proiect cardiopatie ischemica

8/13/2019 proiect cardiopatie ischemica

http://slidepdf.com/reader/full/proiect-cardiopatie-ischemica 1/65



INGRI!IREA PACIENTILOR CU CARDIOPATIEISC"EMICA



CUPRINS

ARGUMENT

CAPITOLUL I- NOTIUNI GENERALE DESPRE CARDIOPATIE ISCHEMICA

CAPITOLUL II- PARTICIPAREA ASISTENTEI MEDICALE LA ACTE DE

INVESTIGATII ŞI INTERVENTII AUTONOME ŞI DELEGATEII.1 PARTICIPAREA ASISTENTEI LA ACTE DE INVESTIGATIIII.2. PARTICIPAREA ASISTENTEI LA INTERVENTII AUTONOME ŞIDELEGATE

CAPITOLUL III- DESCRIEREA TEHNICILOR IMPUSE DE AFECTIUNE

CAPITOLUL IV- PLANUL DE INGRIJIRE AL PACIENTULUI CUCARDIOPATIE ISCHEMICA

BIBLIOGRAFIE



CAPITOLUL I- NOTIUNI GENERALE DESPRE CARDIOPATIE ISC"EMICA

D,4**(*,

C#r$!)+#t!e !"'e!'# "e $e0!&e"te '# 0!!&$ #0e't!&e# '#r$!#'# 'e #+#re '# r#re # $e(e'!,!br,!

$!&tre &e'e"!t#t!,e $e !r!#re #,e !)'#r$,! "! +)"!b!,!t#t!,e $e !r!#re #,e %#"e,)r ')r)&#r!e&e.

Cardiopatia ischemică "# b)#,# '#r$!#' !"'e!'* ' #! e $e&!t* e"te ) "0er!&t # !&!!!

$eter!&#t $e & #+)rt !&"0!'!e&t $e )/!e& &e'e"#r 5'!,! '#r$!#'* 4&$e)"eb! 4& ')&$!3!! $e

"),!'!t#re 0!(!'.S0er!&3# +)#te 0! ,#te&t "# #&!0e"t ',!&!'* +t6&$ ',!&# ' )#rte# "b!t.

C%$3*4*$+,

C)&0)r O.M.S. "e $e"'r! $)# #r! '#te)r!! $e #0e't!&! @

1. '#r$!)+#t!# !"'e!'# &e$rer)#"# "# #"!+t)#t!'# @

- t,br#r! $e r!t "! $e ')&$'ere $e &#tr# !"'e!'#

- )#rte "b!t# ')r)&#r!#&#

- !&"0!'!e&t# '#r$!#'# $e et!),)!e !"'e!'#

2. '#r$!)+#t!# !"'e!'# $rer)#"#

- #&!&# +e't)r#,# 7AP8



&e'e"#r, $e 0,/ "#&!& e"te #r!t. De #"ee&e#* 0,/, "#&!& ')r)&#r +)#te 0! ,!!t#t +r!&

tr)b! #rter!#,!* "+#" "!* r#re)r!* eb),! ')r)&#r!* +re' "! +r!& "te&)(#re# )"t!#,# $#t)r#t##)rt!te! ,et!'e. A&)#,!!,e ')&e&!t#,e* ' #r 0! )r!!&e# #&)r#,# # #rtere! ')r)&#re

$e"'e&$e&te #&ter!)#re "t#&! $!& #rter# +,)&#r#* +)t $eter!&# !"'e!e "! !&0#r't

!)'#r$!' ,# "#r* $#r #'e#"t# '#(# e"te 0)#rte r#r# ,# #$,t!.

De #"ee&e#* !"'e!# !)'#r$!'# +)#te #+#re# $#'# &e'e"!t#t!,e $e )/!e& #,e !)'#r$,!

"&t #&)r#, 're"'te* #"# ' "e 4&t6+,# 4& !+ertr)0!# %e&tr!',#r# "e%er# !&$"# $e

!+erte&"!&e "# $e "te&)(# #)rt!'#. A'e#"t# $!& r# "e +)#te #&!0e"t# ' #&!&#* '#re &

"e +)#te $!0ere&t!# $e 'e# +r)$"# $e #ter)"',er)(# ')r)&#r!#&#.

O '#(# r#r# $e !"'e!e !)'#r$!'# e"te re+re(e&t#t# $e re$'ere# '#+#'!t#t!! "#&e,! $e #

tr#&"+)rt# )/!e&,* ' #r 0! 4& #&e!# e/tre $e "e%er# "# 4& +re(e&t#

'#rb)/!e),)b!&e!. N r#re)r!* $)# "# #! ,te '#(e $e !"'e!e +)t ')e/!"t#* ' #r

0! ) 're"tere # &e'e"#r,! $e )/!e&* $eter!&#t# $e !+ertr)0!# %e&tr!',#r# "t#&# "! )

re$'ere # #+)rt,! $e )/!e& "e'&$#r #ter)"',er)(e! ')r)&#r!e&e. A$e"e#* #"ee&e#

')b!&#t!e ')&$'e ,# #&!0e"t#r! ',!&!'e $e !"'e!e.

De"! #rtere,e ')r)&#re e+!'#r$!'e #r! "&t '#+#b!,e $e ')&"tr!'t!e "! re,#/#re* ,# +er")#&e,e

"#&#t)#"e e,e "er%e"' 4& #re #"r# $re+t ')&$'te "! "&t '&)"'te '# %#"e $e ')&$'t#&t#*



P+**'$%,%, 4/+),%, , )$*4,3($+, $%, CI

1.A&!&# +e't)r#,# "t#b!,# 7'r)&!'# 82.A&!&# +e't)r#,# !&"t#b!,#

9. I&0#r't, !)'#r$!' #'t

. C#r$!)+#t!# !"'e!'# &e$rer)#"#

M$*4,3(:+* %**,

C$+*/'$($ *3;,)*$ &+,+/$3$

A&!&# +e't)r#, #re & t#b,) ',!&!' 0)#rte "e"t!%* $rere# t)r#'!' )'+6&$ & ,)' 'e&tr#,.

Drere# e"te +ter&!' ,)'#,!(#t $e )b!'e! 4& re!&e# +!e+t,! "e "!te 4& re!&e#

retr)"ter&#,* 4& +)r !&e# !?,)'!e* "+er!)#r* $#r* &e)r!* ! 4& 'e# !&0er!)#r.M,t #! r#rț ș

"e$!, $rer!! e"te #t!+!' @ ,# ')t* #rt!',# !# +&,! * &! "# b!,#ter#, 4& re!&e# '),)#&e!ț

t)r#'#,e "+er!)#re "# '!#r 4& re!&e# ,)b#r Drere# #re & '#r#'ter ')&"tr!'t!%* 0!!&$

$e"'r!" '# ) "e&(# !e $e "tr6&ere* '# ) !#r '#re "06"6!e +!e+t,. U&e)r! #'e#"t "t#re e"teț

4&") !t $e te#* $e "e&(# !# )r !! !!&e&te* tr#&"+!r# !!* ,!+" $e #er* er't# !!. A,te)r!ț ț ț ț ț

b),&#%, "!te $rere# '# ) #r"r* )r! '# ) #+"#re $rer)#"* #"e&t)#re &e! ret !ț

'#re 44 +re"e#( +!e+t,.



I& t#r!,e %e"t!'e* "t$!!,e +)"t)rte #,e %!'t!e,)r #''!$e&te,)r "! #,e ')&0,!'te,)r !,!t#re #

#r#t#t '# #ter)"',er)(# ')r)&#r!#&# 4&'e+e #$e"e# "# "e $e(%),te 4&#!&te $e %6r"t# $e 2= #&! "!e"te ,#r r#"+6&$!t# '!#r +r!&tre #$,t!! '#re # 0)"t #"!+t)#t!'! 4& t!+, %!et!!. At&'!

'6&$ "&t ,#te 4& ')&"!$er#re t)#te r+e,e $e %6r"t#* '#r$!)+#t!# !"'e!'# e"te 'e# #!

)b!"&!t# '#(# # $e'e",!* & &#! ,# b#rb#t!* '! "! ,# 0ee! .

L# +er")#&e,e #"!+t)#t!'e* te"te,e $e e0)rt +)t e%!$e&t!# "e&e $e !"'e!e !)'#r$!'#

"!,e&t!)#"#* #$!'# )$!0!'#r! e,e'tr)'#r$!)r#0!'e !&$"e $e e0)rt* &e4&")t!te $e #&!&#K "t$!!,e

$e #&!)r#0!e ')r)&#r!#&# ,# #"ee&e# +er")#&e $e(%#,!e 0re'%e&t b)#,# ')r)&#r!#&#

)b"tr't!%#. Ne'r)+"!!,e +#'!e&t!,)r ' b)#,# ')r)&#r!#&# )b"tr't!%# '#re & # +re(e&t#t 4&

#&te'e$e&te #&!0e"t#r! ',!&!'e $e !"'e!e !)'#r$!'# e%!$e&t!#(# #$e"e# '!'#tr!'e

#'r)"')+!'e "e'&$#re !&0#r't,! !)'#r$!' 4& re!&!,e !r!#te $e #rtere,e ')r)&#re

"0er!&$e. P)tr!%!t "t$!!,)r +)+,#t!)&#,e* #+r)/!#t!% 2:; $!& +#'!e&t!! '#re "+r#%!et!e"'

!&0#r't,! !)'#r$!' #'t +)t "# & #?&# "b "+r#%eere e$!'#,#* #'e"t! +#'!e&t! #%6&$

#'e,#"! +r)&)"t!' &e0#%)r#b!, '# "! 'e! '#re "e +re(!&t# ' "!&$r), ',!&!' ',#"!' . M)#rte#

"b!t# +)#te 0! &e#"te+t#t# "! e"te ) #&!0e"t#re 0re'%e&t# $e $ebt # '#r$!)+#t!e! !"'e!'e.

De #"ee&e#* +#'!e&t!! "e +)t +re(e&t# ' '#r$!)e#,!e "! !&"0!'!e&t# '#r$!#'#* "e'&$#re

$eter!)r#r!! !"'e!'e # !)'#r$,! %e&tr!',#r "t6&* '#re & $eter!&# "!+t)e 4&#!&te $e



> !&0,##t!#!&0e't!# 'r)&!'#

> &e,e #&)#,!! e&et!'e +&'t!0)re

C/)'%*$ **ț

C)+,!'# !# 'e# #! $e tet 4& '#r$!)+#t!!,e !"'e!'e e"te )#rte# "b!t. Se "+&e 'ț

#&!&# +e't)r#, e"te ) b)#, '#re +)#te $r# $e ,# 9= "e'&$e ,# 9= $e #&!. )',Ș

'#r$!)e& re+re(!&t & $e0!'!t '!r',#t)r 'e&tr#, #, +)+e! '#r$!#'e $#t)r#t #+r)#+e 4&

e/',"!%!t#te &e'r)(e! !)'#r$!'e #'te. C)+,!'# !!,e "e'&$#re "&t ')+,!'# !! tr)b)ț ț

eb),!'e #,e !&0#r't,! !)'#r$!'. Eb),!# +,)&#r* #''!$e&t, %#"',#r 'erebr#,*

tr)b)(# %e&)#"* #r!t!! ' )#rte "b!t* r+tr# '#r$!#'* '),#+".

