1

MINISTERUL EDUCAIEI NATIONALE I CERCETRII

TIINIFICE
COALA POSTLICEAL SANITAR
,,ION NANUTI CALARASI
JUDEUL DOLJ

PROIECT DE CERTIFICARE

COORDONATOR:
Prof. Medic: SERBAN EMILIA
Prof. Asistent medical generalist: SOVAILA OLIMPIA

Absolvent:

DAVIDESCU DANIEL

MINISTERUL EDUCAIEI NATIONALE I CERCETRII TIINIFICE

COALA POSTLICEAL SANITAR

,,ION NANUTI CALARASI
JUDEUL DOLJ
TEMA PROIECTULUI PENTRU EXAMENUL DE CERTIFICARE:

NGRIJIREA COPILULUI CU CONVULSII FEBRILE

COORDONATOR:
Prof. Medic: SERBAN EMILIA
Absolvent:

DAVIDESCU DANIEL

2016

CUPRINS

ARGUMENT
ISTORIC

1
2

2.5

.02
2.1
2.
2.3
2.4

CAP .I. DATE GENERALE DESPRE BOAL

NOIUNI DE ANATOMIE I FIZIOLOGIE ALE SISTEMULUI NERVOS
PREZENTAREA TEORETICA A BOLII
1 Definiie
2 Etiologie
3 Patogenie
4 Diagnostic clinic (simptomatologia)
5 Diagnostic paraclinic
6 Diagnostic diferenial
7 Evoluie.Prognostic
Tratament a) igienico-dietetic b) medical (cu indicaii si contra
8 indicaii
upentr
mcedaifispufn)
APCN.IGRJEL
oluRsatenigrjpc
aSupverghncfilot
Alimeantbovu
dnmAaisretclohgu
ecoRltarpdusbgi
Tehnpicusmdaf.grjbolv
APC.INGRJSEF
e*zPrntacuilodbC1grjeaz2PlndiCu3egrj
4

APC.IVOUNZL
eAnx
Concluzigear
BILOGERAF
MOT:

 S ajui individul, fie acesta bolnav sau sntos,

s-i afle calea spre sntate sau recuperare, s
ajui individul, fie bolnav sau sntos, s-i
foloseasc fiecare aciune pentru a promova
sntatea sau recuperarea, cu condiia ca acesta
s aib tria, voina sau cunoaterea, necesare
pentru a o face, i s acioneze n aa fel nct
acesta s-i poarte de grij singur ct mai curnd
posibil.
Virginia Henderson

ARGUMENT

Amalesctpnrudoi,"gjlcCvusFebrdnaitofclesvMarn.itoupcxelfniatsrmuvocldexpaistb mulvnorceapigsdfiz-etrabulmpi.Convsfcdrgetla,iobvcpnseruldza,icontsevumrfilzhpciantesvrholcpamuetivnslrg.Dopadebitucsnrmflagjeopicusvbrn.Itfamlfiodepcursnizavlt edcousingatr.Ppmesuinaortvpmdceisrtunoaczedvilprmuantojegvsicl

6

deaspclitCon.r ufmatdeosnbipglcruametnijoplcsvu.

CAP.IDTEGNRLSBO

1.NOIUDEATMFZLGSINRVO

sStemiuvlnorcpaz,gmfieldnuxtr,pbazcosnuidevtmr.Slos,acutenfimbpr:
esmtivnorald(c),gubehiosanrmldvui;
esmtivnoralg,czpetivaonrl
es.utvlnorcaidpzmeu,lrnfafistcigzodumplevnars,cifzutdeporanslim
7

vneosrlu.Pgiatdxe,corunshil vadmspnrlcoefibavN.trnsmpuleodgacrtsnive(z)audlctrpgonfe(msaidtglnxocre)-vims.Ntunzarloe,fiidgpsc.Ataounrmfilez,santrxouilpeczdbntrmalxoui,segpcrabtonumlie.Cdsgpcatrn-uimfs.Decg,ladrtonuipecsmadth,rinlbuo
anfstcpi.Tremulvodnaisemfitrblucfonp-iaesmrutlcoinsa.Prpefudmtloicngera
iconduerampslv.Atiun:excabodl.Trsmitncpflauxveo,dlbt

nermailuopsctdnerlioap,sfcmtuderhi-anol.
mpuIlsnervoajibtdmfuznreacvlo(sgtdi)upneacmbr,dtvziuoleamrnfstcp.Cueialrvom,cutsedanirmMo.utlchebadifzprnmsotceaidblprmnostcaeuN+iK.

eAsltfopducrzainstpexcor,v-azulgmisneorvpca.t

1.2

PREZNTAOICBL

1.Definitapdomclg
Convuelsitacrb,onsui-celamtgrpdhi,nacesuotdprin.
Consvuialetmp crgdbzinuoa.Clvesf(F),hprtcuinelam
ecvfrnotulsi,azd(e)cp rxsiaungdeofizctbrlmpauine-sSvNorCtl()augicpm.

fiOdenimacupozrt KNelsn(198)mutoar:cvfbinlsepugarco,dbti3ln5asecuf,rbintsaueolrcg.
fiDneiauxcdlosvbfCrF)(pezantoicsvulfbr;demnfiaixcplsrztenovuicafbl.
Convuelsfbirc(F)tazdmounepblrtic,zdjaoelrnsvuicpb5afdt2-3%nouleicsvr.Ia bf(CF)lopizstvren1,3%2la5
o2.Elgtie
9

Studilefcaspnrom vuifebl(CF),sraGntoDmcevixhusaobfiglrmndcteipausvrmofcltneipagvusrb(CF),MetLxnoBchal1973/PgyC.Fr,86e)Dtpfisimzalf:
1)Eraedti.
1/32nduimlrecopvsfbCF()anzluiordcsv;1%penfauilcozrbnstfamldecovui(CFr).MnstmeapdoziurcvlfbCF()fiatsmdoin,cuexpvr l(tabi).
2)Vars.t
StudilefcanprzmodesticvarnulobfCF)(;es6ip5tan,rdcumxevfil9n20asctuLexoBh,173in8rls24ctauegPyC.F1986iolbr
aritReopducnsvlfbCF()tare6igdunlcpmorfe,bihnalcumtr.

3)Febra.
UrmindugpaecosvfblCF(),Hritzn194aces-uopdlmtr 39ag,esCui75%p240tdrlaneicos.RupztvfblCrF()acoisem,dtubf.r
Cauzelcmifrvndtbsouel(CF)ntiamdc,pofelrunsidcopate.Cmlunricsafodetlv.SuinprficaeotglunvsifbCrF()ademotclgpfiinra

10

86n%dcaizur.Reltosfbp i,mcreolntuabsdfixrcemplntivuaof.Pecrntsizladopuvfbe(CF)ntirsElHOx,aockduvepgrila,nosuvcrepitlmgaous.Gnbecritfzlam4%dpn.Iegvsit(clroudShaexFni)stpobdl10/cazurnveifCF().
Exeanmtlfciosvr5%dezunilbf(CFr),acvoptjuge14-20%nxrmlsbi.

o3.Pagetni

RedmschaptognivulrfbCF()dLex-Bach1Mt97.3
bOtualregnic(msdoalnxtcuepvrim)dzanuetsimcorl,dapneuxitvgc(olzarbsfedi).Antmaur,gceintlmxpc,edrvauifnoclsreb(CF).

