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    COALA POSTLICEAL SANITAR CAROL DAVILA,ALEXANDRIA

    NGRIJIRI ACORDATE PACIENILOR CU PIELONEFRIT

    COORDONATOR :

    ASIST.MEDICAL PRINCIPAL : MITROI MIRELA

    CANDIDAT :

    MIRCEA I. ALINA-DANIELA

    20!

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    MOTTO:

    "S#$#%&%'& '(%' ) *)+) ' *&' /$ 1% (# )'/&(*#, '1 &)&' %)/ (' $&(* * '&.3

    4)*&%'

    "S#$#%&%'& $ '(%' %)%5, & %)%5 6## (#$#%&%' '(%'$+*.3

    S*7)'$7&'

    MEMORIU JUSTIFICATIV

    2

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    N+& ) 8&/& (*%# $' '(%' &*)&%# ' 5&$'%& PM9NT 16'*&' %'' (#-1 $# ;$%'&'&:

    "C+ &1 %'& (# $8'(%'(* ;$ %'5' +'5' &(%6'5 ;$*

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    R$*7? C# $&'.1. Rinichiul

    R$*7 ($% )>&$' ''*7' 1 & $ )5 '('$/&5 ;$ 6$*/& ' '@*'%'. E ($%

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    F'*&' 5)B# '(%' '5+%&%# ' ) 6)+&/$' *)$B$*%8)-6)&(# $+%# 6&(*& '$&5#*&' '(%' &5*#%%# $ )# 6)/': 6&(*& ''$&5# ( 6&(*& '%)'$&5#.

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    Forma rinichiului i dimensiunile.

    R$*75 (' &('&+#$# * $ ) ' 6&()5' 1 '$%#: ) 6&/# &$%') +& )+&%#, )6&/# )(%') 5&%# *)$8'@#, ) +&>$' +'&5# *)$*&8#, 1 )# '@%'+%&/ (') ( $6').P' +&>$'& +'&5# (' &65# hilul renal, ) '(*&%# &5$>%# ;$&@5 $*75, ;$ *&' (' >#('(* '5'+'$%'5' '*55 '$&5 8&(', $'8, *# $&'.

    455 (' '5$>'1%' ;$ $%')5 $*75 $%-) (*)%# $+%# ($(5 '$&5, ;$*&' (' >#('(*: /'(% *)$B*%8 >&(, &+6*&/5' 8&('5) '$&5' 1 )/$5' $/&5' &5'*#5) $&'.

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    Nefronul E(%' $%&%'& +)6)6$*/)$&5# '$&5# , ;$'5$'1%' %&%' )*'('5' *)+5'@' *&' & *&'5%&% 6)+&'& $.N'6)$5 '(%' &5*#%% $:

    O *&(5# ?

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    U$ % $6' 5$>. P)@+&5 I$%'+'& (/' D(%&5

    C&(5& K)+&$$, '@%'+%&%'& )@+&5#, ;$*7(# 5&%'&5# & $'6)$5, &' 6)+&$' *' * ''/ 5, +#>$$ ) *&8%&%' *' *)$%$# 5+'$5 %5. $ &5)+'55 &5*#%'(* *&(55 '$&5 M&5>7. S'>+'$%5 )@+&5 &5 %5 $6' '(%' *)$(%%% $%-) )/$' *)$%)%#, %5*)$%)% )@+&5 *&' (' &65# ;$ *)%*& '$&5# 1 '(%' 6)+&% $%-$ (%&% ' *'55' &*#) +'+&$#, (' 5+'$, '$%# ) "+&>$' $ '3, 6)+&%# $ +*)85, *&'+#'(* +5% (&6&/& +'+&$'.

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    Vascularizaia rinichiului A%''5' *&' ># &*'(% )>&$ )8$ '*% $ &%'& &)%& &)+$&5#.V&(*5&&/& &%'&5 & $*75 '$%# $'5' *&&*%'' &%*5&', *&' $ ($% '*7 6)+

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    *#%' % $6', $' (' *&5&', 6)+'%&%8' $ 5'@5 '$&5. A*'(%' 6' &B$> 5&$*7 ' *&5'& 8&('5) '$&5'. C&(5& '(%' $'8&%# ' 6' ('$%8' +'5$*'.

    . Cile urinare

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    o S') ?o MB5)*' ?o I$6').