T+$($),(&% $+*/'$(*,* *3;,)*,

Ob!e't!%e,e 0&$#e&t#,e #,e tr#t#e&t,! '#r$!)+#t!e! !"'e!'e "e +)t re(# #"t0e, @

-+re%e&!re# '#r$!)+#t!e! !"'e!'e ! # ')+,!'# !!,)r "#,eș ț

-tr#t#e&t 'r#t!% e$!'#,

-tr#t#e&t, '!rr!'#,

-re#b!,!t#re# '#r$!)%#"',#r



-N!0e$!+!&# 7 A$#,#t 8 t#b,ete $e 1=* 4& $)( $e 9 t#b,ete (! )r! t#b,ete ret#r$ $e 2=-9=

-Ver#+#!, 7I")+t!&8 t#b,ete =*= 4& $)( $e 9 t#b,ete +e (!

-D!,t!#(e <=-= (!

-A!)$#r)&# 7 C#r$#r)&e8 ' #' !&e ')r)&#r)$!,#t#t)#re ! #&t!#r!t!'ț ș

T+$($),(&% *5*,/-*,(,(*

-re+#" ,# +#t*)b!,!(#re +r)re"!%#

-$!et# !$r)(##r#t)%eet#r!#&# "! re! !+)'#,)r!'

T+$($),(&% ;*+&+5*$%

- Re#,!(e#re# b +#""-, #)rt)')r)&#r!#& ' %e& "#0e&.

- A&!)+,#"t!# tr#&",b!&#,*')r)&#r* +er't#&t.



Re"+e't#re# r!r)#" # +r)r#,! $e re#b!,!t#re 0!(!' ! +"!!'-4& '#re tr#t#e&t,ș

'r#t!%* #,!e&t# !# r# !)&#, ! #&tre&#e&t, 0!(!' )'+ & ,)' !+)rt#&t-$'e 0!re"' ,#ț ț ș

re'+er#re# "tr!! $e "&t#te ! ,# re!&ter#re# 4& ")'!et#te # b),&#%,!* tr#&"0)r6&$-,ș

$!&tr-& #&$!'#+#t !&tr-& ) t!, +e&tr "!&e ! +e&tr '),e't!%!t#te.ș

TRATAMENTUL DE INTRETINERE

A. T+$($),(&% , *(+,(*,+, * $5;*$ ',(/+$%$

Tr#tee&t, #&!&e! +e't)r#,e %!(e#(#@

1. St#b!,!re# '#(e,)r "! # 0#'t)r!,)r '#re +re'!+!t# #+#r!t!# "# 0#%)r!(e#(# #''e",

$e #&)r. De)#re'e #?)r!t#te# '#(e,)r "&t* r#re # #ter)"',er)(e! ')r)&#r!e&e*

tr#t#e&t, %# %!(# re!, "! tr#t#e&t, #ter)"',er)(e!.

A,te '#(e@ "te&)(# #)rt!'#* '#r$!)!)+#t!!* HTA.

I& #'e"t '#(* tr#t#e&t, #&!&e! +e't)r#,e "e +re"+&e tr#t#e&t,! #'e"t)r b),!.

D+# '#( "e tr#te#(#@ #&e!#* !+)/e!#* !+ert!r)!$#* !&"0!'!e&t# '#r$!#'#. Treb!e

')b#tt 0#t,* )be(!t#te#* "e$e&t#r!",* !+er'),e"ter),e!#* b!#bet, (##r#t*

"tre",*!+ert!r)!$!",K ' #,te '%!&te* t)t! 0#'t)r!! $e r!"'.



TRATAMENTUL CRI>EI ANGIOASE

- re+#" #, b),&#%,!* 'ee# 'e !&"e#&# !&trer+ere# )r!'#r! e0)rtK

- #$!&!"tr#re# $e &!tr),!'er!&# "b,!&#, 1 ')+. $e =*===:* "# 2 - 9 +!'#tr!

$e "),t!e. A$!&!"tr#re# #'e"t)r# "e +)#te re'e+t# $e #! ,te )r! +e (!* "e +)#te ,# "!

+r)0!,#'t!e* $e)#re'e & 're#(# )b!"&!&t#* #'t!&e# e"te $e "'rt# $r#t# "! b!&e t),er#t#.

- $#'# $rere# & 'e$e#(# !& 2= - 9= !&. "e ""+e'te#(# & #&)r !&tr!'#t "# &

"$. ')r)&#r!#& "e%er.

Se #$!&!"tre#(# NITRIUL DE AMIL 70!),# !&#,#t#8* #'t!)&e#(# r#+!$ 1= - 1: "e'.

Pre%e&!re# "e 0#'e +r!&@

- e%!t#re# '!r'"t#&te,)r $e',#&"#t)#re 7e0)rt* e)t!!* e"e ')+!)#"e* tt&8

- #$!&!"tr#re# $e e$!'#e&te ' #'t!&e ')r)&#r)$!,#t#t)#re@

- INTENSATINK

- PRESATINK

- AGOOL 7PRENILAMINA8

- &!tr)')+"! ' #'t!&e +re,&!t#@

- PENTALONGK



"ter&#,# "# +e #&tebr#t.

- DERIVATI NITRICI CU ACTIUNE PRELUNGITA 7ret#r$8@ "e #$!&!"tre#(#

(!,&!'* 2 - 9 (! PENTALONG* NITROPECTOR ')+r!#te $e 2=* 1 - 9 (!.

E0e't, #+#re $+# ) )r# "! ?#t#te "! $re#(# - : )re* re$' ')&", $e

&!tr),!'er!&#.

E0e'te "e'&$#re@ %#")$!,#t#t!# 't#&#t#* 'e0#,ee "# #ete,!.

- $!&tre 'e,e ',#"!'e@ - MIOFILILINUL

- PAPAVERINA

- DIPIRIADOL

- BLOCANTI BETA-ADRENERGICI@ - PROPANOL

- INDERAL

- TRASICOR

Se !&'e+e ' / 1=(! 7')+. $e 1= "# = 8 "! "e #?&e +#&# ,# <= (!.

CI@ t,br#r! $e r!t "! ')&$'ere br#$!'#r$!'e* #"t br)&"!'* IC

- ANTAGONISTII CALCIULUI@ !&!b#&$ +#tr&$ere# '#,'!,! !& 'e,,# !)'#r$!'#* e!

re$' ')&", $e )/!e&* "'#(#&$ &e'e"!t#t!,e "#,e !& O2.



MORFINA "# HIDROMORF.

- COCTEILUL LITIC 7ROMERGAN : PLEGOMAIN :=

MIALGIN 2: 8 !& +er0(!e "# !..

- ALGOCALMIN

- OXIGENUL +e ")&$# &#(#,# "# #"'#* e"te &e'e"#r &! t)#t# +er!)#$# $rer)#"#

"! !& 0)re,e !&")t!te $e ")' "# EPA.

Re+#", ,# +#t "! $!et#@

- e"te )b,!#t)r!e !& t)#te 0)re,eK

- !& +r!e,e )re "! (!,e re+#", %# 0! #b"),t !&")t!t $e #$!&!"tr#re# $e "e$#t!%e

7BARBITURICA* DIAEPAM8 "! #,!e&t#t!e !$r)(##r#t# 7"'r! $e 0r'te* ')+)tr!*'e#!

",#b* ,#+te $!,#t !& #+#8K

- re+#", %# $r# !& e$!e 9 - "#+t##&! "! %# 0! ')+,et 70!(!' "! +"!!'8* !#r

+)(!t!# %# 0! "e!"e(#&$#K

- !"'#r!,e #'t!%e #,e ebre,)r* "&t +er!"e $+# 2 - )re* !#r "e$ere# +e

#r!&e# +#t,!* #,!e&t#t!e ,# +#t "! t)#,et# $+# - 1 (!,eK

- )b!,!(#re# %# 0! )b,!#t)r! +re'e$#t# $e #"#?e #,e ebre,)r !&0er!)#reK



- OXIGEN +e ")&$# &#(#,#.

De #"ee&e#* "e #+,!'# tr#t#e&t, IC '@

- LANATOSID 'K

- CHINIDINAK

- PREDNISON.

Tr#t#e&t, $e 0)&$* #$re"#t #ter)"',er)(e! e"te )b,!#t)r!.

I& e&er#, tr#t#e&t, %# 0! $!etet!'@

- < e"e (! ' ) r#t!e '#,)r!'# #$#+t#t# ret#t!! "#,e@

- !& '#( $e )be(!t#te@ - 1=== - 12== '#,)r!!(! K

- !+)'),e"ter),e!#&tK

- !+),!+e!#&tK

- $e")$#t.

D+# '#(* "e %)r #$!&!"tr#@

- #&#,e(!'e@ - )r0!&#* !#,!&* 0)rt#,.

- "e$#t!%e "! tr#&'!,!(#&te@ - $!#(e+#* e+r)b##t* 0e&)b#rb!t#,K

- & "e$#t!% ")rK



- !# e$!'#e&t#t!# ) +er!)#$# $e t!+* "e "!te b!&e* #+re'!#(# $e ,# "!&e'# "-#

%!&$e'#t* !&trer+e e$!'#e&t#t!# "! & #! re"+e't# &!'! !&$!'#t!!,e $e re!K

- & re&&t# ,# 0#t* #,')), "! re! $e "#reK

- & re%!&e ,# t!+ ,# e$!' !& )e&t, re#+#r!t!e! "!+t)e,)r "! & e&t!)&e#(#

'!&"t!t '# & # re"+e't#t e$!'#t!# "# re!, !!e&)-$!etet!'K

M)$, "! 0e,, $e # e/+,!'# b),&#%,! $e 'e "0er# "! 0#+t, '# treb!e re"+e't#t

tr#t#e&t, "! re!, !!e&)-$!etet!' #re !+)rt#&t#.

E"te &e'e"#r & t)& b,#&$ "! 0er* $#r &!'! e/#er#r! "# e/+re"!!@ Q'#'! $#'# &

0#'! ' !t! "+&* #! #! +t!& "! )r!Q* "# #,te %)rbe '#re !, 0#' +e b),&#% "# +,e'e

!&r)(!t*"tre"#t.

D+# %!(!t#* b),&#%, treb!e "# +,e'e ' !&te,eere# b!&e0#'er!! tr#t#e&t,! "!

&e'e"!t#te# ')&tr),,! $e %er!0!'#re # e$!'#t!e! $+# '#te%# (!,e* +er!)$!'!t#te# +re(e&t#r!! ,#

')&tr),, TA* '#&$ e$!'#t!# %# 0! ')&?#t# !& 0&'t!e $e e%),t!e.