fiDecanifosrl

11

doxvainetur
din cortex la copiii
cu
convuelsibf(CFr)

aocFertdi

nztIeir

SuscbepiltanrovfCF():mdaenstiuol xcepasvrtinom

ednrmtaigcuslzofrixdatve

aLimnretpu:6l5odecarpumxivfnotelsbr(CF)

12

uaceislpodbfr,tngeacsidup,mntgraleipzcovusfb(CF)gn.
Evidentarmzucoplsfb(CF)anretip-,so)claunrtedpi smflauconetrziaovulsfb(CF)gen.Stciprzausfeblxtncoiamusrvdebf,oinlctaffrsupm.
DeacsromndzfiiutasepdrvolhmicunatesfdgolvibCrF)(Ben.Acastumpolgiren.Ccusftabplxivnemrtacoulspng,ervicoumapltdsre.i
aobTulzcrpeit.
Consvuilect-gzra f:*oFcnti
n-seailtzbruc,
-

cupierdaonst mcrauitone,

aecfsuildvnp,ohgzb(artisudcpe),

meblrnsupti,aflcoesligmbxnt,

- ucoplindevgr,
- cuaplnhierxst,m
- oracteslimzb,pn

- dacestnurpiom,blv.
aDutresvbidlcnp30ue.*Fazoil:
13

- capulsemirt,nx
- musacetlfrion,
-

globiacurexmtnd,plisexamrz

- maxuilenrofcsdt ,limbaer
micarde

proeulsiatfimc,

- apr,sumelgcdvinotbasr,
- meblrnpztaicudflxs,
- easpritcd,ngulzom
- spuletacrib,
- afcinozt,
- unexoristmvladcfe.
aDutrceszifd1n-2mp0l5ut,eoriasm.
a*zFeduoril:-cnt,spveormal-fcuiz.
UneoricpluatmszboC.apefiturmdsncvo.
eLaztricompnl,usdbaeizf.
14

Deosbnirtcvulf deminatbocrlf
ConvuelsbifrF()
arsVdtecli

aDutrconvlsi

boli

Tonic-elgzrastu

cerbafli
npcriatel0s3
Tonico-clonice generelizate
sau

mfoeratnudGM

hemiganlzrt

Celmaifrcvnt1-3u:

ecvFrnutpgli:10

uneorimaplsgtb(15.)

min

u6nli35a()

Tipuldeconsv

Consvuiledrmta

ocre/na,stdu

auscrizebnt
ntr-ovaiedfcl
esiumtlnrvoac(SNC),
encfa,litmgo
Conutexlciarp
consvuile

Ladeublntiof,crm

ombtrzevnasci,

frecvntaduli

dacenitorbvsul

resopiatclu:

sugari.Delmn,

frecvzntaiodupml

xanetmulsbidpvcr

ocerbtfil

ativcrodl(ebmpun
evsr)
ariVpteudlznflmo
sivaculre;nzo

Tipuldezncabr

cNiunl
asubceint

euzlnistmad
enmigo-cabrl
ecvFrnt:adsouil

fiDecitonulgrps-

Nesobnuit
pa(lizrTod)

manifestorulgc
ednrmtaiuzlcb

15

EG

Semnozarlidpuc

Anormalpetidbf

convulsia.Trem80-

nsaizfcterp(x

90n%pieroadct.

meansifrltcuo)
Estencairzfud(
epafrtDzimuls
Fenobarluitvs().;

Mcedatinosvul

Nuesntcfiarpolxi

atrmenudglp

oveaitlrzcnus.

ofiparxilvtecz
convulsie.(xptr
,atingerlcfuso)

Prognostic

Frecvntsoamulipderbfazntucolivfism.A,pareudntocilmfaresu.nPfitdigcolsveabfCrF()n,uitsvdelbfranpmo.
Trebunitcasglopzvuida2e-3lbtnocfsir,uaevblng.
Copiluesatc,rdbnf sievcot,
dpa,cliunozjgrsetvpiafonl,rmu
critmndopulsaej.Dcrizvtbnlpu5-6me,sa%diczr20u.tnAaespmiut,cl
a5Dgnicosptrl
16

ConvuelsfbirgF)a(pc osdzitenvulapc,rbosietapfiu,ncdbfsreilopzatsnigeu.
Consvueilbfrg(F)pzadtcnilsueormaj.Dcbnspetio-lgzra8(05%dcu).Dtlievraz51nmu.Mcolsiefbrg(CF)paznutoc,ilsh.egrpdunacizlhmte;rospdu2-3cnvilartefb.Dshpmiarconvul18-24deipt,masbvorcneulfig(CF).
Cunoaestrpcil onvuserbfgCiF(m)ptclanvesrimadctupgnos.
1)Punoctiamblresg pnztaicovulesbfr -dtcazebu.Trinmsglapoteuzrimnglsbaofet.Nurimcndpabl sugrznecioapbmlgt.Tru,desnaipflcxmLCRotefiradbunigc;optemlarvinudxoegtlabsircx upnedvobligatr c.
2) Sunetsilxamdr:hog nueai.

3)

onIgramsu.iDctle nzarxisvuoc,tdemphglirbfuaonsgcem.i

4)

naumitespocf:l,dzrngbueihmotclpr.

5)

Examenuldfiochvztbpe124rduacionvlstempraoziu.

17
6) oRadfigirecnustb ovilgenCF()sutcadrpoimnvelbfsugctdar.i

cEexntlmarjoi(

Nefavorbil:cntms

spaeclnizurtEG

oneulgricszv

einrctmoa)l

nevolu.ti

7)

ElectroangfmG()sipdecrtna.obful,svdpcriznao(t)emuscrid,pavnotelfuzmr,davinsfipc.AetolbuiravzpntesdgoculibfrnCeF).(DastulEGdvziomre(a,fcpx-und)strovieac(mnp,hSLI)svtorbdeil.zcnaEGustovgeidblncufreig(CF);tmpaslnEGcroeuitdgsalnvrfbCeF),(pztcusinmaordvel.
8) omTafigrxlicepuzt(AC)sndovlirfebgCF).(Daczonustplirefa,bzxmuncspoltidera TAC.

a6Dgnicosdtferl
Dacritelnosubz,mcvialoteubfsrdfin ige(CF).
Trebupinsdctalgoe.A,fpiusntrmglacebsiv,nftoplacu
18

ctoxa(edimulrb), nspaecdihrtmoueiglavrsdhtcombznielparscovubf(el,ria).
bTualricone,dmpx blazvoret,ncpfixsumheatolbdr,fi-vnsxcatouplmbdeirv;zntfcueasoipdnrmtbf,ucloazeidnvsbfrg(CF).Oamezcot,nvpridf aoulsebgni(CF)dcvatuz,peronxbfil.majtczurdeonvsbfilg(CF)pamrnteibfscovul.mEpradextngi.

Cauezclmifrvntdbso le
gbeni(CF)sut:oamdc,pefilrtunsdcaop.
eCmaliutdnrcsfoavlei.SdmuRysptrzncoae,ifbusd
prezan.Dtcuolisdbmrna(pecvtui)sdgolnrmReyatbiu,do(spcxlerafniht)vfiuzoledm.

7EvoluPierg.nstc
Copiluecafrzdnvsbtcie,aprdlomnzu.Rvisatrde5Elnmcfopiautednvlsfbr,caizeut18lonvsicmx.
Copicunvlsfebrmadzthpicnul.
19

La3%seobrvcundtilfg(CF),a50%prmuesodvntlcia.

95n%dreciutoalmp s.

eEpasilont0.5%dugra3l-4incevtdosubfrg(CF).