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    E(%' $ )>&$ %5& 5$> ' 2-0 *+, *' (' ;$%$' ' 5& &$'%, ' *&' ;5*)$%$# &5 * 2 '>$ +& ;$>(%' $& (%&%#+'&% ( &$'% 1 &5%& 5& $%&'& ;$ +*5 &$. P#%$''& '%'5 ;$8'*& $ '(%' )5*# ' ) (%&$%# ' -2 *+, &*'&(%& 6)+&$ *&8%& &1'&% ;$ +*5 &$, ;$ 5)B& 8'*&5#. E& '(%' $+& ;$&%'& ;$8'5%# ' '%)$'? '(%' 6@&%# ;$ 5)B& ' $%-$ 5>&+'$% '%)$'&5,$ *)$%$%&%'& * '%& 1 '%''5'..V'*& &' ) 6)+ 8&&5# ;$ 6$*/' ' *&$%%&%'& ' $# *&' (' >&('1%' ;$$%')5 '? *%$&5' ?

    L& $8'55 6$5 8'* $&', (%&%5 **5& 6)+' (6$*%'58'*&5 $%'$. T$*& +(*5 +& )&%# $+'5' 1 ' +1*75'%() 8'(*&5 1 &' )5 ;$ '8&*&'& $.

    T$*& '@%'$# ?

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    A%''5' *&' 7#$'(* 8'*& $, )8$ $ &%''5' 8'*&5', 6$ &+'*%' (& $'*%' &5' &%'' 7)>&(%*' 1 &5' &%'' '*%&5' +'.V'$'5' & $&1%'' ;$ (+*)&(# &) 6)+' 5'@ *&' '$'('5' *#%' 8'$& 5&*# $%'$#.

    L+6&*%'5' *)$* 5+6& *#%' >&$>5)$ 5&*.N'8 (+&%*) )8$ $ 5'@5 7)>(%*, & *' &&(+&%* $5'@5 '58*.

    U'%#.

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    *&5 +& +&' '** (' '+# ;$ '@*5(8%&%' 5& '5+$&'& $ 8'*& $.P''%'5' '%' 6'+$$' (' *)+$' $ %$*:

    o M*)&(# ?o M(*5 ?o E@%'$#.

    S%&%5 **5& $ %$*# +(*5 5& '@%'+%&%'& (') (6$*%'5$'%' &5 '%', & 5& *'& $(' 8'(%55 8&>$&5, (6$*%'5 (%&% &5'%'.

    1.. !rezentarea teoretic a bolii

    1..1 Definie

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    P'5)$'6%& &*%& *)$(%%' $65&+&/ &*%' (& *)$*' *&' &6'*%' /'(%5$%'(%/&5 '$&5 (&/5 $%' $'6)$. I+)%&$/& 5) (' &%)'1%' 6'*8'$/' +& 1 ;$*)$%$# *'1%'' & $6'*/5) $&' *&(& )1$%# & $6'*/5) $%'(%/&5', >&8%#/5).

    C*& -20 $ *&&8'5' &%(&%' '$%# 5'$ ' '5)$'6%#. V&%8 $'()5&/, 5)*%) $)+&5 & %&*%5 >&(%)$%'(%$&5,

    &&/$& P)%'(, 5'('55&, A')&*%',P&&*)5 ( A5*&5>'$'( 6&'*&5(. C %)&%' ')+$&$/& >'+'$5) >&+ $'>&%8, ;$ '5)$'6%& &*%# '@(%# *&,+& &5'( 5& )5$&8 (%&5&/ *&'& 6)(% (1 $) +&$'8' )5)>*' (& $)%&%&+'$%' * &$%)%*', ;$ *&' &&/& '5)$'6%'5) &*%' (' '&5' * >'+'$ '(&$6'*/', $%)1 ' *&' &(*'$'$%# (& *&' ;$5)*'(* ' *' $/&5, '&*&/$ %&%&+'$%. A&/& $) >'+'$ >&+ $'>&%8 '(%'$/ P)%'( (& C)5, ' '$6'*/' (&

    (&$6'*/5' * P(')+)$&( '%'+$# %&5) *5$*' ('8''. O '8)5/%' ('8'& )%&8'& '5)$'6%'5' &*%', ;$%5)-)%8 (& (+5%&$ * +& +5/ >'+'$,, 65)& &*%'&$#+@%# 6$ '((%'$%# ( %'$&*' 5& %&+'$%.