Tr#t#e&t, #0e't!&!,)r '#r$!)%#"',#re !& #b,#t)r !"! #re "+e'!0!', e! "! "e

$e)"ebe"te $e 'e, $!& "+!t#,@

- treb!e "# "e t!&# ')&t@ - $e ')&$!t!!,e +e '#re ,e #re #'#"# 0!e'#re b),&#%K



- '))+er#re# b),&#%,! ' e$!', e"e 0)#rte $!0er!t#* %#r!!&$ !& 0&'t!e $e +er")&#,!t#te* $e

e$'#t!e* &!%e, $e ',tr#* "t#re# +"!))t)r!'#* $e )b!'e!, $e # 0# "#

')&" $e #,')),K

- & treb!e &e,!?#t e$!, ")'!)-e')&)!' !& '#re tr#!e"te b),&#%,* +e&"!)&#r*

"#,#r! !'* 0#!,!e &er)#"#* "t#r! ')&0,!'t#,e* "t#r! $e "tre" '#@ )#rte# &! #+r)+!#t -")t*

")t!e* +#r!&te* ')+!,* 0r#te* +r!ete&.

L#&$ !& ')&"!$er#t!e 0#'t)r!! $e #! "" &e +te #0,#* '# #"!"te&t# e$!'#,#* !&

0#t# &! b),&#% ' HTA* '#re "# 0!e ) 0)r# ")#r#* e$!e "# r#%#* !&")t!t# 0re'%e&t $e

&# $!&tre ')+,!'#t!!* '#@ !+ertr)0!e %e&tr!',#r# "t#&#* b)#,# ')r#&#r!#&# !"'e!'#*

t,br#r! '# e)$!&#!'# 'erebr#,#.

B),&#%, ' 0)r# r#%# $e #0e't!&e '#r$!)%#"',#r# "# !&")t!t# $e &# $!&

')+,!'#t!!,e e&er#te* #re !&$!'#t!e $e !&ter&#re re&t# !&tr-& #"e(##&t "+!t#,!'e"' '

+r)0!, '#r$!)%#"',#r &$e "e %)r ,# #"r! #$e'%#te.

I& )e&t, '#&$ "-# ,#t )t#r#re# '# b),&#%, "e tr#te#(# !& #b,#t)r* "e !+&

#&!te +r!&'!+!! $e ')&$!t# $e '),#b)r#re e$!'-+#'!e&t* '#re +)t 0! re(#te #"t0e,@

- "t#b!,!re# $!& +#rte# e$!',! # &e! "'ee $e tr#t#e&t '#t #! "!+,#* ')&"t#&$ $!&@

- & !+)te&"!%K



- +er")#&e,e ' r!"' 're"'t $e # 0#'e HTA* %)r 0! "0#t!te "# #,e## +r)0e"!&! ' "tre"

+r)0e"!)&#, #re. V)r e%!t# $e #"ee&e#* +r)0e"!&!,e '#re +re$!"+& ,# "e$e&t#r!" "!

)be(!t#te.

E$'#t!# +e&tr "#&#t#te "e #$re"e#(#@

- +)+,#t!e! #'t!%e !& e&er#, "! t!&er!,)r !& "+e'!#,K

- 'e,)r ' !&'#r'#re ere$!t#r#K

- #$),e"'e&t!,)r "! t!&er!,)r* '#re $e"! &)r)te&"!%! # !& )$ ')&"t#&t %#,)r! #,e TA !& ,!!t#

"+er!)#r# # &)r#,,!K

- "e$e&t#r!,)rK

- "+r#+)&$er#,!,)rK

- #r!,)r ')&"#t)r! $e "#re $e b'#t#r!e 7+e"te 1= (!,e8.

Te&$!&t# #'t#,# e"te "# "e $e+!"te(e 0#'t)r!! $e r!"' !&tr-) 0#(# '#t #! +re')'e* t!&er!! "!

'!#r ')+!! 0!!&$ !& 'e&tr, #te&t!e!. E"te !+)rt#&t "# "e "r+r!&$# tre'ere# $e ,# "t#re# $e

"#&#t#te ,# "t#re# $e b)#,# "! "# "e !$e&t!0!'e "b!e't!! +re$!"+"! ,# b)#,#.

M!?,)#'e,e "&t "!+,e "! ,# !&$e#&# ttr)r@

- %er!0!'#re# ret#t!! - "#+t##&#,K



CAPITOLUL II – PARTICIPAREA ASISTENTEI MEDICALE LA ACTE DE

INVESTIGATII AUTONOME SI DELEGATE

II.1 > PARTICIPAREA ASISTENTEI LA ACTE DE INVESTIGATII

I&%e"t!#t!! &e!&%#(!%e

1. E,e'tr)'#r$!)r##

Pr!# te"t#re # !&!!! "e 0#'e +r!& e,e'tr)'#r$!)r## 7EG8. D#'# EG #r#t# )$!0!'#r! #,e

!&!!!* $!#&)"t!', e #! +re'!" "! & "&t &e'e"#re #,te te"te.

D#'# !&"# e,e'tr)'#r$!)r## e"te &)r#,#* $#r "!+t)e,e "&t +re(e&te "e 'er #,te

!&%e"t!#t!! +e&tr $!#&)"t!', $e '#r$!)+#t!e !"'e!'#. P#'!e&t, e"te +" "# e#r# +e &

')%)r r,#&t "# "# +e$#,e(e +e ) b!'!',et# e$!'#,#* EG-, 0!!&$ $e e0)rt.

E,e'tr)'#r$!)r## re+re(!&t# et)$# 'e# #! +ret!)#"# $e !&%e"t!#re # b),&#%,! #&!&)".

Pe e,e'tr)'#r$!)r## "e +)t !$e&t!0!'# #&!te &$e "! "ee&te@ &$# P* ')+,e/, RS*

&$# T* "ee&te,e P "! ST .



0!(!),)!' !& 0&'t!e $e %#r"t# 7#! "'#(t# ,# t!&er!8 "! 0re'%e&t# '#r$!#'# 7"'#$e !& t#!'#r$!e8

7V#& $er Gr##00 H#& A&#t)8.

C)+,e/, RS re+re(!&t# $e+),#r!(#re# %e&tr!',#r#* '#re !&'e+e ' +)rt!&e# "t#&#

# "e+t,! !&ter%e&tr!',#r "! #+)! "e +r)+## !& %e&tr!',! $e ,# %#r0r! "+re b#(e "! $e ,#

e&$)'#r$ "+re e+!'#r$. Dr#t# "e #")#r# ,# &!%e,, ,!&!e! !()e,e'tr!'e* 0!!&$ &)r#,# "b =.12

"e'. F)r# ')+,e/,! RS e"te !& )$ &)r#, ' %#r0r! #"'t!te* 0!!&$ 0)r#t $!& #!

,te &$e* +)(!t!%e "# &e#t!%e #r'#te +r!& ,!tere,e *R*S 7A&#t) #&$ P"!),) >

te U&!t 0)r #&$ F&'t!)&8.

See&t#, ST re+re(!&t# +r!# 0#(# # re+),#r!(#r!! %e&tr!',#re 7re+),#r!(#re#

,e&t#8. Dr#t# "ee&t,! ST e"te ,!+"!t# $e !+)rt#&t# +r#'t!'#* !#r +)(!t!# "# e"te !& )$

&)r#, !()e,e'tr!'#. P#t),)!# "ee&t,! ST '+r!&$e $e%!#t!!,e #'e"t!# 7"b- "#"+r#$e&!%e,#r!8* e,e 0!!&$ !& e&er#, e/+re"!# &)r t,br#r! "e%ere #,e '!r',#t!e! ')r)&#r!e&e.

Re+re(!&t# 0#(# 0!&#,# # re+),#r!(#r!! %e&tr!',#re 7re+),#r!(#re# r#+!$#8. Dr#t# e"te $e

=.12-=.9= "e' 70#r# !+)rt#&t# +r#'t!'#8. F)r# e"te r)t&?!t# "! #"!etr!'#* #%#&$ +#rte#

$e"'e&$e&t# #! r#+!$#. I& )$ &)r#, &$# T e"te +)(!t!%# !& t)#te



N#r, $er!%#t!!,)r "! r#$, "b$e&!%e,#r!! "ee&t,! ST ')re"+&$e e/t!&$er!! "!

r#$,! $e "e%er!t#te # !"'e!e! "! ')re,e#(# ' & +r)&)"t!' &e0#"t ,# $!"t#&t#. 7198

Pe&tr # 0! re,e%#&te #'e"te )$!0!'#r! '#r$!)+#t!e! !"'e!'e "e re')#&$# +r)be $e

e0)rt !& "')+ $!#&)"t!'. Se 0),)"e"te 0!e & te"t $e e0)rt ,!!t#t $e "!+t)e* 0!e & te"t $e

e0)rt "b#/!#,* '#re +)#te #$'e r#t)#re,e )$!0!'#r! e,e'tr)'#r$!)r#0!'e@ "+r# "#

"b$e&!%e,#re# "ee&t,! STK )$!0!'#r! #,e &$e! TK #+#r!t!# t,br#r!,)r $e r!t "#

')&$'ere '#r$!#'# 7G. O'e#&#* 2==<8.

Trei tipuri de denivelare a segmentului ST: A) Ascendent, B) Orizontal, C) Descendent.

E/t!&$ere# )&!t)r!(#r!! #b,#t)r!! # e,e'tr)'#r$!)r#e! # $" ,# ,#r!re#

')&"!$er#b!,# # +)"!b!,!t#t!,)r $e $ete't#re # !"'e!e! !)'#r$!'e "!,e&t!)#"e. O e/+re"!e #!



igura *. Arterele coronare + piese anatomice inectate cu su!stanta de contrast si

radiograiate: a) in vitro- !) la cadavru

#amenul coronaroangiograic permite vizualizarea vaselor coronariene si prezinta inormatii e#clusive

asupra prezentei, localizarii si severitatii leziunilor aterosclerotice. Coronarograia se e#ecuta indeose!i pentru

diagnosticul dierential as cardiopatiei ischemice ata de alte cardiomiopatii. Diagnosticul dierential al cardiopatiei

ischemice se ace cu toate cauzele sindromului miocardic.



igura (. a), !), c), d) Arterele coronare: coronarograie.

a) !)

igura /. Coronarograie stanga a), dreapta !) stenoze multiple ateromatoase

Angiograia coronariana cu su!stanta de contrast eectuata la intervale de timp va arata gradul de

evolutivitate al o!structiei coronariene si modul de dezvoltare a circulatiei colaterale $Dr. 0. 0. 1ateescu, 233*).



ventricular dintre care i!rilatia ventriculara este cea mai grava sarsind de regula prin oprirea !atailor inimii care

este de regula atala- trom!oem!olii in care se ormeaza cheaguri in cavitatile inimii, iar ragmente din aceste

cheaguri sunt preluate de circulatia sanguina i#andu7se ulterior in vase din dierite teritorii anatomice cum ar iarterele cere!rale, renale, arterele mem!relor inerioare in cazul trom!ilor ormati in cavitatile stangi ale inimii si in

vasele pulmonare cu producerea trom!oem!olismului pulmonar in cazul trom!ilor ormati in cavitatile drepte $Dr.