Risculdepn:ovbfrmx,italpu
sepaodivlrt6un,3mceafiorglpt,ncdmaesil.

Diverstaoc13-8%dnmg,esifutv;lobrc.Fadpei:t95n%osvulfbrg(CF)aecpidsvu3tnl5m,a2i.
uEvotialeprmnscg:
-

4-5n%dpiaoutlgervc sfbnimputel;

consvueilbfrg(CF)pdtacuisl
afectrinlu;

scurildeazvotp 25%ce(lasirnoutg).Nbamspflcridet
uneicosvlfbr(CF)dt30-4a%,meijcsorz(57)pdnulaemvit.

Cansdextiucrmpovlebfi:
-

primaconveulsfbtd15-8i;

xaiseuotdrpcnvleiabf;r

emptaurnsfocidb(38.5geCl)amprnvusfi;

adutrscelboipmnvfa
Risculdaefpormnvbisatedc:
20

esotcnvulfbirapjm ,dtngsucoveliabfrpzotevnimfbrlucads;

ucoplinestmardvgpcih.
Parintcopleufvsb rmaticenlpuvdosfartg(celpuinvd7)sbtrunicofma.Aepdlturbiaocesnvzlrptduce,ima shrlu.Sedtcinamopf luetracsniDzpm,oletracuisdnmzorxaectulpisnv.Mdmobluaceftnrismdpo,ucaletridnmsoupl.Cacerti,xbfosncmet,ufiailDzpsn1e2o,rcmatilpubszdecafnrt.
Copilrsub3an-edmztc r5g,iaoeplst3nud10m.Tficieps9t%nazur,voilesmtcdavnufobrel,imtpac.
Convulsi:2-4%edctrpa65nuovlsidcezbrf.Sampt,olunecdfami.Vrs,t12ndeoclasvtrmuifnecalspodb.riCvunmelctsfdraiz,gunomte.Eclsiardgjpnu,eltcosigrav.Cupxz-netlmidusrfao(),cenlmtpsah.Covuifebrcl:
21

conasvueiltprdm,coeatvnisrpmucldezonai;

consvueilbf(CFr)atd ;

eabfsrpotdnuci(xm,lvzaer);

consvueilbf(CFr)tmap.oces,blnvidutmapecfosnvilb(CFr).tIu,meacpolisntdvue(amcl,ori).

8 raTmetn
a)

gienIco-dt:masurl

ngIrijedsut,pvamlozbni
decaubtil,rnspvfecuidonslar,tmecbfi.
emgRiparusltodbv.Deingspafilcrt
ezPranfbtmipuocsldhe:anrptu1c-i(.5L\24o)segmalnrhpt,d-czsuielromaptnc,zusvlboiamtpe,rnzdculgsif.
Uncopilufebratzmgsnvliexcdoarupztmcei.lsVnauopbrfitesznlvpc,ioahrmjetdcluapingm.
Peopadrictulsbf,znmadvoriecpftsug,ndvaroletmpin-udscrahe.
2

Nuesrctomandplif esbtr,cuxanoifijl(ez.vtcmd)
b)

medical(unsortpifiecaufn)
aTrmetnuzlciovsp- ,eavcobtiprmdznsuMvel.catidzpmnsraveo(.)0,23kmg/cuitzd1n;earojulzcivsdea.Lnozpmtr
Sevatrbfnp:cidsl,mozeua;ptclijmrvozfiga(descpiltumnor,bgealcmutinpdsae/ol,frctiugmnpdeavsli).Dmn,trcufeadbzoixlptrnvsfebg.Laoicuvntslredh,oipamcglesutadpronvi.
ofiPralxecivdsnutmlecadiuptronsvlfebig(CF)uatrpnvscelio,gatdurnvfble(CF).
naIcest-romdfipxlivunfbatze3-5kmg/i,dsrpuncaletm,id2supanvre3-4coil,dtsnuae.
Inprezot,isculavfbnge(CF)stmil;doazrfpucemntisovluprgceafbtn.Pdsori-lughpefintaxcvsi.
23

Sa-sbtfiilcproxevdnu btaicfmoresl:
- canzdriovulsebfp15tm;
- canzdrioestfl;
-

canzdriovulsetm gcanzrisupet

cansdextiuorvlfbgnecaptiusdro.
ConseuDvlpmtrf1c98(0)abiuenofiptlsvaciznreuoplvsfbmtiacnderluzsbvt12i.Sndcafi,polxusteicn2adupmltrzosvi.
shmFian(197tr-)cuexlo,gzfidspnvuecrtl:

svatrdebuconlif18;

consvuifeblradtp15m,oc(fl)uasetbinrdp30m;

dezavorltnu-psihm ;

sctoifamrldenvubpoarti.
Ceimaultorcsnd vaielmcfitnproxdszaeufbilo3-5kmg/,ndstrzpacuiel(21onrvat),simcpdelu21naticrzosvel.
pVaroltudesifcnmaltvrpoeinucsfial.toDeriundpvaltso,imerjuncad!
Unicoptrezafsudlnicobar:tdempnugi,chvrat
24

dpieracton ,sh-uarilmfet.Acnpofiizaelrtmungd,cozipresvant-dmoguizpr,caentl iromda;czunelbtipormsendcalufibtmphorMe(al).Esnczitvoredfbalcsngiptoruzamcedinsfiptl.

Fenitoascrbzmpg(Tl,Sn)uaefcfitiroxvslb.
Idealrfiutizncosv peadmtriunzlcosv,featiunrpdlg.UoecmasinrtDzpl,coeuiasnvt;-zrlcoefidabsi80%nrvtlcmeu.IpzaiDnltrcsomueidEpaztlbnrucoedmip,SUAnstarbulzecopigdflsatuero.

PARTESCIL

CAPN.IGRJEL
2.0uRolaesintgrjpc
25

eunPtrcopilaszbxent,dcualris fpetdmiulsobn,racetdg.

eacRiuoplsztrbdnvx,epialotr-usdnecpfiba,itldregvcunfi.
eCuglarodtzv:cfiihpsm
eacrisplzt:n,fvgecfiibalrntdms(vpegiroblantcusepiorlbtadcsezv)
aspliztrexnoc( atri,mdepcflzsuortamnei)dcpbfi(msaurfileozvtc,dsparlngij)
2.1Supraveghfnocilt
Funecilvtad:rsp, elmtua.Esnfrcvizdoteasubm.Ulrincfovtpea,drnclgutesiboa,lrdgnsutcevbimpaonr.
oluRsatenimdcrfv:
-spregatcminluozsretdfcai
-spregatcoiludnvfiz(respaticlmod),
-spregatchiuol(xn,vgadecstiufrolpa),
26

-saigurecondmltflzfievan(,mpurtodcszae)
-scunoavrilemft,dsvr
-scunoatedmliprnsce,-ftvadurlnoipcste,
-scomuneidlfiartvfcoei.
Masureinotp,
fiDeni:Rasprfutcgomleziaprdxncsovlet,uimarsfxdolebcnztmuarp .
eMaritnlcs:-udoevrfaimpthnTc:
e-szarlinpc,dgutmo
-sedzbracfontimulseapcnortuil
e-szarlinumpotd
esp-raimondbuterlacsmoptui,dreacosnvlimedu.
aloVriemnsp:
a-lnousct

40-45 respiraii /
minut

25-35
respiratii/minut

a-l2ni
nupslevmari:-tcofnmulrespia

a12-lni

15e-2asprnti/um

27

-amplitudnecros
-tipulresa,codbmn
Seconsmazvlrbuit onfdempra
aNoret:
-seconmazvlrbuipt efdmfiarc(linoztep2sa)

-seuntapoivlrzc ebnaui
Masurepli
Esteodinrcmapfil(usetrafdo,bmnizvctuserpladm.
sPulpoatefimrci b,poatmreunlsd(i,aocthmerfulpdsi).