    !atogenie D$ $*% ' 8''' &%)>'$*, &**'(5 >'+'$5) 5& $8'55 &'$*7+5 '$&5 (''&5' ' )# *# 1 &$+':

    C&5'& &(*'$'$%# *&' '(%' *'& +& 6'*8'$%#, $%'8$' +& &5'( #$ *&5)5$&85) * )&% )(%*%8', '@5)# $(%+'$%&5', +&56)+&/*)$>'$%&5' ' *# $&', '65@ 8'*5)-'%&5 '%*.

    C&5'& '(*''$%# 7'+&%)>'$# '(%' ;$*+$&%# ;$ *(5 $6'*/5)

    >'$'&5', *&' & *& $*%' ' 5'*&' 6'%' 6)*&' ' $6'*/' ;$ &*'(% +)(' '&5' '5)$'6%& &*%# ;$ *&5 (%#5) &*%''$', +& &5'( 5&)5$&8 * '(%'$/# '$&5# (*#%#.

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    C'& '-& %'& *&5', 1 &$+' calea limfatic, *)$(%%' +& +5% ) )%'&:S' '($' *# >'+'$ ($% 8'7*5&/ $ *#5' 5+6&%*' ' 5& $ 6)*& $6'*/)( ;$

    8'*$#%&%' & '@(%& 5'>#% 5+6&%*' ;$%' *)5)$5 &(*'$'$% 1 $*75 '%.L)*&5&'& ')+$&$%# & )*'(5 $6'*/)( 5& $8'55 +'5&' (' '@5*# $: F)+&'& ' &+)$. * &*6'' 5)*&5 1 $&*%8&'& *)+5'+'$%5 ? 4'%)$*%&%'& &*'(%' )$', *''& *' ;$*'%' &(& &*%8%#/ 6&>)*%'5) ? F5@5 '$&5 +$&% ;$ &*'(% %'%).

    1..# $natomie patologic

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    &%'& &$%')-$6') & &)+'$5, +'$%&5' '@%'$' 1 *)&(& $%'$& '('*%8&. D''& 5)+ ()$%&$#, $5&%'&5#, ' $%'$(%&%' '(# (#, (>'' ) %)#'$&5#, 5% '$&5# 5&%'&5#, ) '5)$'6%#, ) %'*5)# (& *&$*' '$&5.

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

    1..( Diagnostic paraclinic

    D'(') )&5& ;$*'' ( 6)+& $' (%# $6'*/)&(', * 6()$ 1 6'#, (* $(%&5&%';$()/%' ' ' 5)+&' $ (& 5&%'&5', ' $%'$(%&%' 8&&5#, $') (', &5%')$%'$(', * &' *#%' '>$'& &$# *& ) &'8#&%# *)5*& $'6%*#. S$% '('$%' %5# ' +*/$': +*/$ ')&(', )5&' $& 1 $)*%$#,('. U$& '(%' %5', $') 5'$%# (& 7'+&%*# (' '+&*# ;$ ('*&5 )7'+&%' %'+$&5#.U$ )5$&8 )% ''$%& 1 >'/, 8#(#%, ' &)+$&5'. L(& '5) 5)+&' 1 & %5&5) +*/)$&5' )&%' 6&*' +& 6*5# )'$%&'&+'*5 *#%' ) '5)$6%# PNA, %&5)5 *5$* 6$ *)+ $ * *'5 &5 &5%) (%#

    $6'*/)&('. L& '@&+'$5 6* *)$('+$#+ ('$(5%&%'&& 5)B'5) '$&5', '8'$/ $+&$'8& G)&$), *&' )&%' 6 )%8# $ (& 5&%'&5. P$*%5 *)(%)8'%'&5 1 +& &5'( *'5 *)(%)+(*5& ($% 85'. A*'(%' ('+$' 6*'($% %5' '$% 5)*&5&'& '$&5# & $' (%# $6'*/)&(' &&'$% +%8'. P$*%'5''%&5' ($% ('$(5' &%

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    L& $ )5$&8, ;$ ('*&5 5& #%'$'&5# )&(%#. $ PNA, *)$%&(%&/' ;$%$)(%*5 6''$/&5 ;$ &6'*/$5' $'6)5)>*' (' 6&*' &(%6'5: ;$ '5)$'6%# && &( 5& +*/$', )5', $# %5', '

    5)+&' 1 6()&$' ' *5)+'5)$'6%# $ && &*'(%'

    (+%)+' & && 7'+&%', )5>', ''+' '6'*' 1 *)$6'. ;$ '5)$'6%# && &%&5>5' 1 +&5>5' & ;$ $(6*'$/# '$&5#

    &*%# && ' ;$ 65&$* 1 ''+&/''& *)&'5) 1 & 5&'*)&'5).