0. 0. 1ateescu, 233*).

In sarsit complicatia cea mai de temut este moartea su!ita care se poate instala, dupa 8allavardin,

9dupa 3 de secunde sau dupa 3 de ani din momentul aparitiei primelor simptome;.

2. E')'#r$!)r#0!#

D#'# &!'! EG-, ,# e0)rt +r)re"!% & "t#b!,e"te $!#&)"t!', "e 0#'e ) e')r#0!e # !&!!!.E')'#r$!)r#0!# #r#t# ')&tr#'t!!,e "'!,! !&!!! "! )$!0!'#r!,e* !&$!'#&$ '# !& #'e# ()&#

& #?&e $e"t, )/!e& "# e"te ) !'# '!'#tr!'e.

9. S'!&t!r#0!#



I& "0#r"!t #"!"te&t# e$!'#,# treb!e "# '&)#"'# "! +r!e,e !&r!?!r! '#re re#(# "# 0!e

#')r$#te !& &e,e re&te '#r$!)%#"',#re.

S# '&)#"'# "e&e,e ")',! ')+e&"#t "! #"r!,e $e +r)0!,#/!e +e&tr # !+!e$!'# !&tr#re#

!& "t#$! $e')+e&"#t.

S# '&)#"'# +r!e,e !&r!?!r! '#re treb!e"' #')r$#te !&tr-) ,!+)t!!e "# "!&')+#* #"r! $e

re#&!#re &e'e"#re 7re"+!r#t!e Qr# ,# r#Q "# Qr# ,# &#"Q8.

R/%&% $3*3(,(,* * *5+*@*+,$ /%$*%/+ & $+*/'$(*, *3;,)*$7

-"e$#re# $rer!!*

-"+r#%eere# 0&'t!!,)r %!t#,e

-#"!r#re# &e! #,!e&t#t!! ")r $!er#b!,e

-#?t#re# +#'!e&t,! !& "#t!"0#'e#re# &e%)!,)r 0&$#e&t#,e

-+re#t!re# +#'!e&t,! +e&tr e/#!&#r! r#$!),)!'e

-re'),t#re# +r)$"e,)r b!),)!'e +e&tr ,#b)r#t)r

-#$!&!"tr#re# tr#t#e&t,! e$!'#e&t)" +re"'r!"

-e$'#t!# +#'!e&t,! +r!%!&$ +re%e&!re# re'!$!%e,)r

-+r)0!,#/!# !&0e't!!,)r +e&tr 'e! ' ,e(!&! %#,%,#re



CAPITOLUL III- DESCRIEREA TE"NICILOR IMPUSE DE AFECTIUNE

E,e'tr)'#r$!)r#0!# 7 EG 8 4& '#r$!)+#t!# 'r)&!' !"'e!' +r!& e/#!&#re#

')+,ee&t#r $e b#( 4& $!#&)"t!', 5! e%#,#re# '#r$!)+#t!e!* re+re(!&t ) et)$

!+)rt#&t 4& +)0!$# &e! "e&"!b!,!t3! #! re$"e ')+#r#t!% ' #,te et)$e

7 e')'#r$!)r#0!# * te&!'! &',e#re 8 * EG-, 4& 12 $er!%#3!! 0!!&$ te&!'# $e b#(.

ELECTROCARDIOGRAMA STANDARD

E,e'tr)'#r$!)r## "t#&$#r$ ' 12 $er!%#3!! 4&re!"tr#t 4& re+#" e"te &)r#, ,#

#+r)/!#t!% ?t#te $!& +#'!e&3!! ' #&!& +e't)r#, t!+!' * $#r +)t e/!"t# "e&e #,e &!

!&0#r't !)'#r$!' %e'! . C t)#te ' #&)#,!!,e $e re+),#r!(#re * #$!' )$!0!'r! #,e &$e! T

5! "ee&t,! ST 5! t,brr! #,e ')&$'er!! !&tr#%e&tr!',#re 4& re+#" * "&t "e"t!%e +e&tr

'#r$!)+#t!# !"'e!' * e,e "&t &e"+e'!0!'e * 4&tr'6t +)t 0! 4&t6,&!te 5! 4& b),! #,e +er!'#r$,! *

!)'#r$,! * b),! %#,%,#re "# 4& #&/!et#te * )$!0!'r! $e +)"tr * $r)r! "# b),!

e")0#!e&e. M)$!0!'r!,e t!+!'e #,e "ee&t,! ST

5! &$e! T '#re 4&")3e"' e+!")#$e,e $e #&!& +e't)r#, 5! $!"+#r $+ #'ee# "&t #!

"+e'!0!'e . M)$!0!'r!,e 'e,e #! '#r#'ter!"t!'e !&',$ $e&!%e,#re# "ee&t,! ST * '#re e"te

#"e&t)#re 4& t)#te '#(r!,e 4& t!+, &! te"t $e e0)rt . See&t, ST e"te $e )b!'e!



0!(!)+#t),)!' #! +3!& "e%er * !#r ,e(!&e# e,e'tr)'#r$!)r#0!' * re+re(e&t#t $e )$!0!'r!

#,e "ee&t,! ST * ) !"'e!e #! "e%er.

Abe,e t!+r! $e )$!0!'r! "&t 0re'%e&t '#r#'ter!(#te 4& +r#'t!' $re+t t,brr! $e

re+),#r!(#re * $e5! 4& +r)$'ere# #be,)r !&ter%!& 5! )$!0!'r! #,e $e+),#r!(r!! !)'#r$!'e.

D#t)r!t 0#+t,! ' #t6t )$!0!'r!,e "ee&t,! ST*'6t 5! #,e &$e! T tr#$' !"'e!#

!)'#r$!' * #be,e "&t 0re'%e&t $e&!te 4& +r#'t!' )$!0!'r! !"'e!'e * 0r 4&" # "e

0#'e !&t)t$e#&# +re'!(#re# +re(e&3e!

M$3&+$+,$ 3* /($+,$ +,3'*+$(*,*

De0!&!3!e@ - +r)'e", +r!& '#re "e re#,!(e#( "'!br!,e #()#"e.

S')+@

St#b!,!re# $!#&)"t!',!.

E%#,#re# "tr!! b),&#%,!.

Ob"er%#re# e%),3!e! b),!!.

Ob"er%#re# e0e'te,)r e$!'#e&te,)r.

I&$!'! 4& #+#r!3!# &)r ')+,!'#3!!.

E,ee&te $e #+re'!#t@



A+re'!ere# 'e,)r,#,te e,ee&te #,e 0&'3!e! re"+!r#t)r!! "e 0#'e +r!& "!+,# )b"er%#re #

!5'r!,)r re"+!r#t)r!!.

N)t#re#@

1 ,!&!e +e 0)#!# $e te+er#tr 1 %#,)#re.

U&!re# %#,)r!,)r "''e"!%e CURBA RESPIRAWIEI.

& &e,e $)'e&te e$!'#,e &)t#re# "e 0#'e '!0r!' 4&")3!te $e '#r#'ter!"t!'!,e

re"+!r#3!e!.

L# $!"+&ee "e &)te#( )r#r,* !&te&"!t#te#* t!+,* e%),3!# 4& t!+.

I&ter+ret#re@

Re"+!r#3!# &)r#,@ "+,* #+,* re,#t* +r)0&$* "!etr!'.

Re"+!r#3!# +#t),)!'@ $!"+&ee* r!t &ere,#t* "+er0!'!#,* 4&'r'#t* ())t)#".

Fre'%e&3# &)r#, 4& 0&'3!e $e %6r"t.

Fre'%e&3# +#t),)!'@

T#!+&ee 7+),!+&ee8 0re'%e&3 're"'t.

Br#$!+&ee 0re'%e&3 "'(t.

A+&ee #b"e&3# re"+!r#3!e!.

D!"+&ee re"+!r#3!# re)#!e* $!0!'!, 7"ete $e #er8.



M$3&+$+,$ 3* /($+,$ '&%3&%&*

De0!&!3!e@

Re+re(!&t "e&(#3!# $e 5)' #rter!#, +er'e+t ,# +#,+#re# &e! #rtere "+er0!'!#,e +e &

+,#& $r.

Pre"!&e# e/er'!t#t $e '),)#&# $e "6&e "!&'r)& ' #'t!%!t#te# !&!!! +er'e+t "b

0)r $e 5)' "# +,"#3!e

S')+@

Ob3!&ere# $e !&0)r#3!! +r!%!&$ "t#re )r0)-0&'3!)&#, # !&!!! 5! %#"e,)r. St#b!,!re#

$!#&)"t!',!.

E%#,#re# e%),3!e! b),!!* # "tr!! e&er#,e.

E,ee&te $e #+re'!#t@

R!t!'!t#te 7re,#r!t#te8.

Fre'%e&3 7r#+!$!t#te8.

Ce,er!t#te.

A+,!t$!&e 7!&te&"!t#te8.

Te&"!&e 7%),8.

L)', "rr!!@



P"!!'.

F!(!' re+#" 0!(!' 5! +"!!' 1: !&te.

Te&!'#@

Se "+#, 6!&!,e. Se 0!/e#( %6r0, $eete,e +#,+#t)#re #,e 6!&!! $re+te 7!&$e/*

e$!"* !&e,#r8 +e tr#!e't, #rtere! r#$!#,e 4br3!56&$ #&tebr#3, ' +),!'e,e.

Se e/er'!t ) 5)#r +re"!&e #"+r# +erete,! #rter!#, 5! "e +er'e+ (%6'&!tr!,e +,!&e

#,e +,",! t!+ $e 1 !&t 7"e +)#te "r# 5! &#! 1: "e'&$e +,", re,#t* %#,)#re# "e

4&,3e5te ' 5! "e )b3!&e %#,)#re# &)r#,8.

N)t#re@

C!0r!' 4& '#!et > "e &)te#( !&',"!% )r#* $#' +,", # 0)"t "r#t 4& 0r!")&* 0#'!e",

er# r)5 et'.

Gr#0!' 4& 0)#!# $e te+er#tr 8+e&tr 0!e'#re ,!&!e )r!()&t#, "e ")')te"' +,"#3!! >

#$!' %#,)r! +tr#t8.

U&!re# +&'te,)r CURBA PULSULUI.

I&ter+ret#re@

N)r#,@ +," re,#t* b!&e btt* r!t!'* "!&'r)&* 'e,er!'.

P#t),)!'@ +," ",#b* !+er'e+t!b!,* #r!t!'* #"!&'r)&



M$3&+$+,$ 3* /($+,$ (,3*&** $+(,+*$%,

De0!&!3!e@

TA +re"!&e# e/er'!t#t $e "6&e,e '!r',#&t #"+r# +ere3!,)r #rter!#,!.

S')+@ - E%#,#re# 0&'3!e! '#r$!)%#"',#re* e%),3!e! b),!!* # "tr!! e&er#,e.

L)', "rr!!@ - Arter# er#,.