Lamsurepli,bonvtfiaczshelpui5-10nmtdar,coefintmpulsa fi(odeczr),vfulgtinxmdsearp.
Lasputreblmivo dn,aspulicetr.
sPulemaonzric,vbt uelasrponfditmbvuleconfiairztfep4su.l
nfuecdtivrsa,plzmo:-nuct1304bai/;
a-lcopim102btnu/;9ai
Tensiuartl
28

ensTiuarcxtdglpoei,cnstuarl(T.A)Vemdinto,fcrae(sguplniarbot),edszmpngiratdeslcbumiardvoztesngl.
ehnTic:

eunPtrmdiaT.A,bolvfiszepcutmindr-oflseba.

se-capmlintubrj,exnsi
-sefiazxmbnrotcupilh,sgaerfmnti;
n-sedoiuclvtphr;
-sepomaznrtuicjeldapnsrzmotui;
edu-rcompgsivnaltdechruojvniaspglb;
-primulzgotaecnsrulipmaoetzns x;
e-sinrvalocdt munelriptaficos;
-sencoutidmpra,zglveotinucr;
e-sinrvalocdtumezglispar,ctnduem;
ensTiuartlmozc,vbsenaulriofdmpt,enficasoiu-tldemr.Snczoaiuvtleshrpz.-13aniTmx7590,6Hg;
4-1aniT.mx90,r65Hg;2-18aniT.0,rm65g
LacopilT.Asetunrv,dmf:=80A+2a(sVcotupil
29

empTratu
ermoTtulaxizndcsgpCeiula34,5-2om.Trntzsuildeafcobmrt2%,snzeiauchmbtl.
Maseurmpticolxbnsfaevtichum,pnrobeaidtc.l
eAsltmfpuraonx,icghlaudrmsotpeibncrvago,lesdt50Cmicpuraxl.
empTatursod2i/z-ne,valrbutsoc nfiadempurtbolvsc.
ouNnasctiplm1:36,8-7.
uCopliescta,mndrouliceastgprdvnzlo.Pit-mcae,rudlotisncemgrupl;asoztiemcndur.Dptieloafiscmur.Snztafdiepsocrufinlzatfidveg.Suloarpzntciebglrm.

Dupcitresgmolandvucpresitfo.

eDiuzar

eDiuzarscopldmngbteuivrdmaolsnpctu,egdvoxinrasm.Elcetubfoapismnrcelguiaprmsoedltbnci,arogsmulev.
uMicneta-ofizgl,sdmri.
30

oCuarel-gbndschi;Mm.
pH5:47-,usoracid.Senbl102C
Caneti:-lousc30m/24h;p51l
-adulti1204m/h;pn8.
Aspect:laur.DzinoFdm
Scaunl
epRnzrtaisulmxocgdenaitrsmpulfc.
eDacf:tinlmropusv;Fenact1-2/zi
aduzlt1is/2e.Con:mg;rubaMsilfecd
uOral:citmesozdg,n.aCticl:150-2
SenotazFdimpurvsfigce:-anol(I)
-scaunemo(l/)dri pP-scaunge(S)orZjmX-nlM

2I.AMELNTBOVU
31

alim-entACTIV,cdbovusgr;
-alimentPASIV,cdsrgbouvilpemtanzsgrdc,bufijt;
-alimentTACIFRL,cdrbuosangmipcjlfiet.

Alimeantscfru:

Mnoucalresfimtbvdpuolecarsfmidtgneu.

ngael,rboicmpdut enarvibclosmt,fiapeuf:
prin-sodagtcue;lmnr
-prinfistulaomc;e :bnr-iuas.l

-snauperfzibctAlmovuaes:

-sacoperuhiltngdbzm;
-saigurepoltdmn csaeufriolmtb.
a-svofrizecndtlpuarogenmblvitsudaprencgomilu.-svatefbrnczmoilav;

m-saepcditronfblu;meicaprtdvo
-saconlidezurtpbaomedtrn.

egRimuldtcabonvrsfitecalnvspiorgmu.l
ncazuloprivesbfdtfignacrioseu,Tfztlpadichsemo.
32

2.3Adsmintraecolhgui
Unadiesrclmpot nairedcmlo.
cMedaintmsulbzoprv,deamsliuncb.Etxezodpsrvga,nlimubte.Acorspagnmidluectorha,impndeusoaztr,pcmilne.

nAdaismretclofpu,maiertns:
e-cadlvsig(otr);xn

e-caplnrt.
Altecaidsmnro:-uvj;
e-cavlgin;r.t

uRelignadrsmtco-peinrld;atfmcops-veildntram;pcies
esp-ractodzl;i uenasmrtp-colibvu;emnardt

n-adismretclohpfnadismetr;-cuv onl
uea-lmrdicntopzsv;bul
3

amu-lriebonvspcdt;
apo-retmduiclgsnaeotr.Aibusc:
-medicantulpsxorfize;-datuic
e-calobisnutdmr;
-modulenaisrtfic pzeunamscgltirode;

nco-impatbeldr;usmicaeontl-f pdm;iulacreszft-undalmeicor;
dnmAaisretclopufzndimaesbtrvco.dnmaielpstgurdoiacenmtjozur,ilapsdecbn tvrieduca.
nAdaismertcopl:

egaPrtinvdmsclo:
esantiplm;
pregatnulidmscv;
piseazbtlvdruj;
coretazugslnpidm,hctu;
aenzujlrgticops;
esantimcdlgurpoz vei;
gasurimoblzecpnd;
nsetrodiuclgapbzmvnitadgrjcesplv;
mpenitrchdavbul,g;
urmedtgialcnpobsvmrdegh;i

eCaolrsctundmiaeor,lcstpun-bivmaeltsurgo.

34

esnadmiztrpcohl(,uf)
espunrcolizmd;
egorzanilcudm,sftepin;

dmAsinetarclop
eCaplrntzicoubdgesv.Datfinfplrjcioesubdgtv,naclproesfitndaumcljbesitrdano.
njecIiaostrdubmnelichogasprtud vezil,acfindptsgr.Avejal:

nobeiaurfctpd
dozarepcismnlt
bposiltaednmrc uotie,

xoperalt

nsegritl
amptonesdrilv
usoilndezafct()
avtrenil
ogaudreci
npeirmua
egaPrtipcnulj:
pregtihsc(onmfazvduljei)
pregtifiszc(anofb,lueditpc

hemoragidstv,u.Scplnj:
-

eraptcuiM:l

njeci)arsg:

espamlincurt
fisevricngau(lpt,mdbie)
35

fisevrinctgaolufl,hdzmenrvabiltspuco
nsedpaztmbjulgri,csepao(nzulfir)

nsedpazrtulifig,ovcnaedprtsu
msenpgioutlarcdsepin

seapoirlvntug
nsedpazrtclumiflo
sendzfciatopulverci
septrundcaloi entdslvpcri

secoatuldinflgpmzovare

ncazublpoer:i

Scop:

eraptcui
ocuLelinj:
masuclferi,dnpxot
afexrntcopsi,mjl
usoziltne
usoilea
usoildceantmr
esoRarb:i
ncempdiatusr
esnrmti3-5u

cualres-opftdihmbcualenrjIts.M
epRnzrtioducaslmehniprtudacslg.

