*/ 6& / &%*.*2/ '" N&0*/ 6& / &%*.*2/

P(04%&./ 6&6&$&26&2@8

- 0onstipaia- 4iaore9a

- 4iaore9a - 0onstipaia- 4iaore9a

E*0%01*/ - #limentaie inadecvata- 4iminuarea mobilitaii- &idratare neadecvat

- &idratare neadecvat - #limentaie inadecvat- 4iminuarea mobilitaii- &idratare neadecvat

M/2*7&/(&/ 6&6&$&26&2@8

- ran9it intestinal ncetinit- Ealonare- ranspiraii nocturne

- ranspiraii nocturne abundente - ran9it intestinal ncetinit- Ealonare- ranspiraii nocturne

'


36/69


;" N&0*/ 6& / /60(.* =* 6& / & 06*52* ;" N&0*/ 6& / /60(.* =* 6& / &06*52*

;" N&0*/ 6& / /60(.* =* 6& /& 06*52*

P(04%&./ 6&6&$&26&2@8 - 4iicultatea de a se odiHni- /pui9are - 4iicultatea de a se odiHni- /pui9are - 4iicultatea de a se odiHni- /pui9are

E*0%01*/ - 4urere! jungHi tHoracic- 4ispneeLtuse- 4iicultate n a stpni stresul

- 4urere! jungHi toracic- 4ispneeLtuse- 4iicultate n a stpni stresul

- 4urere! jungHi tHoracic- 4ispneeLtuse- 4iicultate n a stpnistresul

M/2*7&/(&/ 6&6&$&26&2@8

- omn insuicient! tre9iri repetate- 4escurajare- lbire- #patie- #stenie

- omn insuicient! tre9iri repetate- 4escurajare- lbire- #patie- #stenie

- omn insuicient! tre9irirepetate- 4escurajare- lbire- #patie- #stenie

'=


37/69


2%*.*& 20(./%&

P(04%&./ 6&6&$&26&2@8

- &ipertermia - &ipertermia - &ipertermia

E*0%01*/ - .roces inlamator inectios pulmonar - .roces inlamator inectiospulmonar

- .roces inlamator inectiospulmonar

M/2*7&/(&/ 6&6&$&26&2@8

- 4iaore9a- ebr moderat (I'?J0)- risoane- .iele rosie i ierbinte

- 4iaore9a- ebr ridicat (I'C!2J0)- risoane- Piele rosie i ferbinte

- 4iaore9a- ebr moderat (I'?!


38/69


39/69


>" N&0*/ 6& / *28@/ 3'. 8 >=* $8(&)&828/&/

>" N&0*/ 6& / *28@/ 3'. 8 >=*$8(&)& 828/&/

>" N&0*/ 6& / *28@/ 3'. 8>=* $8(&)& 828/&/

P(04%&./ 6&6&$&26&2@8

- 0unotine insuiciente - 0unotine insuiciente - 0unotine insuiciente

E*0%01*/ - +naccesibilitatea la inormaie - +naccesibilitatea la inormaie - +naccesibilitatea la inormaieM/2*7&/(&/ 6&6&$&26&2@8

- 0unotine insuiciente asupra bolii! amsurilor de prevenire! a diagnosticului

medical"

- Cunotine insufcienteasupra bolii, a msurilor deprevenire, a diagnosticuluimedical.

- 0unotine insuicienteasupra bolii! a msurilor de

prevenire! a diagnosticuluimedical"

PLANIFICAREA INGRIJIRILOR

'C


40/69

PACIENT " PACIENT PACIENT

OBIECTIVE

"+ -P/3*&2/ 8 $0/8 (&$*(/20(./% >2 ./*. # 5- P/3*&2/ 8 $(&)*2& 0 /(&6& 2'(**& /6&3/8 >2 ./*.

# 5- P/3*&2/ 8 7*& 5*6(//830(&$'2)80( >2 ./*. # 5- P/3*&2/ 8 &$(*.& /4&2@//' 6*.*2'/(&/ '&* >2 ./*.# 5- P/3*&2/ 8-=* $0/8 .&2@*2&&.$&(/'(/ 30($'%'* >2%*.*&%& 20(./%& >2 ./*. #5++ E6'3 $/3*&2/ >2 &6&(&/3'20/=&(** =* >2@&%&1&(**$(04%&.&%0( %&1/& 6& 40/%8- P/3*&2/ 8 4&2&7*3*&)& 6&

(//.&2 30(&$'2)80( >2&6&(&/ (&7/3&(** 30.$%&&- P/3*&2/ 8 (&$&3&(//.&2'% $(&3(*- P/3*&2/ 8 (&$&3& (&1*.'%*1*&20-6*&&*3 (&30./26/- P/3*&2/ 8 &*& )02&%& 3'/.07&(8 $0%'/8, 7(*1'% =*'.&)&/%/-P/3*&2/ 8 &*& &70('% 7*)*3