    ;$ '5)$'6%# &&' ))('&5& &()*&%# * ) (%&' >'$'&5# )&(%#,

    6()&$'5', $&'%'$/# 1 *'6&5'& ' *$)(%*5 '(%' +& $ '*5)+'5&' 1'$' ' '*)*%&'& &>$)(%*5, ' %&%&+'$%5 &$%)%* &+$(%&%, ' ''$/&

    7'%'$($ &%'&5' 1 ' '8'$%&5& ''$/# & $ 6&*%) 6&8)&$% *' )&%' 6')58&% *7>*&5.

    Complicaii P$*&5'5' *)+5*&/ &5' '5)$'6%' &*%' ($%:

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    P'$'6%& (&%& 65'>+)$5 '$'6%*, '5%&'& $6'*/' ;$

    /'(%5 ''$&5 ' *&5' 5+6&%*# (& $ '6&*/& $ )*'( (&%8(*&(5& ;$ &%+)(6'& ''$&5#.

    P)$'6)& &*%# $ *&' ;$%'>5 $*7 (' %&$(6)+# ;$%-) $># ' )

    &*'&(%# *)+5*&/' &&' 5& )5$&8 * )&% *)$(%*%8' 1 * '(%'$/#(*#%# 5& $6'*/, *& +&' & $' '$%/ (& & $' )5 *)$(+%8'.P)$'6)# &*%# (' )&%' ;$()/ ' ('%*'+' (& ' ('%*))+'.

    N'*)# &5 '$&5# (' %&*' $: S%&' ('%*# >&8#? C)5* '$&5'? 4'+&%' +&*)(*)*#? K&*%'' +)%&$%#? E5+$&'& $ $# & $) 6&>+'$%' ' &5# $'*)&%#?

    S'%*'+& '(%' ) $6'*/' >'$'&5&%# &%)&%# #%$' ;$ **5&/& (&$>8$#,*)$%$ (& $%'+%'$%, & >'+'$5) &%)>'$ 1 & %)@$'5) 5) $%-$ 6)*&('%* (& *$)(*% (& $, +&$6'(%&%# *5$* $ 6'$)+'$' %)@*' $6'*/)&(' 1* ) '8)5/' '@%'+ ' >&8&.

    I$(6*'$/& '$&5# &*%# (' '6$'1%' $ (*#''& & 6$*/' '$&5',

    '5%&%5 6$ $*&&*%&%'& ' & +'$/$' '*755 7)'5'*%)5%* 1 ' &'@*'%& )1 &)%&/.

    1.., -ratament

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    .1. Internarea pacientului n spital

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    5$1%'& )5$&85, *'&'& $' (%# 5#*%' ' *)$6)%.

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    o (' 6*)$' +'+'5' $6')&' * &5*))5 1 ('

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    )*+'$%&/& 1 &5%' $%'8'$/ (8'$%' 5%') 1 6)&%' +)%&$%' '$% $%'8'$/&*7>*&5'. T&$()%5 (' 6&*' * $ *#*) )5$&85 6$ &1'&% *)$6)%&5 1&*)'%.#n sala de preanestezie: S' 8'6*# '>$'& &(# 1 (' $)%' '8'$%&5'5' '(*)&/ '*'+', $%'%>)

    '%*.? S' 8'6*# (%&'& ' *#/'$': '>$'& $>7$&5#, )+55*5, &@5'5', (&/5'

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    +#% &*'$%5: (' $(%&5' 1 ('6@' &*'$%5 ' +&(& ' )'&/', +)$%)&'& 6$*/5) 8%&5', )/$''& $&) 8'$)( &$5#, *&%'%' ;$ 6$*/' ' $%'8'$/' 1 ' &*'$%, '>#%'& *

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    )'&%), &B)$&'& * %$*%# ' ) &5*))5 ' 0) C (' 6&*' ;$*'$)(%*5. L& ;$%'# 6*5', (' 8& #($': " 8& %' (# ;$%'#++'*5.3

    S# (' $# ;$ &*'5&1 (&5)$, ;+'$#, ) &*'$/ )'&/, ;$ &*'&1 , * &*'&1

    $%'8'$/'.