afexrntbui,lmschodSae:

emanilptusorPgjc:

36

esprgatcmli
mseobilzacpu(jr)t
seanzdcubitvrl
seafizxmbrinlofcuptagehli

espamlincurt
mabcrenuilst
ndezfcitaoulj
securplainmtobdzf

aceltmnrgiuob-Exjec:

nseapdricul tgnamoseri

fisevricapozunl
nsejciaztlou
estragubclnidzfo
semazuorptcivl,fndbsa
seazucoplnimd,t
ndcIeita:
eduvrnpiatglcs
aplizrnevucst
hematonprizluvs
uperacil

mbeolin(pracjtduse-nv)jcIiatro.V
epRnzrtioducaslmenivprtudlacseg
Scop:

venlcpraiSoudsmt:

usoilhpenrtRba:
nasiteEcuxrj:

xoperalt
eraptcui
ocuLelinj:
venladcpiuot
venlaubrti
37

envldpartosmi
venlmaorti

usoziltne

espamlincurt
mabcrenuilst
alegocupnidzft
mseobilzacundptr vei
escuxtapvino
seaplicgrou7-8mdn
efiazxvncupolimsgt4-5bnerazdoucmpsitjaerlonv.Cusgiptcdeoralvnizbus,pdteraclongivumtperlnoscdivgzateu.Cncligosptrde1-2muacnzlvbihprse

nsedpazrtvoifcgul
nsejciaztl
fisevricaopdulnt
estragubclndji-m
alocupniesmtb lcorv
ngrijoultea:
senmicoprualjvte
seaupvrghztnl

ndcIeita:
umefitarsoilnpjcuve
38

2.4

emhatonprisugv.Scj
ameli,pot.Snucd

sepamlincurt
mabcrenuilst
sedzbacuoplirvn
desamblzupoitr
seazucoplnidbtr, masngfelucopi

nsetrodiucmapzfiln,strgeoifpcdmlte,anirupvofzcdstnlreipafiu
egorzanilcudm

nAdaismertcopl
egaPrtindmsupoz:l

Recoltarpdusbgi
egaPrtinzclbovu
n-secadrzmutil,pesancmdoubvltprinsec;
-atiundesmcrblflotaipned-ju;
nepmarxjulidocts, avmrepunlctiofsxa;
-asufiprcetinl,damxuericvntlofip maresi;
n-boavlutreidscpavnerdsolugij;
-senvatimdulpc.1Roreaxsin
ncurslexamifiz,d:tosurlenia.
39

eunPxtramlchi:sodntpe24r,saumiondctear.
eunPtrxamc-si105l,devnrmtasixedulnar.
2.Recaorltsnugivpxmhceafsubntiogldprca.
ecoRltarsfpinuv.Cgetoslc:
-Henparic,td012mgls/;Ceuoniztcad3,8%PrmeV.SH:

eunPxtramlfizic,bopde24.r

e-scorazlt61m,dngpuivetsrl40m,dozinca 3u8%().
eunPxtramiobchsz
-gliceamp,onstrfiemialfuocrtp,nidasobelptrm,czdinae5t-6mlsgrfubanico.
ecoRltarsnguipxm.
eco-rltadsngpuizfrabtcognl,fideviumsra.
ngael,ruptoizsc5-10mng.
Decobiratlsgupnde2oriva7l-104zsumtpnceiafzdrlbo:PRIZEe.AsiantpFdmurbolvitacnsef-zdprfixomuinletaczdrsg.
e2.5hnTicmpusdafgrjbovle.
ebFranuscofd.lEpfitiager,onsvublpcatei.
Febrascomtnuidpvlrseamut,fncpoilevargsmu.
40

Lanousctep39C,rmlivaocdsuen,grpilmatcoevsundpra4t0C,lvse38.
Bolnaevubfripzfimtdc oalepsritmnd cu:
-hipermo,altdcsngveiumfrta,polsneirvutgmloa.Ahpsevrdiucolmastn ecu,garsioplm.
nBoavulfebripztcsmd.
esAantirbudcopgjvlebifr.1ASIGURENCOPL
fi-vecarinmodptgulbsraei.-vnjdptcousar;
-vauefcotlnbi;
-vamschbilenjoruta.
-urmaesntpcobl(dzahierfpt),sgun-cvibale.
2.ASIGUROELNBVCDH PTUIREAZ;-combatehiprdsvljo;
n-segrijatcomdpuhneblavi;-dsmtrzcune,lavgtdpcsi;-obnrema l,csotfbnr.aepmulvsoit,barcegmnlpotubavei,sgrzhmjnutdcl.
.3CAPLRIEDOMSU
-pregastduncomzilepatr10-5oCc;ms,epidantruch;
-puneladmcrsifth,bepozanusc.t
fi-vecarispulo,tgmnb;
41

ntre-upalicoms,dgvnte.
m-schbaireopnlvtd510u,3-6riacseobvdmptuil1-2C.
4.MPACHERT
-dacplireomsnuft,
efctumazphnrsidlt10-5ofiC;vecapu,rgmnlst;

m-schbaipertdn5u(23o);
n-cazulorbvimgpetjnucarslfdbhimevt2n0u,arcldspf5imte;
c-aplinbovumres;
-adsmintrezbovulch ,pdaitem;l-uchrsgnboavipeuct;
-dupcair10mntelhsoaubrvei(cpfit2-3C,mdnacheri);
-pregatiulbonvs pegrh,dulactomvnsirepagutl.
5.BAIRECSUMODT
-dactempurnbovliszatepgrib3co(C)sumda5t.
fi-vecaristlnbou,dpegasit20lrb8-1mnu,peoad23i/4.r
fi-vecarinpmtoulgs,eairbnv;ut-pczloegmnrsiatdp.-bufiecgmnltvihpr.
nBoavulisefimpcr,tabiledsorunpzt;
dup-abeiocfrntzgmlsuaier.-tbcnovljzsuapt;
fi-vecaridstfon,zle2uparisdmntcbfi.
6.ANDMISTREZC V
42

-seadminztrp,foblvg.
7.

8. GASURIEMLNTCOPZ
emgRuinlboavfrsthpcd60-7%,ionelautd20%.
9ETDUCIASNR-esucfaztinrbovlp decastiurmhlob,nsecapivrtgdbl,eompnsaic.

ADMSINTRECOLPUAFINDEBZ
n-segrijatxcuom lpdei

APC.INGRJSEF
*Prezantcuilodb

AZCULI
A.CulegradotnIvi
Nueml:IOESCU.

Nr.FO14

PrenumlD.AV:INEL
rsVtau:4nli
oNanielt:rm
aDeintr0:31.26
aDextrni:132.06
Diagnostculer:f,v
43

Diagnostculexr:vbf,i
B.vMoetinlr:
-febr39C
-ladomuicepznrtvs
oC.Iscrtuilb
nmurcozisgalpetbf39,5Cvunrmasdeziclformnatupiecjb.lrmoxvatfzinsuepcradltinvgsoueprc.
D.eAncdthro-la:xuis
E.Antecdprsoa:l
-fiziolgceA=m8,anturvfshei-pogcltma,CdnAb
F.Examencligr
reuGta640gli,2cmPC9TFR0resp/in,
FC120bnt./me,ipura-39dzcsonimer,talfizcg
- staregnlfl-ui
- esutcalrbnmopzg,Tef

egutmnicoasdpl,r etnzial

- esimtolfganr-pbfiuc
- esimtuacrl-nof, k
-

partcdio-vsul:zgem ,xapnsiVrcotlgemdavu
aprtesio:cmnlf,ubazsteriponm,lvuczairfig.
aprtdigevs:conf,bmulresapfictodn,libsaermtzolficgi,pdus
aprtuogenli:jdsc,hpabmiunfiozgelrc,atxnomlfer

eSismtnrvocal-fdig
4

Organedsim-ol
eExrnatbovlui
ugSardeptnlisxmc, 6.40ga2einrtzpubf39Cs,vladomcirentupsbfl.
Examenldbortucfspizaenmotbludvsgircpnemoal.Szdigsutcnvfebr
DuptramenlfciszPa0G1.UIptrueilmn5x2,soag-rt.
uCopliesxtrnacmd:
-

vancoutirmel015.gbzx2/

evarnilcotpsu3
45

CAZULI

NevoilfundamtpcVrgeiHndso
Nr.