M#ter!#,e@

Te&"!)etr ' er'r 7R!%#-R)''!8* "0!)#&)etr* te&"!)etr e,e'tr)&!'*

)"'!,)etr P#')&.

Stet)"')+ b!#r!',#r. T#+)& ' #,')), 7+e&tr $e(!&0e'3!e ebr#&e! "tet)"')+,!

5! # ),!%e,)r.

F)#!e $e te+er#tr. Cre!)& r)5.

Met)$e@ - P#,+#t)r!e. A"',t#t)r!e. E,e'tr)&!'.

Pret!re# b),&#%,!@

P"!!' "e #&&3 b),&#%, 5! "e e/+,!' te&!'# 74& tere&! "''!&3! 5! +e 4&3e,e",

,!K "e e/+,!' et#+e,e te&!'!!8.

F!(!' re+#" 0!(!' 5! +"!!' 1: !&te. B),&#%, "e #5e#( 4& +)(!3!e '))$* '

br#3, re,#/#t. De +re0er# "r#re# "e %# 0#'e 4&#!&te# "er%!r!! e"e!* "# ,# 9 )re $e ,#



E%!$e&3!#( #+,!t$!&e# )"'!,#3!!,)r #rter!#,e 'e "e )b"er% +e '#$r#&, r#$#t #,

)"'!,)etr,! P#')&.

Se $e"')+er ebre,e "+er!)#re 5! !&0er!)#re > 4br'!&te# & treb!e " 0!e

"tr6t.

M#&5et# "e 0!/e#( ,# &!%e,r!,e $)r!te +e ebre,e b),&#%,!* $e &$e +,"#3!!,e "e

tr#&"!t ,# #&)etr.

Se +)+e#( #er 4& #&5et +6& ,# $!"+#r!3!# +,",! +er!0er!' > '6&$ +re"!&e#

$e+5e5te te&"!&e# #rter!#, #/!.

Se '!te5te )"'!,#3!!,)r +e '#$r#&, #&)etr,!.

Se "'#$e +re"!&e# $!& #&5et ' 1= H 5! "e '!te5te $!& &) %#,)#re# )"'!,#3!!,)r

#rter!#,e.

Se 0#' "'$er! 5! '!t!r! "''e"!%e +6& "e "e5te %#,)#re# #/! # #+,!t$!&!!* 'ee#

'e "e &e5te !&$!'e )"'!,)etr!'.

Se #+re'!#( %#,)r!,e &)r#,e 4& ,!!te 0)#rte ,#r! > %#r!#b!,e $e ,# !&$!%!$ ,# !&$!%!$.

V#,)r! &)r#,e@

Y 9-< $!%!(!&! ,# ')#+".

Y 2- $!%!(!&! 4& 19 "+er!)#r #b.



A$,t 12== H + !&t.

F#'t)r!! '#re !&0,e&3e#( te&"!&e# #rter!#,@

F#'t)r! b!),)!'!@

Y V6r"t# > ,# ')+!,, !' TA e"te #! !' $e'6t ,# #$,t.

Y Deb!t, '#r$!#'* 0)r3# $e ')&tr#'3!e # !&!!!* e,#"t!'!t#te# 5! '#,!br, %#"e,)r*

%6"')(!t#te# "6&e,!.

Y S)&, > "'#$e TA #rter!#,. E0)rt, 0!(!' > 're5te TA.

Y A,!e&t#3!# > 4& t!+, $!e"t!e! TA 're5te 5)r.

F#'t)r! +"!),)!'! > e)3!!* "tre"* #&/!et#te.

F#'t)r! ")'!#,! > e$!, #b!#&t* 0r!, "# ',$r# e/'e"!% 70r!, +r)$'e

%#")')&"tr!'3!e 5! 're5te te&"!&e# #rter!#,* !#r ',$r# +r)$'e %#")$!,#t#3!e 5! "'#$e

te&"!&e# #rter!#,8* ',!#.

Ob"er%#3!!@

M"r#re# "e 0#'e ,# #'e,#5! b),&#% ' #'e,#5! #+#r#t* 4& #'e,e#5! ')&$!3!!. M#&5et# %#

0! b!&e 0!/#t +e br#3, +#'!e&t,!.

M"r#re# "e 0#'e $!!&e#3# 5! "e#r#* $!& )r 4& )r 74& "er%!'!! ATI8* ,# $!0er!te

!&ter%#,e re')#&$#te $e e$!'.



) A5e(#re# b),&#%,! 4& $.$. 5! !&ter(!'ere# )r!'r! e0)rt > !&',"!% %)'#,.

) P"!)ter#+!e.

Pre%e&!re# #,t)r ')+,!'#3!!@

Se$#re# $rer!! > ,# !&$!'#3!# e$!',! ' M)r0!& 1 0 !.. "# ".'.* M!#,!& !.. $#'

"&t $rer! #! !'! "e +)#te 4&'er'# #$!&!"tr#re# $e A,)'#,!&* F)rtr#,* C)$e!& > !.%.

Se rre5te te&"!&e# #rter!#,* +,",* re"+!r#3!#* ',)#re# 5! #"+e't, tee&te,)r.

Se !&"t!t!e $#' e"te +)"!b!, +er0(!e ' "er ,')(#t :;* De/tr#&* M#r!"#&*

He!"''!&#t $e H!$r)')rt!()&.

Se #$!&!"tre#( X!,!& > $e ( '#r$!)e&.

O/!e&)ter#+!e.

S'rt#re# t!+,! +6& ,# !&ter&#re# 4& "+!t#,@

Tr#&"+)rt re&t ' &!t#te )b!, ')r)&#r!#&.

P+*)&% $@&(/+ * $5*$ ',(/+$%$

De0!&!3!e@

A&!&# +e't)r#, e"te ) "0er!&3 !)'#r$!' $eter!&#t $e & $e(e'!,!br 4&tre

&e'e"!t#te# )/!e&r!! !&!!! 5! #+)rt, ')r)&#r!#&.



Se$#t!%e #,e "!"te,! &er%)".

A"!r#re# ")&,! $e &)#+te > b#rb!tr!'e* br)r!* Re(er+!&* ',)r+r)#(!&.

Cr $e ",b!re +e&tr b),&#%!! )be(! > re$'ere# r"!!,)r $!& #,!e&t#3!e ,# <=-=

+e (!.

V#")$!,#t#t)#re > M!)0!,!&* +#+#%er!&* &!tr),!'er!&.

TE"NICA RESPIRATIEI ARIFICIALE

- "e #"e#(# b),&#%, !& $e'b!t $)r"#,* "#,%#t)r, "e +,#"e#(# &! e&!&'! ,# '#+, %!'t!e!

,# +#rte# ,#ter#,# "t#&# "# $re#+t# "! e/e't# et)$# re"+e't#&$ t!+!! 0)r,e! HELP.

1. H!+erte&"!&e# '#+,! - "e +)#te e/e't# +r!& $)# 728 +r)'e$ee@

- "e tre'e ) #&# "b #t, b),&#%,! "! ! "e r!$!'# 'e#0#* !#r ' # $)# #&#*

#"e(#t# +e 0r&te* "e !+!&e '#+, "+re "+#teK

- "#,%#t)r, #+,!'# ) #&# "b 're"tet* !#r # $)# "b b#rb!# b),&#%,! "! !! !+!&e '#+, "+re

"+#te.

2. E,!ber#re# '#!,)r re"+!r#t)r!! "+er!)#re.

M#&e%re,e +r!& '#e "e +)#te )bt!&e e,!ber#re# '#!,)r re"+!r#t)r!! "e +)t e/e't# +r!&@



- ' #&# "t#&# - !& #'e"t '#(* #&# "t#&# e,!ber#t#* "#,%#t)r, +)#te #"ter&e +e"te r#

%!'t!e! & #ter!#, $e +r)te't!e* #+)! +e&"e#(# &#",K

- ' +e&"e "+e'!#,e $!& tr"# $e +r! #?t)r e$!'#,.

R,3'*+$(*$ #5&+$ %$ 5&+$#@

- "#,%#t)r, tr#e #er !& +!e+t 7!&"+!r#t!e +r)0&$#8K

- !"! ret!&e re"+!r#t!# !& !&"+!r#t!e +r)0&$# 7#+&ee %),&t#r#8K

- #+,!'# re+e$e r# ,#r $e"'!"#* b(e,e +e"te r# !&tre$e"'!"# # %!'t!e! ' +tere #er,

$!& +,##&!! "#! !& '#!,e re"+!r#t)r!! #,e %!'t!e!K

- "#,%#t)r, "e r!$!'#* 0#'e ) &)# !&"+!r#t!e 7!& #'e"t t!+ ,#"# ,!bere &#", "! r#*#er, !e"!&$

#"t0e, $!& +,##&!! %!'t!e!8* #+)! !&"0,# $!& &) #er !& +,##&!! %!'t!e!*re+et#&$ #'e#"t#

"''e"!&e $e 1 - 1< )r! !&tK

- ,# #$,t! "e !&"0,# ' 0)rt#* ,# ')+!! #! ")r* !#r ,# "#r! 0)#rte ")r +e&tr # & "e +r)$'e

r+tr! #,%e),#reK

- !& t!+, !&"0,#t!e! "e !&$re#+t# +r!%!re# #"+r# t)r#'e,! %!'t!e!* +e&tr # #+re'!# e0!'!e&t#

re"+!r#t!e!.

C)&tr#!&$!'#t!!@

- r# %!'t!e! & +)#te 0! $e"'!"#K



C)&tr#!&$!'#t!!,e #"#?,! '#r$!#'@

- ,e(!&! r#%e #,e +erete,! t)r#'!' ' 0r#'tr! ')"t#,eK

- e)r#!e #"!%# !&tr#+er!'#r$!'# "! t#+)&#$# !&!!!K

- eb),!e #()#"# #"!%#.

A''!$e&te@

- $#'# +)(!t!# '#+,! %!'t!e! & e"te ')re't# 7& #"!r# ,!bert#te# '#!,)r #er!e&e8

#er, !&"0,#t +)#te ,# '#,e# $!e"t!%# +r)%)'#&$ $!,#t#re# "t)#',! "! 're!&$

+er!'), $e %#r"#tr! ' !&&$#re# '#!,)r #er!e&eK

- "e %# #+#"# $!& t!+ !& t!+ +e e+!#"tr !& t!+, e/+!r#t!e! +#"!%e* "e %# ')&tr),#

"! ')re't# +)(!t!# $e !+erte&"!e # '#+,! ,# #$,tK

- '#$ere# ,!b!! "! !&e0!'#'!t#te# !&"0,#t!!,)r.

REGULI DE ADMINISTRARE A MEDICAMENTELOR

1. Re"+e't#re# e$!'#e&t,! +re"'r!" $e e$!'.

2. I$e&t!0!'#re# e$!'#e&t,! +re"'r!" $+# et!'et#* 0)r# $e +re(e&t#re*',)#re* !r)"*



19. A$!&!"tr#re# !e$!#t# # e$!'#e&te,)r $e"'!"e 70!),e* "+)(!t)#re8.

1. Pre%e&!re# !&0e't!!,)r !&tr#"+!t#,!'e"t! +r!& re"+e't#re# "tr!'t# # $)# re,! $e b#(#@

- "+#,#re# +e #!&! !&#!&te "! $+# #$!&!"tr#re# tr#t#e&te,)rK

- t!,!(#re# "er!&!! !&$!%!$#,e.