    Suravegherea os!oera!orie

    S&8'>7''& )(%)'&%)' & )5$&85 ;$*'' $ +)+'$%5 %'+$# $%'8'$/'*7>*&5', ;$&$%' *& &*'$%5 (# 6' %&$()%&% ;$ (&5)$? $ &*'(% +)+'$% '8$')'*%5 &%'$/' *)$(%&$%' '$ +)$%&%' ;$ ''%', * ' ;$ (%&' ' 6$*/)$&' 1 * &&&%# '$% &(&/'. P&%5 8& 6 '8#% * +1&+& 1 &5'# $' ;$%$(#, 6## '$# 1 &*# '(%' *&5

    #ngrijiri acordate pacin$ilor opera$iD' *&5%&%'& 1 +$)%&%'& &*'(%) ;$>B '$' ;$ +&' +#(#, '8)5/&)(%)'&%)' 1 &('$/& *)+5*&/5).

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    '$% '8%&'& %'*' &*'(%)& ;$ *#5' &''$'. &>%&/& ''$/& &((%'$%' +'*&5' '(%' )5>&%)' 5# &*'$%, 5& %'', ;$

    (%&'& ' ('+*)$1%'$/# )'&%5 %$' (# %&># ' &$(&+'$%', ' '$ (&()$'.

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    +'$/' )(5' (# 8'& (# *))&' $ &%, (# 8'& (# '& ;$ &*'(% *&

    &((%'$%& +'*&5# '(%' *'& *&' ; 8& & (# '& -2 5$>/' ' , # %'',&*# )5$&85 $ & 8)+&% ;$ 5%+'5' )& )', (& *& +'+ & 6&+5' &65&/5# &*'$% (#- '& (# '& 6## (*'$#+)+)%)&(', 6## 8%&%) +5/. 8& ;$*&B& &*'$%5 (# (' +1%' $ &%, (# (' ;$%)&*# ($> ' ' ) &%' ' &5%&,

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    D&*# (-& 5#>% (& (-& '5&(&%, '5 8& 6 ;$%#% * ) 6&1# $)# (&(#, 6## (# (' '(6&*#*'5 &5*&% ;$ (&5& ' )'&/'. S' *)$%)5' ' +& +5%' ) ' &*# 5&>& $('', &*# &$(&+'$%5 $ (-& &% * ), &*# +& B)( ' '>$'& 5'&%# &&& ''+' (& *&$)#, (' 8& 5#> &$(&+'$%5 '$% & '8%& (*7'+& '>$ $*&& %5#5) ' **5&/'. D# )'&/5' &('%*', &*# &$(&+'$%5 &+'

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    (& 5&>& (' (' '(6&*' &$(&+'$%5 '$% *)$%)55 5#> 1 (' (*7+& 5&$%'8&5' 6@&%' ' +'*. D&*# 5&>& (', 6'*8'$/& (*7+# &$(&+'$%5 ('8& 6&*' ;$ &)% * ('+$'5' 5)*&5' 1 >'$'&5' ' *&' 5' '$%# )5$&85. C+'$%'5' $ B 1 ('*'/5' '@(%'$%'. L& $'8)' (' 6&* '*)5%#'$% ;$(#+*&5' &(& )>&$'5) $%'$', '5' )% 6 ('6*&5, ')>$' &'$%&5# (& )6$#, ' )>$' 8(*'&5#. $ %)&%' *&5', +'*5 *7>*&' & '6'*%&% $%'8'$/& *7>*&5# '*' *)$% ' +&% 1 '(*' &$&5>'*'5'.

    Lupta &mpotriva insomniei

    E@(%#, ;$ 5'5' $)&(%', ) ;$%'&># >&+& ' 7$)%*', $%' *&' (' >#('(* *'5' *' )%6 &+$(%&%' 6'*# &*'$% '$% & )/$' '6'*%5 )%.