Neavofunidmtl

Problemadpn

sSufiadrecitl

1.

eAasprivo
buncirela

Tuseac,virt

uObsectrinazl

2.

Abeaimnc

Apetidurs

eabF,oruscit
nazl

3.

Anelima

Nueaconrfitlsi

arsVt

4.

Asemican
obunpstr

Depndtma
pentrudlas

arsVt

5.

Amdoirasehn

oSmnecrspuzt
cavlitn

useTa
eabFr

6.

Amsebcari
dezbcar

uNsepoamtbcri
deazbcr

arsVt

7.

Amenitapur
courpnilmte
normale
Aficurat,-eoipj
tegumnl

T=39C

Rinofagrt

ncIapeitd-or
ngrijec

arsVt

9.

Aaevpitrcol

sRcdieompal

ocePrnsufli

10.

Acomunai

Nucomni

arsVt

1.

A-aipcretlg

Depndt

arsVt

12.

Aseprocuad
realizpo

Depndt

arsVt

13.

Aescra

14.

nAva

8.

46

47

CAZULI
Analizedbortxp
aDt

zAnaelifctu

ezRautl
obinute

aloVrinme

031.

Hemati

03./
m3

,53-mil./3

Heomgnbli

1g%

213,ag%l-5uni

Heomacrit

3%

532-49%(1
spmtni)

Globeua

12.50/mc

40-9mc/

olinPeucar

87%

60-7%

oLimecft

10%

30-8%

Monecit

2%

3-8%

finEozile

1%

0-4%

Grupsang,iRh

OI,Rh+

eticuRlo

15%

5-1%

cCaoiuln

54m,Eq/l

5,2-60mEq/lasugr

Magunezi

819,mEq/l

1,2-7mEq/l

baumlinabsent

albunm-iset

ugcozl-absent

igmpenabr-ls
msedniatrpl

2016

Examensurdi

glucoz-absent

gpmeinblarabseni
sedimnut-r
aemorf

eplat

48
DATEVPRINMS COTERL
Nr.crt Mcedamint

Module
ul

epznrta

Dozadmsintr

uAcneia
atepruic

Reacidsvr

PenicalG

aFcolne
40.UI,
01.UI,

50.Ui/e24onr
1(62,84)
i.mntread
efxintracops

05.UI
conid
puelbrnt
epar
soluri
einacjbtl

nAotibc
bacteidrf
decoaigmr
pozitvgram
nevgait

Reacirgl,
cueati,ro
fianclti
(foarte)

Fenobarlit

oCmpriated
15mg

ePros1cpx2/4(
20)

eSvda,ti
phcnoi,t
anticovuls

oaPteprzn
fenomd
excita
nervoas,
earglditp
cuartin

aPcertmol

oCpmriated
50mg

Peroscp/24

nAalgecz,i
anetipcr

Dup
adnmisret
nduegalt,
uepraicnt

cpx2(18)

nperioadslztbvum icaen:
03.01. 7.01

2016

1+2+
3

08.01. 013.

2016

1+2

CAZULI
49

PLANDEURSIG
Dat
a

031.

Problema
de
depn

-tuse
seac,
irtav
obstrucie
nazl

eObctiv

n-boavlu
saibo
bun
easpri
atmrenul
useti

nvteIri

uEvaelr

-apreubiolnvmdt
mceduli
-msorfunecilvtaz
foaiedmptur
-nadmeisxztrgopc(35
l/min).Oxgeuzscpr
baroetn-uflcp
aemsctulo70-950
caol10mp.
-puncioezvdaf
dorsalmeubipt
irecoltz
eucfartnlizodb

-seconta

amelior
easpri
40
emsprin/
=1P20puls/
min

snge

pentru

dmasintrezlco u vpntreilasmo
dezuobstrcilapnfim
asupverghzfncilt moaedpurtnbli
4.01
7.01

tus-e
seac,
irtav
obstrucie
nazl

-bolnavu
sbaoi
bun
respia
atrmeunl

ad-sminetrpc
sedativ,onbc
-avertizmpcunl
upenstrcilamz
esprcindta
-supraveghzncfilt

b-olnavu
epzinrot
asretd
eign
ecosprunz
toare

tusei

-ameztcopnilur
nmailtupervos

res-api
fiozigcl
-ma
coupil
est
epocurat
de

caresuzpi

ngrijea

egvtaimnofd
emptaurdlnobi
-ajutmlefcori
ucopliashmbernj

50

acestui

8.01
-

tus-e
devin

-bolnavu
sbaoi

obstrucie
nazl

esrpia
atrmeunl
tusei

fidacuitel
nase
odihn

-ajuret
bolnauvi
nase
odihn
normali
lintreua

opducr tiv

bun

su-praveghzncfilt
vegtaimnofd

empt aur edlt nobeui t

ev-aolui
avofrbil

T=370C

01.

01.
1

aju-tpcienlfr
oeatlischmbrnj
ad-smintrezcl
ecormandti
g-asnuierltocd
deocnrtfmi
s-aericnpt
somunilctr
sup-raveghzfncilt
vegtai

ev-aolui
avofrbil

ad-smintrezcl
ecormandti
p-otenial
de
compali
e

012.
1

-s
respct
atrmeunl
indcate
mcedi

fidacuitel
nase
reca

-ajuret
pacienutl
nase
reca

51

ugSardeptnlisxmc, 6.40ga2einrtzpubf39Cs,vladomceintupbfr.
Examenldbortucfspizanmebtludvsgoricpnmea.Szdgsutlcovifbre
DuptramenlfciszP0G1.UIpatrueilmn5x2,sog-rat.
uCopliesxtrnacmd:
-

vancoutirmel015.gbzx2/

evarnilcotpsu3

CAZULI
A.CulegradotnIvi
Nueml:PATRUOI

Nr.FO29

PrenumlANL:-IOUT
rsVtau:7nlioNemDr0:73.216atxeni4

Diagnostculer:vbf,pmital
Diagnostculexr:vbf,pmital
B.vMoetinlr:
-febr

am-dsintreulc
decmi
b-aneiotrp

e-abrilf
ap-eti
mnoarl
evo-lui
avofrbil

- dispne
- usetopvdcri
oC.Iscrtuilb
Mamucoplsinert damiculefBspto,nabdurceztosvi.lMamfrndeugpivtsarmn.
D.

eAnctdhro-la:xuis
E.

eAnctdprsoa:l
52

- ofizclgie-A=8,amnturvfshei
- opaclgteibmr6un
F.Examencligr
Greuta860gli,72cmFR34sp/n
CF120bnt./me,ipura-39dzcsonimer,talfizcg
- staregnlfl-ui
- esutcalrbnmopzg,Tef

egutmnicoasdpl,r etnzial

- esimtolfganr-pbfiuc
- esimtuacrl-nof, k
eSismtnrvocal-fdig

partcdio-vsul:zgem ,xapnsiVIrcotlgemdavu
aprtesio:dn,jculvrabiet,ocmnlfusrazeitponml
aprtdigevs:bomnul, aficetdrosplinb,matrzeslfioicgp
aprtuogenli:jdsc,hpabmiunfiozgelrc,atxnomlfer

Organedsim-ol
eExrnatbovlui
Sugardeoptlnixsmc,680.gerntazpufb39C,sodcivlmnreztupsodbfil.
ePbazurltoxmndcfesapliztrunmobdevsgaizprcnoutlmea,svifbr.
mnuarteilcfpgjb(24h,flumilcr/paetox4lc,umin015pz3de/obstraCRSfilgic-2uenrsaomz.
uCopliesxtrnacmd:
-

vancoutirmel015.gbzx3/
53

evarnilcotpsu3

54

CAZULI
NevoilfundamtpcVrgeiHndso
Nr.