IN!ECTIA INTRAMUSCULARA

De0!&!t!e@ Re+re(!&t# !&tr)$'ere# &)r "),t!! !()t)&!'e* ,e!)#"e "# "b"t#&te

'),)!$#,e !& "tr#t, "',#r ' #?t)r, &! #' #t#"#t $e "er!&#.

S')+@ U&!' - ter#+et!'@ !&tr)$'ere# $e e$!'#e&te !& )r#&!".

L)', $e e,e't!e@

- re!&e# "+er)-e/ter&# 0e"!#r#* $e#"+r# tr)#&ter,! #reK

- 0#t# e/ter&# # ')#+"e!* tre!e# !?,)'!eK

- "'!, $e,t)!$.

Te&!'#@

1. Pre#t!re# #ter!#,e,)r "! # !&"tre&t#r,! &e'e"#r.

2. Pre#t!re# +"!!'# "! 0!(!'# # b),&#%,!@

- ! "e e/+,!'# &e'e"!t#te# te&!'!!K



- "e 'ere b),&#%,! "# !&'!$# "! "# $e"'!$# +&, $e '#te%# )r! "! "# r##&#

' e, !&'!"@

[ #%#&$ "er!&# !& #&# $re#+t# !&tre +),!'e "! 'e,e,#,te $eete '

!&$e/, $re+t "e 0!/e#(# #b), #',! #t#"#tK

[ ' !&$e/, #!&!! "t#&! "e +#,+e#(# !#r#"! ,)', +&'t!e!* !#r '

+),!'e,e "e 0!/e#(# %e&# ,# - : ' "b ,)', #,e" +e&tr +&'t!)&#re*

re#,!(#&$-"e ) ")#r# ')+re"!e "! #+)! tr#'t!&e # te"tr!,)r !& ?)"K

[ "e !&tr)$'e #', !& !?,)', %e&e!* $e-# ,&, tr#!e't,! ,)&!t$!&#,K

[ "e "!te #', tre'#&$ +r!& "tr#t, $e +!e,e re(!"te&t "! #+)! +r!& +erete,e %e&e!* +t!& #!

e,#"t!'.

I& #'e"t )e&t "e !+!&e #', $e-# ,&, #/,! ,)&!t$!&#, ,# ) #$#&'!e

$e 1 - 1*: '.

[ ' #&# "t#&# "e tr#e !&'et +!"t)&,* #"+!r#&$* $#'# #', #+#tr&" !& %e&#* !& "er!&#

#+#re# "#&eK

[ "e ')&t!&# te&!'# !& 0&'t!e $e "')+, r#r!tK

[ !& '#( $e "#&er#re* "e ')&t!&# #"+!r#re# "#&e,! +#&# ,# e/tr#ere# '#&t!t#t!! $)r!te* !#r



"e retr#e* "e #"+!r# +e&tr # %er!0!'# $#'# # +#tr&" $!& &) !& %e&# "! $#'# &

+r)$'e e/tr#%#(#re $e "#&e* "e ')&t!&# )+er#t!&e#K !#r $#'# "! !& #'e"t '#( #+#re )

'),)r#t!e %!),#'ee* +&'t!# "e !&trer+e.

- F,eb#,!e - $rere %!e $e-# ,&, tr#!e't,! %e&)" - #+#r!t!# e! "e $#t)re#(#

!&tr)$'er!! +re# r#+!$e # "err!,)r "# #'t!&!! !r!t#&te # $!0er!te,)r "b"t#&te* ' #r 0!

',)rr# $e N# b!+ert)&# 22;K

- Ne'r)(# te"tr!,)r - #+#re '# r#re # !&tr)$'er!! +#r#%e&)#"e # "),r!,)r

!r!t#&teK

- L!+)t!!# - +!er$ere# $e '&)"t!&t#* $e "'rt# $r#t#* ' !&trer+ere# 0&'t!e! $e

re,#t!e "! +#"tr#re# 'e,)r,#,te 0&'t!! #,e )r#&!",! "!* '#re +)#te "# #+#r# 0!e $#t)r!t#

0r!'!!* 0!e $#t)r!t# &! tere& +"!!' e)t!%* "#* !& '#(r!,e r#%e* '# r#"+&" # )r#&!",! ,#

$!0er!te "b"t#&te.

L!+)t!!# e"te #&&t#t# $e +#,)#re# 0ete! !&$!%!$,!* #ete,!* tr#&"+!r#t!!.

Se !&trer+e +&'t!#* "e #&&t# $e re&t# e$!',.



∼ U$ ORS 3,5),(&% ST * &$ T re+re(!&t e/+re"!# e,e'tr!'# activit ăţii ventriculare.

O3,+$=** ∼ I&ter+ret#re# tr#"e,! e"te 0't $e e$!' 4& ,!&# $#te,)r',!&!'e.



CAPITOLUL IV- PLANUL DE INGRI!IRE AL PACIENTULUI CU CARDIOPATIEISC"EMICA

D#te 0!/e@ Ne@ T.Pre&e@ A.

N#3!)&#,!t#te@ r)#&#V4r"t#@ 2 #&!Gret#te@ <

&,3!e@ 1< 'Se/@ MRe,!!e@)rt)$)/#

D#te %#r!#b!,e@D)!'!,!@ ?$. Pr#)%#

D#t# !&ter&r!!@ 1.=.2==<

D#t# e/ter&r!!@ 2.=.2==<

D!#&)"t!' e$!'#, ,# !&ter&#reC#r$!)+#t!e !"'e!' 'r)&!'*!+erte&"!&e #rter!#, e"e&3!#, "t#$!, II*PTCA +eADA 4&#&te'e$e&te*#&!& !&"t#b!,*!+ertr!,!'er!$e!e*0e&)e&e $e !&"0!'!e&3%e&tr!',#r "t4&.A&te'e$e&te ere$)'),#ter#,e-## '#r$!)+#t!e !"'e!'-$e'e$#t-t#t, $e'e$#t $e +&e)&!e



D!"+&ee ,# e0)rt* 0#t!#b!,!t#te* +#,+!t#3!!* #&/!et#te* r!"' 're"'t 0#3 $e !&0e'3!!* t"e*

!+erte&"!&e #rter!#,* rete&3!e r!&#r.

Pr)b,ee,e +#'!e&t,!@

- #,ter#re# re"+!r#3!e!*

- +)te&3!#, $e ')+,!'#3!!*

- t"e '!&!t)#re*

- )b"tr'3!# '!,)r re"+!r#t)r!!*

- #,ter#re# 0&'3!e! '#r$!#'e*

- #,ter#re# $!re(e!*

- $rer! +re')r$!#,e ' '#r#'ter $e #+"#re 5! $e #r"r '#re #+#re +re$)!&#&t $!!&e#3#

5! 'e$e#( ,# &!tr),!'er!&*

- 0#t!#b!,!t#te ,# e0)rtr! !'! #")'!#te ' $!"+&ee*

- +#,+!t#3!!.

C)&"t!t3!e &)r)"te&!'*0#'!e" #+#t!'*tee&te 5! ')#"e &)r#, '),)r#te* t)r#'e

e0!(e#t)"* MV $!!&#t b!,#ter#,* AMP 4& ,!!te &)r#,e +er't)r!'* SA "+#3!, :

!&"0!'!e&3 '#r$!#' "t4& +e LMC ())te '#r$!#'e r!t!'e* +," +er!0er!' +re"e&t +4& 4&

#%#,*#b$)e& $e#"+r# +,#&,! /!0)+b!#&* &e$rer)" ,# +#,+#re "+er0!'!#, 5!



$!#&)"t!' $e !&r!?!re )b!e't!%e !&ter%e&t!! e%),t!eA,ter#re# 0&'3!!,)r re"+!r#-t)r!! #&!0e"t#t +r!&@$!"+&ee ,#e0)rt*0#t!#b!,!t#te #")'!#te' +#,+!t#3!!.

A"!r#re# &e%)!! $e# re"+!r#.P#'!e&t, "re"+!re &)r#,*b!&e +e &#"*" #!b)+)(!3!e '#re "0#%)r!(e(e re"+!r#3!#.

A"!"te&t# e%#,e#( "!t#3!#*#$!&!"tre#( )/!e& +e#"' 5!%er!0!' "#tr#3!# )/!e&,! ' +,")/!etr,.&$e+rte#(*,#&e%)!e*"e're3!!,e &#(#,e*e(e5te #er, $!& 4&'+ere*#"!r &#+)rt "0!'!e&t $e ,!'!$e +e 2$e )re.I&"t#,e#( +#'!e&t, 4& +)(!3!e "e!5e(4&$

P#'!e&t, re"+!r #!5)r.Re"+!r#3!# re%!&e,# &)r#

P)te&3!#, $e ')+,!'#3!!$#t)-r!t "'$er!! $eb!t,!'#r$!#'#&!0e"t#t +r!&@$rere*$!"-')&0)rt*!&t),er#&3 ,#e0)rt*r!"' 're"'t 0#3 $e!&0e'3!!

P#'!e&t, " 0!ee'!,!br#t +"!!'*" +re(!&te re(!"te&3're"'t 0#3 $e!&0e'3!!.

A"!"te&t# #"!r +)(!3!e #&t#,!'*4&$r +#'!e&t, "t!,!(e(ete&!'! $e re,#/#re*+rete5te +"!!' 4& %e$ere#)r!'re! te&!'! $e4&r!?!re.&%#3 +#'!e&t, " e%!te "'!br!,e br5te $e te+er#-tr 5! $!"'3!!,e 4& r+r!*#,)er#3!#

P#'!e&t, 4&3e,ee&e%)!,e +e '#re treb!e5 ,e #+,!'e 5! "e"+&e 4&$rr!,)r#"!"te&te!

A+#re 'r!(# $e #&!&#&!-0e"t#t +r!&@"e&(#3!e

$e "0)-'#re*t"!&"!"te&t*$!"+&ee*re"+!r#3!#"e #''e,ere#( ,#29re"+!r#3!! +e !&t $!&'#(##&/!et3!! 5!"tre",!.Ve&e,e ?,#re"e e%!$e&3!#-(*$e%!&tre"'e&te

A"!r#re# &e%)!! $e# re"-+!r#.A"!r#re#

&! ',!#t$e"!r#&3*+#'!e&t," +re-(!&te '!re"+!r#t)r!! +er-e#b!,e.S "e#e,!)re(e 'r!(#$e#&!&

&%#3 +#'!e&t, " t5e#"'*" e/+e't)re(e7,# &e%)!e8 5!"'),e'te(e "+t#.S0t!e5te " re"+!re +r)0&$ 5! r#r.Ue(e5te

#er, $!& 4&'+ere ' #+ #,')),!(#t*#"+!r"e're3!!,e br)&5!'e7,#&e%)!e8*4&%#3 +#'!e&t, " 0#'!&#"t!' re"+!r#t)r!e*#"!r +)(!3!e 5e(4&$ "# "e!-5e(4&$.A$!&!"tre#( tr#t#e&t, +re"'r!" $ee$!'7#&t!t"!%e*e/+e't)r#&te*br)&)$!,#t#t)#re#8*N!tr),!'er!&"b,!&-#, 1 t#b,et*Met)+r),), := $e $) )r! +e (!.