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    A$@'%&%'& )()'&%)', ;$ 6&/& $'*$)(*%5, '''$%&% ' &*%5 *7>*&5*)$%$# 1 )(%)'&%). F*& ' '', ' *)+5*&/, ' ('*7'5' 6&*' *& &$@'%&%'&

    )'&%5 (# 6' ''$%#. A* $%'8$' )55 +)&5 &5 &((%'$%' +'*&5', *&' 8& %' (# 6&*# )'&%5 (# $*''' ;$ '*7& ' *7>, ;$ '*7& ' &((%'$' +'*&5', (#-5 6&*# (# ;$/'5'&>#'8)5/& )(%)'&%)' 1 6&%5 *# 8$'*&'& 8& 6 6## *)+5*&/ (& ('*7'5'.

    Lupta &mpotriva distensiei digestive

    T)&%' $%'8'$/5' *7>*&5' &)+$&5' ($% +&%' ' &'' $%'(%$&5', * '%'$/'' >&' 1 5*7' $%'(%$&5'. A*'(%'& ($%, ' )*', ' (*%# &%#, $''#1$ 5'. A*'&(%# (%'$(' &)+$&5# '8$' $)*8# *'1%' 1 &$%'$'$%&%8' 1)&' '5&'& 6$*/5) 8%&5'.D' &('+'$', (' &+$(%' )*' *&' 6&8)' '5&'& '(%&5%(+5$%'(%$&5, (&, ;$ &$+%' *&, (' $(%&5' ) &(&/' *)$%$# * ) ()$#>&(%))'$&5#.

    Lupta &mpotriva stazei venoase

    46

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    C %)&%' )>'('5' %'&' &$%*)&>5&$%', &**'$%'5' %)+)' 8'$)&(' #+'.S*5&%5 $ &% '*)*' ''$%# +'%)& *'& +& '6*'$%# '$% '8'$'&*)+5*&/5) 8'$)&('. $ &6&& *)$%&$*&/5), %)/ )'&/ (' 8) *& $ &% ;$('&& 5' $%'8'$/' (& & )& # )'&/'. A*'&(%# +&$'8& (+5# '(%' '$'6*#

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

    RehidratareaD# $%'8'$/ *7>*&5', ;$ +) ('*&5 ' %5 >'(%8', &5+'$%&/& $)+&5 ('

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    #%, *

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    $ 8& *)$(+& 6*%' *' (& >5*' ;$ '@*'(.$ & )'&/', &*'$%5 8& '& * 5$>/&, '7&%&'& 6$ *)+5'%&%# *'6. D# 2! ' )' *'&, *%)$ 1 (# ' &&8&% $+& '&+#, & & )# *'&, *%)$ ;$5*%#, 5&%' * *'& 1 ', &('+'$'&, '&+# ' 5& (& ' &&8&%? &%' &%, 6'&, %#'/' * 5&%', ' ' *&%)6, (*/.

    D# '5&'& %&$%5 $%'(%$&5: *&$' ' , '1%' &5 1 '8$', %'%&%, 5&&5+'$%&/& )1$%#. N %'' %&% *# '$% & 6&8)& '&5+'$%&/&, &5+'$%'5'%'' (# 6' *&5', $' '&&%', ''$%&%' '(%'%* 1 ;$ 8'('5# 6)&%' *&%#, ;$()/%' '&+&5%&%'& 1 $#8)$/& &((%'$' +'*&5'.

    .19 "ducaie pentru sntate. !rofilaxia bolii

    K)&5& '$&5# )&%' 6 '8'$%# $') $ *)$%)5&'& $) )5 (& 6&*%) *'*)$%' 5& &&/& &*'(%'&. D$ +)+'$%) *' )&5& '$&5# '(%' *'5 +& 6'*8'$% &%# '7'%'$($' &%'&5# (& &'% &7&&%, +'$/$''& ;$ 5+%' $)+&5' & %'$($

    &%'&5' 1 & >5*'+' '8$' &&/& )5. C *. P&*'$/ %'' (#;$8'/' (#-1 +#()&' ($> %'$($'& &%'&5#.

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    %&%&'& &5%) &6'*/$, *& 5% '$&5# (& &5%' )5'+& &5' %&*%5 $& *&')% 5)*& 65@5 $& $)+&5.

    '8%&'& +'*&+'$%'5) * )%'$/&5 (%*%8 &(& $*75.M'*5 *&$%%'' $6)+&% ' )*' +'*&+'$% (& (5+'$% $%%8 ' *&' &*'$%5)'1%' (# 1 5' &+$(%''.