Neavofunidmtl

Probemladpn

sSufiadrecitl

1.

eAasprivo
buncirela

sDnpiue,Tovdcrt

neuPmoia
nsteiarl

2.

Abeaimnc

Apetidurs

eabF,oruscit
nazl

3.

Anelima

Nueaconrfitlsi

arsVt

4.

Asemican
obunpstr

Depndtmaru
deasplr

arsVt

5.

Amdoirasehn

oSmnecrspuzt
cavitln

useTa
eabFr

6.

Amsebcari
dezbcar

uNespoamtbcri
deazbcr

arsVt

7.

Amenitapur
courpnilmte
normale
Aficurat,-eoipj
tegumnl

T3=9C

neuPmoia

ncIapeitd-or
ngrijec

arsVt

9.

Aaevpitrcol

sRcdieompal

ocePrnsufli

10.

Acomunai

Nucomni

arsVt

1.

A-aipcretlg

Depndt

arsVt

12.

Aseprocuad

Depndt

arsVt

8.

realizpo
13.

Aescra

14.

nAva

56

CAZULI
Analizedbortxp
aDt

Analizeucft

083.216

Hemoglbin

ezRautl
obinute
1g%

Hematocri
oGbulea

3%
690./mc

036-4%(12spt.)
60-175/mac2l
unli

Polinucear

84%

60-7%

mLfocite

1%

30-8%

Moncite

3%

3-8%

Eozinfiel

2%

0-4%

VSH

30m/h

7-8hm/

Caulcion

54m,Eq/l

5,2-60mEq/lasugr

Magneziu

819,mEq/l
baumlin-set

,21-7mEq/l
albunm-iset

ugcozl-absent
gpmeinblarabseni

lucgoz-absent
pigmenabr-ls

Examensurd
nuri

aloVrinme
8132,g%la6unli

msedniatrpl

esdimnut-r
aemorf

eplat

8IEaGsetrudomncpifzealocstr
aodRfigierctnlsahiobzert.Cdmnlgc
57

CAZ1ULI
TDEPANRIVSM CLO

Nr.c

Medicamn

Module

rt

ult

prezant

Ampnicl

lacFone250
i50mg

1gla24h/eor
1(62,84)

co-nid
bpuerlnt
prea
usoilr
njecitabl

.mintread
efxintracops

Comprieadt

Peros1cpx3/24

enoFbaitr

Modeanmisrt

ciunAea

Reacidsvr

eraptcui
bAnciotu
specatrugl

Reaci
eacrgl,i
cuearti,o
fianclti
(foarte)

Sedativ,

Poateprzn

al

15mg

(10-62)

hipnotc,
canotivsul
t

enfomd
excita
nervoas,
earglditp
cuartin

arcPemt
ol

omCprieadt
50mg

Peros1cp/24

gAnaezlic,
panciret

Dup
adnmisret
nduegalt,
uepri
cutane

mFluic

licuPr
granuled10
g

2plicur/4oe

izoDlv
mucsl,
escilrdn
cares
fidflucipot
fiexpcator

bTulri
gastro
e-instal

cpx4(8-126
20)

nperioadslztbvum icaen:
073.1426

1+234

58

CAZULI
PLANDEURSIG
aDt

oebPrmal
de

eObctiv

nvteIri

Evalure

depn

7.03

tus-e
opducrtiv

s-dpnie

n-boavlus
aiboun
easpri
-

e-piaurnbovlmdt
medicul
-musoncrfileavtz
nfoaiedmptur

s-ecoant
amelioera
easpri
40

atmrenul
useti

8.03
013.

-tuse
opducrtiv

n-boavlus
aiboun
easpri

obstrucie
nazl

atmrenul
useti

ad-smintrezgoxp3c(
5l/min).Oxgeuzscpr
baeotrn-uflcp
namestculo70-950
alco10mp.
-puoncezivdaf
sdoalr
drepti
efctuarznolidb
meduicl
upentrilasmvo
nateidficrms
-supraveghzncfilt
vegtaimnofd
emptaurdlnobi

resnp/mi
P=12s0pul
n/mi

meublri
ecorzlt snge

adnmeisztr
atrmen
dezobstru

su-praveghzncfilt
vegtaimnofd
emptaurdlnobi
aju-tml
ucopli
am-eztcopnilur
nmailtupervos

recomand
sevdati
ceilsproat

ad-sminetrpc
sedativ,onbc
ave-rtiz
upenstrcilamz
enusprctdia

upserio
pentru

maeipcnutl

-bolnavu
epzinrot
estadr
gien
ecosprunz
toare
-resapi
fiozigcl
efectuarea -ma
toaletei
ilaschmbrenj ucopli
est
epocurat

59

caresuzpi

de
ngrijea
acuesit

0123. fidacuitel
013.
nase
odihn

u-aetjr
nboavuli
asehodni
mnoarli
niltreau
-

0143. p-otenial
de
compali
e
fidacuitel
nase
reca

e-sprct
atmrenul
ncdiate
medic
u-aetjr
epacunilt
nase
ecra

Sugardeoptlnixsmc,680.gerntazpufb39C,sodcivlmnreztupsodbfil.
ePbazurltoxmndfcesurzpitalnmobedvgsatizprcnoulmei,svbf.r
nmuarteilfcpgjab/24h,fluimlcrpeotxamlcu4,ni015pz3d/eobstraCRSfilgic1-2uenrsoamz.
60

g-asnuierltocd
deocnrtfmi

-uevoial
favobilr

s-aericnpt
somunilctr
-supraveghzfncilt
vegtai
-adsmintrezcl
ecormandti
am-dsintreul
ncdiatem
b-aneiotrp

-afebril
-apeti
normal
-euvoil
favobilr

uCopliesxtrnacmd:
-

vancoutirmel015.gbzx3/

evarnilcotpsu3

CAZULI
A.CulegradotnIvi
NuemAlD:REI

Nr.FO39

PrenumlBOG:DAN
rsVtau:9nli
oNanielt:mr
aDeintr0:156.2
aDextrni:2.061
Diagnostculer:vbf,i
Diagnostculexr:vbf,i
B.vMoetinlr:
-febr
- dispne
- beiatplornus
oC.Iscrtuilb
Mamucoplsined-trampcil1g/24oe(du)ntascfb,rpezovuli.Mdamfrcnetugpvisamrn.
D.

eAnctdhro-la:xuis
E.