St#re# +#'!e&t,! "e#e,!)re#(*t"e#

'e$e#(

L# "'rt t!+ $e ,#!&"t!t!re#tr#t#e&t,! +#'!e&t,r"+&$e &e#t!%

+r!& #,ter#- re# 0&'3!e!'#r$!#'e #&!-0e"t#t +r!&@t,brr! $er!t'#(#te $e e)3!! 5!%4r"t#4&#!&t#t #

& %e$ere# re,r!!0&'3!e!'#r$!#'e&)r#,e "e %#

0#'e')+e&"#re#')r$,!.

M)&!t)r!(e#( +#'!e&t, ' rr!re# te&"!&!! #rter!#,e5!0re'%e&3e! '#r$!#'e.A$!&!"tre#( tr#t#e&t, !&$!'#t $ee$!'*&)te#( 4& 0)#!# $e )b"er%#3!e "'!br!,e

+r)$"e*e$!'#3!# #$!-&!"tr#t 5! ,!'!$e,e !&er#te 5!e,!!&#te.Se %# e0e't# e,e'tr)'#r$!)r# $e ')&tr), +r!&#+,!'#re# e,e'tr)(!,)r &"e ' e,*+e ebre 5! +re')r-$!#,.

P#'!e&t, r"+&$e +)(!t!% ,# e$!-'#e&te 5! re%!&e 4&

r!t"!&"#,.E/+,)r#re#E*.G.-,! # $e'r"0-r +r)b,ee 5!



+#'!e&t,!. re(,t#t, e"te 0#-%)r#b!,

A,ter#re# $!re(e!#&!0e"t#-t +r!&@'re5tere#te&"!&!! #r-ter!#,e 5!rete&3!e! r!&#re

Re,#re# 0&'3!e!re&#,e*re"-t#b!,!re#te&"!&!! #rter!#,e

A"!"te&t# #$!&!"tre#( e$!'#e&te +re"'r!"e $ee$!'7$!ret!'e@Fr)"e!$ = 8Urre5te te&"!&e# #rter!#, +r!& "r#re*0re'%e&3#'#r$!#'*")#r !&e"t!#-e/'re3!#*")#r e/#'t$!re(#

P#'!e&t, r"+&$e +)(!t!% ,#tr#t#e&t*"e"t#b!,!(e#(.



SUPRAVEGHEREA FUNCTIILOR VITALE

Data

233/T.A 6uls 0esp. T°C Diureza Scaun

&(.3* &(3<&23

4*

42

&'

&/

(,(

(,4&2*3 ml

N

&/.3* &*3<&33

/4

/'

&/

&(

/,/

/

&33

ml=

&4.3* &>3<43

/>

/

&4

&/

(,'

(,4

&*3

ml=

&'.3* &&3</3

/

/3

&/

&/

(,'

/

&>*3

ml=

23.O* &&*</3

('

('

&4

&4

(,(

(,4

&>33 ml =

?A1=@% D %ABO0ATO0

#amen cerut 1od de recoltare 0ezultate 5alori normale

5S 3,> ml citrat de =a ,4,se aspira

sange pana la 2 ml.

5S><&2mm

5S&7&3mm<h

/7&*mm<h%eucocite

emoglo!inaInteparea pulpei degetului.Serecolteaza 2 ml sange pe cristalede DTA.

%&3333mmc

g!&

%>23374333

g!&>7&(g



Trom!ocite

ematocrit

T2&*33

tc>2

T&*37>33333mmc

tc>37>*

i!rinogen 3,* ml citrat de =a,4 si >,* mlsange

&43mg 2337>33mg

8licemie 2 ml sange pe lorura de =a > mg 8&3mg 8437&23mg

@ree

Creatinina

Acid uric

*7&3 ml sange,punctie venoasa

@43 mg

C2,>mg

A.@&72mg

@237>3mg

C3,(7&,2mg

A.@27(mg

Colesterol *7&3 ml sange,punctie venoasa 2(3mg &437243mg

#amen sumar de urina 0ecipiente sterile,din etulmilociu.

=ormal

nzime *7&3 ml,punctie venoasa

T8O2*@<%

T86&,*@<%

T8O2723@<%

T8627&(@<%

AD1I=IST0A0A 1DICA1=T%O0

Data 1edicamente 1od de administrare

&(.3*Dipiridamol

Diazepam

1ialgin

& t!<oral

&t! seara<oral

2ml iv



eparina &33 @I<

&/.3*

Aspirina

Betaloc

Trom!ostop

Diazepam

E oral

&33mg

37372 oral

3737& seara oral

&4.3*

Betaloc

Aspirina

Trom!ostop

=iedipin

&33 mg

E oral

37372 oral

2& oral

&'.3*

Captopril

Betaloc

Trom!ostop

Diazepam

&3mg oral

&33mg

37372 oral

3737& seara oral

23.3*

Betaloc

Trom!ostop

Diazepam

&33mg

37372 oral

3737& seara oral

INVESTIGATII PARACLINICE

Data #amene curente 6regatire pt e#amen Ingriiri dupa e#amen



&(.3* F8

Bolnavul va i asezat in decu!it dorsal,isi varela#a musculatura.

1ontarea electrozilor:

-pe membre:rosu7mana dreapta

gal!en7mana stanga

negru7picior drept,verde7picir stang.

7precordial

5I7sp > intercostal drept

527sp > intercostal stang

57intre 52 si5>

5>7sp * intercostal,pe linia medioclavicularastg

5*7sp * intercostal stg pe linia a#ilaraanterioara

5(7sp * intercostal stg pe linia a#ilaramilocie.

=u necesita ingriiri speciale.

&/.3*

0tg toracic

F8

&4.3* F8

&'.3*

0tg toracic

F8



$,?,



R,&',+$+,$ /%$*%/+ $+*$* '+* $%*),($(*,

A"t#(! "+&e '#te)r!' NU re"tr!'t!e! $e ,!'!$e* #+,!'#t#* 0#r# $!"'er&##&t* !&

)r!'e '#( $e #0e't!&e '#r$!#'#* #! #,e" '# ## ,#r# $e $!ret!'e +er!te & re!

#,!e&t#r %#r!#t* re,#t!% ")r $e re"+e't#t. De'! %) re')#&$# b),&#%,! '#r$!#' )

#,!e&t#t!e %#r!#t#* b)#t %!t#!&!(#t#* )0er!t# #tr##t)r ,# 0!e'#re #"# 7 - : (!8* ' &

#+)rt '#,)r!' +e #"r# ')&"#t)r,! e&eret!' +e '#re-, +er!te !&!# #! ,t "# #! +t!& ')+e&"#t#. I& IM* re!, !$r),#'t#t $e

#+r)/!#t!% 1=== - 1:== ,(! 7'e#!*

,!)&#$#* ,#+te* b,!)&* "' $e 0r'te8 $!& +r!e,e (!,e ! "e %)r #$##* !& (!,e,e r#t)#re@

'ere#,e* '#rt)0! 0!ert!* +!re* & ) )#,e* "+# $e ,ee* br#&(# $e %#'!.

D+# 0#(# #'t#* "# '!#r $e ,# $!#&)"t!'#re# IM !& 0)re,e ")#re* re!, %# 0! $e

1=== - 12=== '#,)r!!* 0)r#t $!&@ := +r)te!&e* 2= r#"!!* 1:= (##rr! 7"+e* 'ree $e ,ee* !#rt* br#&(# $e %#'!* b$!&'!* +!rer! $e

,ee* 0#!&)#"e* et'8.D!& # 2-# "#+t##&#* re!, b),&#%,! ' IM %# 0! !& ')&t!&#re !+)'#,)r!'*

!+),!+!$!'* &)r),'!$!'* !+)")$#t* &)r)+r)te!'.

P#r#"!&$ +#t, "! re,#&$-"! #'t!%!t#te#* ,# !&'e+t )$er#t#* #+)! &)r#,#* re"tr!'t!#

'#,)r!'# %# 0! re$"# tre+t#t* e&t!&#&$-"e &#! ,# "+r#+)&$er#,! "# )be(!K +e&tr

'e,e,#,te '#(r!* #,!e&t#t!# treb!e "# e'!,!bre(e #+)rt, ' &e%)!,e )r#&!",!

S+e,e 'ree $e ,ee "# "+e,)r ,!+e(!* ,! "e %)r #$## '#r&e# 0!#rt# "# t)'#t#

0r!+t#.Se %)r e%!t# #,!e&te,e !+er'#,)r!'e* re $e $!er#t* '#re +r)$' b#,)&#re# "# 'e,e

+e '#re & ,e t),ere#(# b),&#%,.

N "e %# #b(# $e 0r'te 'r$e* "'r! $e 0r'te* ')&$!e&te* +r)$"e $e +#t!"er!e*



'#r&e "! +e"te #0#t* "#r#t* br#&(etr!. Gr#"!!,e %)r ')&"t!t! #! +t!& $e 9:; #+)rt,

'#,)r!'.

R,$$'($+,$ '3*;*$ $ /%$*%/+ $+*/$3&%$+*

A"te+t#re# #re ) !+)rt#&t# ')&"!$er#b!,# !& re'+er#re# e$!'#,# "! +r)0e"!)&#,# #

b),&#%!,)r '#r$!#'!.

Re#'t!! e)t!)&#,e ')&"!$er#b!,e !&")te"' b),!,e '#r$!)%#"',#re !&@- )e&t, $e+!"t#r!! &)r #0e't!&! 'r)&!'e "! ')&!'#r!! ,)rK

- '#(, "r%e&!r!! &)r #0e't!&! '#r$!#'e #'te.

Pr!& re#$#+t#re# +"!!'# !&te,ee re'#"t!#re# !&$re$er!! !& "!&e* !& +)"!b!,!t#t!,e $e

%!&$e'#re # b),!! "! $e re!&ter#re ,ter!)#r# !& %!#t# ")'!#,#. St#re# +"!!'# # b),&#%!,)r

'#r$!#'! e"te 0r#!,# "! #?& re+e$e ,# $e"'r#?#re.

P"!)ter#+!# t!,!(#t# ,# '#r$!#'! !&'# $!& +r!e,e (!,e #,e re#$#+t#r!! e$!'#,e e"te

&e'e"#r "# !&$e+#rte(e "+#!# $e )#rte "b!t# '# "! )b"e"!# 'e,e! #! &e!&"e&#te!"'#r!.