"+ P/3*&2'% 8 $0/8 (&$*(& 20(./%>2 ./*. # 5- P/3*&2'% 8-=* $0/8 .&2@*2&&.$&(/'(/ 30($'%'* >2 %*.*&%&

20(./%& >2 ./*. # 5- P/3*&2'% 8 &$(*.& /4&2/ /'6*.*2'/(&/ '&* >2 ./*. # 5- P/3*&2'% 8 7*& 5*6(//30(&$'2)80( >2 ./*. # 5- P/3*&2'% 8 $(&)*2& 0 /(& 6&2'(**& /6&3/8 >2 ./*. # 5++ P/3*&2'% 8-=* (&3/$&& /(&/ 6&4*2&, 3/(& 8 7*& >2 30230(6/2@8 3'6*.*2'/(&/ /' (&)0%/(&/$(04%&.&%0( 3' 3/(& -/ $(&)&2/- P/3*&2'% 8-=* (&3/$&& *26&$&26&2@/3/ ./* (&$&6& $0*4*%- B0/%/ 8 &0%'&)& 78(8 30.$%*3/@**+

+ E6'3 $/3*&2'% >2 &6&(&/3'20/=&(** =* >2&%&1&(** $(04%&.&%0(%&1/& 6& 40/%8- P/3*&2'% 8 4&2&7*3*&)& 6& (//.&230(&$'2)80( >2 &6&(&/ (&7/3&(**30.$%&&- P/3*&2'% 8 (&$&3& (//.&2'%$(&3(*- P/3*&2'% 8 (&$&3& (&1*.'% *1*&20-6*&&*3 (&30./26/

"+ P/3*&2'% 8 $0/8 (&$*(/ 20(././*. # 5- P/3*&2'% 8-=* $0/8 .&2@*2&&.$&(/'(/ 30($'%'* >2 %*.*&%&

20(./%& >2 ./*. # 5- P/3*&2'% 8 &$(*.& /4&2@/ /'6*.*2'/(&/ '&* >2 ./*. # 5- P/3*&2'% 8 7*& 5*6(// 30(&$'2)8>2 ./*. # 5- P/3*&2'% 8 $(&)*2& 0 /(& 6& 2'(/6&3/8 >2 ./*. # 5++ P/3*&2'% 8-=* (&3/$&& /(&/ 6&4*2&, 3/(& 8 7*& >2 30230(6/2@8 3'6*.*2'/(&/ /' (&)0%/(&/ $(04%&.&%3' 3/(& -/ $(&)&2/- P/3*&2'% 8-=* (&3/$&& *26&$&26&2@3/ ./* (&$&6& $0*4*%- B0/%/ 8 &0%'&)& 78(8 30.$%*3/@**+

+ E6'3 $/3*&2'% >2 &6&(&/3'20/=&(** =* >2&%&1&(** $(04%&.&%0(%&1/& 6& 40/%8- P/3*&2'% 8 4&2&7*3*&)& 6& (//.&230(&$'2)80( >2 &6&(&/ (&7/3&(**30.$%&&- P/3*&2'% 8 (&$&3& (//.&2'%$(&3(*- P/3*&2'% 8 (&$&3& (&1*.'% *1*&206*&&*3 (&30./26/

;D


41/69

-P/3*&2/ 8 & (&*2&1(&)& >27/.*%*& =* 03*&/&++ P/3*&2/ 8-=* (&3/$&&*26&$&26&2@/ 3/ ./* (&$&6&$0*4*%- P/3*&2/ 8-=* (&3/$&& /(&/6& 4*2&, 3/(& / 7*& >2

30230(6/2@/ 3' 6*.*2'/(&//' (&)0%/(&/ $(04%&.&%0( 3'3/(& -/ $(&)&2/- B0/%/ 8 &0%'&)& 78(830.$%*3/@**+

- P/3*&2'% 8 &*& &70('% 7*)*3- P/3*&2'% 8 &*& )02&%& 3' /.07&(8$0%'/8, 7(*1'% =* '.&)&/%/- P/3*&2'% 8 & (&*2&1(&)& >2 7/.*%*&=* 03*&/&+

- P/3*&2'% 8 &*& &70('% 7*)*3- P/3*&2'% 8 &*& )02&%& 3' /.07&$0%'/8, 7(*1'% =* '.&)&/%/- P/3*&2'% 8 & (&*2&1(&)& >2 7/.*%*&03*&/&+