eAnctdprsoa:l
- ofizclgie-A=9,amnturvfshei

- opaclgteirnfu3
61

F.Examencligr
Greuta890gli,72cmFR6sp/n
CF120bnt./me,ipura395dzcsont,imrae lfizgc
- staregnlfl-ui
- esutcalrbnmopzg,Tef

egutmnicoasdpl,r etnzial

- esimtolfganr-pbfiuc
- esimtuacrl-nof, k
eSismtnrvocal-fdig

partcdio-vsul:zgem ,xapnsiVIrcotlgemdavu
aprtesio:dn,jclbparusitev,lnmbarpuo
aprtdigevs:bomnul, aficetdrosplinb,matrzeslfioicgp
aprtuogenli:jdsc,hpabmiunfiozgelrc,atxnomlfer

Organedsim-ol
eExrnatbovlui
Copildenusxmf,cagrt980.einzpufb3,5Cstrodvcalmieznupsodfbr.
ePbazurltoxmndfcesurzpitalnmobedvgsatizprcnoulb,svife.
nmuarteilfc
- apcermotlx4
- mfluic2l1p/rx4h,
- mpachetri
- aportlichdne102m4/
uCopliesxtrnacmd:
62

vancoutirmel015.gbzx3/

evarnilcotpsu3
63

aspreiclobnvutf

CAZULI
NevoilfundamtpcVrgeiHndso

Nr.

Neavofunidmtl

oebPrmaldpn

Sursafidecilt

1.

eAasprivo
buncirela

Dispne

oBnrlit

2.

Abeaimnc

Apetirdus

ebFra,ostuci
nazl

3.

Anelima

Nuareocnlsfiti

sVtar

4.

Asemica
mneiobu
postur
Amdoirasehn

epDndtma
upentradsl

sVtar

omSnecspruzt
activln

Tusea

5.

Febra

6.

Amsebcari
dezbcar

uNsepoambtrci
dezbrac

sVtar

7.

Ameni
tempuracoli
nelimtora
Aficurat,-eoipj
tegumnl

T=539C,

obnrlit

ncaIpteid-
daconrgije

sVtar

9.

Aaevpitrcol

Riscdeompla

Procesulinf

01
.
1
.
12
.

Acomunai

Nucomni

sVtar

A-aipcretlg

Depndt

sVtar

Aseprocuad
realizpo

Depndt

sVtar

8.

31
.

Aescra

64

41
.

nAva

65

CAZULI
Analizedbortxp
aDt
O1526.0

zAnaelifctu

ezRautl
obinute
12g%

Heomgnbli

aloVrinme
8132,g%la6unli

eHomacrit
Globeua

13%
10./mc

036-4%(12spt.)
60-175/mac2l
unli

olinPeucar

83%

60-7%

oLimecft

12%

30-8%

Monecit

4%

3-8%

finEozile

1%

0-4%

VSH

28m/h

7-8hm/

cCaoiuln

74m,Eq/l

5,2-60mEq/lasugr

Magunezi

813,mEq/l
baumlinabsent

,21-7mEq/l
albunm-iset

ugcozl-absent
gpmeinblarabseni

igmpenabr-ls
msedniatrpl

Examensurd
urin

glucoz-absent

eplat

esdimnut-r
aemorf

16IEGtraseudomnli vRfigraectinslb.
dComnralgic
6

67

CAZULI
TDEPANRIVSM CLO
cNrt.

Medicaumnlt

Module
epznrta

arcPemotl

oCmpriated50Ps1c/24
mg

uFciml

cPulirgane
de10g

Modeasmintr

cpx4(8-1260)

c2pulir/e4o
cpali6H(-1284)

ciunAea
eraptcui
nAalgecz,i
panciret

zDvoimlucs,
secrildn
ecasrfifluid
poxtfiecra

nperioadslztbvum icaen:
015.23

1+2
68

CAZULI
PLANDEGRIJ
aDt

0156.

Problema de
dependen
s-dpnie
fi-dcuieltan
maenlit

eObctiv

n-boavlusi
bunrespia
m-aenlit
corespunzat

eInrvti

-apreuibolnvmdtc

-msuorncfileavt
tempura
-nadmeisxztrgopc(35l/).Ou
lumezsncpbriaot-fl
aemsctuol70-9501p.
-puncioezvdafrslmb
suoperidtczl
anlizeordbt
-nadmeisztrclou
sevdaptiunlrmo
-dezuobstrcilapnfi
mas
-asupverghzfncilt mo
onafdietmpurlb

69

016.

-oubscietr

-bolnavusi

eil

-nadmisretpcv

snge

nazl

buenaspri

ncazulrespidt
-asupverghzfncilt mo

0186.

fi-dcuieltan
sehodni

0196.
026.

-ajuretnbovli
naseodihmrl
lintreua
-

p-oteniald
compeali

026.

-srepct
atrmeunlidc
mcedi
-ajuretpcnil
naserc

fi-dcuieltan
serca
Copildenuxsfm,cgtar8.90enizupbf3,5Ctsrodcval
domuiclnpreztvs fb.
ePbazurltoxmndfcesurzpitalnmobedvgsatizprcnoulb,svife.rmatnuc-polx4,mfli21c/urh-paetolidn102m4/r,-aspecobi.
70

uEvoialesftbr.
uCopliesxtrnacmd:v ulina015.gtbx3/z,evrcolpsuni
CONUZILASPR

Amnceuptraloidsfzgnev.caplutI,mrdsioebfacpltvn:,gioudscexpralvtgn,m.
eCFbutrconiasd mvl entrdoipEc(,g201)
uCopliatedvncsrmozaleupi
CFsunatdeclbfri
eDuazrdlgmnip5,sot1ue
Apaerdgunlvts5i

-azvertimpcunls

onafdietmpurlb
u-atjmlecforip
schimbealnrj
-ameztcuoplnir
aveopstucrzi
-asigurlnteocdfm
-aerisncptomul
-saupvegrhzncfilt
-nadmeisztrclo
-amndistreucl
supraveghzncfilt

rebTuisnagmcopltvreijsnuzm
ReducamfbrntpvFiC.
FCesuncvtfralgiopmzd,eacsntrpulimo.
uCopelcairntzvsbm eualch
Roluaseintcdmrp,bolueifamcntrpxoesvuliarmdpftcnoeulga(DEiTSIN)
ncaupitolImsdergjbv zcflaiopusner.btI9mdc
echntidgrjaplubov.
oCapluitIcrndegj svfbamiuortplzngjecbisoar.
eCicotrpaufsngjlmd,bitecapnsrluomidvtaepcrbusl,miotfnare.

duEacioensrlfm
Educaiesnrtpmoljfbcdeui

nPaiercsutpohglm

Conveulsfbi:radcpjzth-;nemiruocpsdbtleanm
74

RisculdepaoCFm=2-4%;rupclexa510)
aLucresnhiozlbfgtpuearcnijolsvfb.

BILOGRAFE
1. BaGlt,SnescuM.OKyowkiATrLhapldgjebnvo,EitumrcB198

2.

ucePriltad,EmB197

3.

uBonderlC.Macmitped,EuArL197Bci

1.

4.

EnescuaLrmFogli,dDtCTueM1r98

5.

GhemrasLiM.cdnt,voluIE Brei20

6.

HuliczI-oFeg,EdratmB19

7.

eIftimM.,NcuslGCopndaEitfircelo,Bu198

8.

MozesC.Thnicagrjbvl,EdtumBe198.

9.

PunR.Mcedirt,EapgoBuei

10.

TitrcL.-Ghdensug,EaVmolcBreti19
AgendamicluErtB198
76