RECUPERAREA BOLNAVILOR CARDIACI



Et#+e,e +r!&'!+#,e &e'e"#re +e&tr re'+er#re# )r!'#r! b),&#% '#r$!#'@

1. E,!!&#re# #&/!et#t!! $eter!&#te $e b)#,# $e ')r$.

2. A+,!'#re# &! tr#t#e&t e$!'#, "! '!rr!'#, #$e'%#t.

9. E%#'#re# "t#r!! e$!'#,e +"!!'e* +r)0e"!)&#,e "! ")'!#,e # b),&#%,!.

. Pr)&)"t!', $e ,&# $r#t# "! $e !&t)#r'ere ,# %!#t# &)r#,#.

:. I&$!%!$#,!(#re# +re"'r!+t!!,)r ' +r!%!re ,# #'t!%!t#te# 0!(!'# "! "),!'!t#re &er%)#"#

!& 0&'t!e $e &#tr# b),!!* "e/* %#r"t#* ')&$!t!! +r)0e"!)&#,e $e e$!.

<. I&'r#?#re# !& tr#!re# %!et!! 'e,e! #! &)r#,e ,# ,!!te,e !+"e $e b)#,#.

. Obt!&ere# '))+er#r!! b),&#%,!* '#re ')&"t!t!e 0#'t)r, 'e, #! !+)rt#&t !&tr-)

re'+er#re "#t!"0#'#t)#re.

Re'+er#re# e$!'#,#@Pr!& #'e#"t# &)t!&e !&te,ee #"r!,e re')#&$#te "# #+,!'#te $e e$!'* !&

"')+, re0#'er!! '#t #! ')+,ete* #&#t)!'# "! 0&'t!)&#,#* # )r#&!",!* t!,!(#&$@

- e$!'#t!#* !&ter%e&t!!,e '!rr!'#,e* !&#"t!'# e$!'#,#* +"!)ter#+!#.

Pr!&'!+!, $e b#(#* #"t#(! &#&! #''e+t#t* e"te '# re'+er#re# treb!e !&tr)$"# !&

+,#&, ter#+et!' #, 0!e'#r! b),&#%* !&'# $!& 0#(# #'t# # b),!!* #$)+t#&$ $e ,# ) #t!t$!&e

')re"+&(#t)#re "! #+,!'#&$ et)$e )$er&e $e tr#t#e&t.

I& ')&%#,e"'e&t# #+#r #! #,e" e0e'te,e +"!),)!'e &e#t!%e #,e b),!!* b),&#%, "e're$e #! b),&#% $e'#t e"te !& re#,!t#te* !"! re"tr#&e +re# ,t #'t!%!t#te#* 'ee# 'e $'e ,#

) #r#%#re # !&'#+#'!t#t!! "#,e ,ter!)#re $e &'#. I& #'e#"t# +er!)#$#* b),&#%, treb!e

!&'r#?#t@ ! "e %)r e/+,!'# +)"!b!,!t#t!,e re#,e* ! "e %)r "er# +re)'+#r! +e&tr #'t!%!t#te#



"# %!!t)#re.

E/!"t# !&"# ) #,t# '#te)r!e $e b),&#%!* #'ee# '#re !"! "be%#,e#(# r#%!t#te#

#0e't!&!!* "! '#re* $!+)tr!%#* %)r treb!! te+er#t!.

Re'+er#re# 0!(!'#@Met)$e 'r#t!%e #,e re#$#+t#r!! 0!(!'e@

- !&e(!ter#+!#K

- G!&#"t!'# 'r#t!%#K

- Ter#+!# $e )'+#t!e.

INE>ITERAPIA

I& re'+er#re# $+# IM* ! "e +#r'r +r)re"!% "! ?$!'!)" et#+e,e@- +r!e,e ')&t#'te ' b),&#%!!* '&)#"tere# '#(,!* '#"t!#re# !&'re$er!! +#'!e&t,!K

- e/er'!t!! re"+!r#t)r!!* ) $#t# ' $!"+#r!t!# $rer!!* te+er#tr!! "! # "t#r!! $e ")'K

- #'t!%#re# ebre,)r "+er!)#reK

- #'t!%#re# ebre,)r !&0er!)#reK

- e/er'!t!! re"+!r#t)r!! ' "#' $e &!"!+ +e #b$)e&K

- e/er'!t!! #,e ebre,)r "+er!)#re #")'!#te ' e/er'!t!! re"+!r#t)r!! !& $e'b!t

,#ter#,K- +re#t!re# +e&tr +#r#"!re# +#t,! - +)(!t!e "e(#&$# 7"#+t##&# # 9-#8

- er", +r)re"!% +e ,#&# +#t 7!& (!# 218

- !e"!r! +r$e&te $!& '#er# 7"#+t##&# # <-#8K



- re,#re# &)r #'t!%!t#t! "e$e&t#re 7$+# 9 - ,&!8.

GIMNASTICA CURATIVA

C)!&tere"e#(# b),&#%, '#r$!#' !& +r)'e", $e %!&$e'#re #, b),!!* "+)r!&$-!

!&'re$ere# !& "!&e "! $)r!&t# $e # &'!!. S&t &e'e"#re & '#$r !!e&!'* & "+#t!')re"+&(#t)r "! ) #+#r#tr# !&!#.

- "e !&'e+e er", +e tere& +,#t* "e tre'e #+)! ,# +#", $e !&#"t!'# "! ,# #&e%re

$e ,#$!ereK

- "e ')&t!&# ' e/er'!t!! $e e$'#t!e # #t!t$!&!,)r* $e '))r$)&#re )t)r!e* $e

$e(%),t#re t)r#'!'#* # "',#tr!!K

- "e ter!&# "e$!&te,e !&t)t$e#&# ' !"'#r! re"+!r#t)r!! +e&tr re"t#b!,!re#

'#,,! "! e'!,!br,!* +t#&$-"e e0e't# $+# '#( 1= - 2= $e e&)0,e/!&!. N!'! ) ,e't!e & %# $e+#"! 1: - 2= !&te* ""+e&$#&$-"e 'r",,e't!e! $e '#te )r! +#'!e&t, $e%!&e )b)"!t.

L# '#r$!#'! "e re')#&$# !& )$ e"e&t!#,* e/er'!t!!,e re"+!r#t)r!! t)r#')-$!#0r##t!'e

' er", +e ?)". A&tre&#e&t, 0!(!' & treb!e !&trer+t +er!)#$e ,&! $e t!+. I&0,e&t#

#&tre&#e&t,! e"te te+)r#,# "! $!"+#re $+# 1 - 2 ,&! $e !&#'t!%!t#te.

TERAPIA DE OCUPATIEC)&"t# !& #&tre&#e&t, ,# trebr! "!+,e "! &e)b)"!t)#re* ' "t!,#re# #+t!t$!&!,)r

#&#,e* # #te&t!e! "! +re'!(!e! !"'#r!,)r +e&tr 0)r#re# e"tr!,)r "! # &)r $e+r!&$er!

&)!.



Ter#+!# $e )'+#t!e +)#te !&'e+e '!#r $!& +er!)#$# !& '#re b),&#%, "e #0,# ,# +#t*

+r!& $!0er!te &'! #&#,e +e '#re "b!e't, ,e #,ee* $+# $)r!&t# "! !&tere"@ ,'r#r! !&

,e&* #rt!e* !+,et!tr!* br)$er!e.

A'e#"t# #'t!%!t#te #re '# "')+ e0e't#re# &e! "#r'!&! $e !&'#* $e)"eb!&$-"e $e'!

$e !&#"t!'# e$!'#,# +e&tr '#re !"'#r!,e !+"e & # & #"ee&e# te,.G#&$r!,e b),&#%!,)r %)r 0! ""tr#"e $e ,# b)#,#* e! 0!!&$ "t!,#t! "#-"! 0)re(e +,#&r!

$e #'t!%!t#te %!!t)#re* +re%e&!&$-"e !& #'e"t 0e, "t#r!,e #&/!)#"e* $e+re"!%e. Se %# !&%!&e

!&$!0ere&t# "# re"e&#re# #+#t!'# # #,t)r# "! "e %# '#t# "# "e '#"t!e '))+er#re#

+#'!e&t!,)r. I& #'e"t 0e,* )b!e't #, tr#t#e&t,* e! +)t $e%e&! & 0#'t)r !& +r)'e", +r)+r!e!

,)r %!&$e'#r!. At!t$!&e# "! ')+)rt#re# e$!'#,# ?)#'# & r), +r!)r$!#, "! +)t 0!* !&

#'e,#"! t!+ "!+,e "! e0!'#'e.

O $#t# ' re!&'e+ere# &'!! ,# "#,#r!#t!! '#r$!#'! "e )b"er%# ) te## e/#er#t#*'#re ,e !&0r#&e#(# #'t!%!t#te#* +e&tr '#* #+)!* +e +#r'r"* $+# & t!+* e/+er!e&t#*

!"'#r!,e* e0e't#re# ' "''e" # &'!!* "# !&,#tre #'e#"t# 0r!'#.

E"te !+)rt#&t# "! #t!t$!&e# '),e!,)r $e &'#* '#re & !&te,e* !&t)t$e#&#

e&#?#e&te,e &e'e"#re 0#t# $e & '),e '#re & #re ) !&0!r!t#te %!(!b!,#.

R),,* &e)r! !+)rt#&t #, e$!'#t!e!e +"!)tr)+e & %# 0! !&)r#t* $e"! ) tr##

+"!!'# +)#te "# $e+#"e#"'# +)"!b!,!t#t!,e #'e"t!#. Re#'t!!,e +"!!'e "&t &e)r! &

e,ee&t $e'!"!%* $e "''e" "# $e e"e' !& re#$#+t#re. A&/!et#te# e/'e"!%# # +b,!',! b),&#%!,)r "! e$!'!,)r* !& 'ee# 'e +r!%e"te #'t!%!t#te# &! )r#& #t#t $e %!t#,

'# INIMA* e"te !& #re #"r# re"+)&"#b!,# $e +r$e&t# e/'e"!%# $e '#re $# $)%#$#

!& +re(e&t b),&#%!! "! #?)r!t#te# e$!'!,)r. A'e"t ,'r ')+r)!te re#$#+t#re#



,t)r b),&#%!.

- t)#te e/er'!t!!,e "e e/e't# ,e&t* &#r#&$ !& #&$ re+et#r!,eK

- !& t!+, e/e't#r!! "e re"+!r#* & "e b,)'e#(# re"+!r#t!#K

- $+# 0!e'#re e/er'!t! "e 0#'e ) +#(# $e 2= - 9= "e'&$eK- &#r, re+et#r!,)r $+# 0!e'#re e/er'!t! 're"te tre+t#tK

- $#'# e/er'!t!!,e $e '#+ +r)$' #ete,!* e,e "e %)r e/e't# !& +r!e,e "e$!&teK

$!& +)(!t!e "e(#&$ "! "e %# 0#'e '#te ) "!&r# !"'#re $!& 0!e'#reK

- +r)r#, %# $r# ,# !&'e+t 1: !&te* #+)!* +r!& 're"tere# &#r,! $e

re+et#r!* %# #?&e ,# 2= !&te.

proiect cardiopatie ischemica

Documents