INTERVENII - '.&)&3 /&('% 6*2 >238$&(&- /&(*&3 3/.&(/

- >28@ $/3*&2/ 8 &*&35*.48(*%& 4('=& 6&

&.$&(/'(8 =* /1%0.&(/@*/- >28@ $/3*&2/ 8 7/38 1*.2/*38

(&$*(/0(*&

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46/69

+ DIFICULTATEAN A-I MENINETEMPERATURA

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D'$8 # 5 7&4(/-/ 6*.*2'/ =*$/3*&2/ /(& 0

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51/69

TRATAMENT

DENUMIREAMEDICAMENTULUI

FORMADE

PREZENTARE

ACIUNE MODDE

ADMINISTRARE

DOZ ZILNIC

PACIENT " STREPTOMICINA Flacoane Antibiotic IM. 1g!i 1gAL"OCALMIN Fiole Analge!ic IM. 1 #iola

$i%ineata& 1 #iola'ea(a

) #

NILFAN Ca*'+le Anti,i'ta%inic O(al 1 c*!i 1 c*PREDNISON Ca*'+le Co(tico'te(oi$ O(al& *(i%a !i - c*

/0%g 'e 'ca$t(e*tat *ana la

$o!a $e int(etine(e$e 12/ c*!i

Se ince*e c+ /0%g'i 'e 'ca$e 1 c* la

3 !ile

DIAZEPAM Ca*'+le Se$ati4 O(al 1 c* 'ea(a 1 c* )%gEMETIRAL Ca*'+le Antie%etic O(al 1 c*!i 1 c*

O5I"ENOTERAPIE Cent(ali!at6 *(in%a'ca

O7igena(e O(al 8092-09concent(atie O)

CODEINA Ca*'+le Antit+'i4 O(al / c*!i PERFUZII2"LUCOZA2

SER FIZIOLO"ICFlacon :i$(atante I;. 2 300 %l

2 300 %l


52/69

PACIENT STREPTOMICINA Flacoane Antibiotic IM. 1g!i 1gACID

ACETILSALICILICCa*'+le Analge!ic O(al 1 c*

$i%ineata& 1 c*'ea(a

) c*

MEPRO


53/69

$o!a $e int(etine(e$e 12/ c*!i

DIAZEPAM Ca*'+le Se$ati4 O(al 1 c* 'ea(a 1 c* )%gEMETIRAL Ca*'+le Antie%etic O(al 1 c*!i 1 c*

O5I"ENOTERAPIE Cent(ali!at6 *(in%a'ca

O7igena(e O(al 8092-09concent(atie O)

DE5TROMETORFAN Ca*'+le Antit+'i4 O(al / c*!i

PERFUZII ="LUCOZA = SERFIZIOLO"IC

Flacon :i$(atante I;. 2 300 %l 2 300 %l


54/69

EAMENE DE LABORATOR

ANALIZA CERUTA MOD DERECOLTARE

VALOARENORMALA

VALOAREAOBTINUTA

PACIENTUL " E/.&2 4/3&(*0%01*3 -$'/

- e ia eprubeta petampon steril! se

ume9ete tamponulde vat cu ap

distilat! se apaslimba cu spatula! seintroduce tamponul

n aringe cerndpacientei s tueasc"

negativ negativ

G%*3&.*& - 2ml snge pelorura de sodiu ;

mg"

D!?D M 1!2DgN D!?>N

T(/2/.*2/)& - snge simplu < M1Dml"

- vacutainer galben"

*6 2 M 2D7+*. 2 M 1=7+

*6 1


55/69

D!;ml citrat de sodiu'!?N"

- vacutainer negru

- 1D


56/69

- vacutainer negru"LG - 2ml snge pe

cristale de edt 1N!D!


57/69

VS - 1!=ml snge OD!;ml citrat de sodiu

'!?N"- vacutainer negru"

1 M 1DmmLH - >;- 1D=Lmin

LG - 2ml snge pecristale de /4#

1N! D!


58/69

ETERNAREA

D// &&(2/(** S/(&/ %/ &&(2/(& B*%/2'% /'020.*&* R&30./26/(* %/ &&(2/(&PACIENTUL " +!+!"# P/3*&2/ >2


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PACIENTUL "+!#+!"# P/3*&2'% >2


61/69

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III+ BIBLIOGRAFIE

P1Q #natomia i i9iologia omului M ndrumtorpentru proesori i elevi:

.roesorG *rad + M 6lga .anaitescu

.roesorG *rad + M /lena .reda

P2Q 3edicina intern.roesorG 4r" 4ocent icolae 0rngulescu

P'Q 3edicin intern4r" R" .un4r" /" eropian.roesor 4r" ." eodorescu

P;Q .leure9ia seroibrinoas4r" +" *ologan

P


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lucrare de diploma :pleurezia

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