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    '8%&'& $) $8'(%>&/, *' $'*'(%# &+$(%&'& $' ((%&$/# ' *)$%&(%,'*+ )>&6& $%&8'$)&(#, &$>)>&+& (& *)+%' %)+)>&6-5. S(%&/&' *)$%&(% )&%' '%')& 6$*/& '$&5#.

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    .11 "xternarea pacientui P&*'$%5 (' $%'$' '$% ' 5)+&' 5&%'&5', )5&(', 6()$, 6'#) C, 5)+&5> 1 %5# +*/)$&5'.E@&+'$5 )'*%8 '(%' 6#*% * +&$8'&G)&$). I$8'(%>&/5' ' 5&)&%): *'&%$$&, '', (+& ' $#, )*5%#, '*)>&6' '$&5#\ UIV. S' *)$(%%' %&%&+'$% * &$%)%*' &$%(&(%*', 7&%&' )&5# \ PEV *>5*)# a.

    E8)5/' 6&8)&5#, &*'$%5 (' '@%'$' &+'5)&% ;$ 6$*/' ' *&. V& +& $'>+ >'$)-'%'%*, '()&%, ;$ 6$*/' ' &6'*/$5' &()*&%'.

    $ 6$*/' ' '8)5/& )5, 8& +& %&%&+'$% &% ' +'*5 *&$%.R'*)+&$# ' 8&/#: '8%&'& *)$(%&/'? &)% 5*7&$ *'(*% '$% & &(>& ) '# &$'$%#? $# '>5&%'? '8%&'& 6>5 1 & +''5? '8%&'& $6'*/5).

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    Cap. III. /ngri0iri specifice$azul I

    ).Informaii generale:N+': TP'$+': I.D&%& $&1%': .2.!2S'@: F'+$$O*&/': P'$()$

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    P'5)$6%# *)$*#? L% '$&5# 5&%'&5#?

    Istoricul bolii: P&*'$%# *$)(*%# * 5% '$&5# 5&%'&5#, * $6'*/ $&' ''%&%' 1 *&5*5'5+$&% ;$ +# * 2 &$, (' $%'$' '$% ' 5)+&' 5&%'&5, %5#

    +*/)$&5'.*.Informaii generale Capul T'>+'$%' 1) &5'? M*)&(' $)+&5 *)5)&%'? P& +', *#$%? U'*7 ' *)$6>&/' +'' $';$>B%'? C&8%&%' *&5#:

    '$%/' $*)+5'%#? >$> &''$%' $/5) +*)&(# *&5# +'#, ), 5+# $)+&5#.

    -runchiul F## ('+$' &%*5&'? P'5' $)+&5#, 1)# &5%&%'? '(% *'55& &)( $)+&5 '''$%&%? P)5'+' *&&*' ''$%'?

    50

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    P)5'+' '(&%): ++ 8'*5& ''$%.:embre F## ('+$' &%*5&'? N)+&5 *)5)&%'? M'( $)+&5.

    2istem ganglionar: $'&5&5?

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    $parat respirator:

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    5+)$&'. N %1'1%'.

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    $parat digesti+ A)+'$ +)5 * '(&/&, S'$(5 5& &5&' ;$ 65&$*5 '% 1 65&$*5 (%. A'%%5 ''$%, 1) +$&%. T&$% $%'(%$&5 $)+&5.

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    )1$%#? $+#5 ' +'(': 2 +'('? &'%% ''$%?

    2. Comportament 0- />&'%'? $'&># *)$(+5 ' &5*))5?

    . 4biceiuri n legtur cu eliminrile: (*&$:

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    $#: $# %5'? * 5'*)*%' 6'*8'$%' 1 7'+&%? H- +*/$.

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    G5*'+'Y 00 +> L?"xamen sumar urin?

    U)*5%# . E. *)5 00.000 >'+'$++?

    A5+$'-!,? A56&->5)5$' -,? A56& 2->5)5$' -0? K'%&->5)5$'- 2, G&++&- >5)5$'- 22,

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    I$*' &'$*7+&%)( '(.-ratament medicamentosD&%& M'*&+'$%' M) ' &+$(%&'0.0H.20! L'8)65)@&*$# 00+> PEV. N)-(& 6 @ 2 PEV

    A5>)*&5+$ 6 @2 PEVF)('+ 6 PEVG5*)#

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    ,. #iagons!ic medical D&>$)(%* ' %+%'':

    P'5)$'6%# *)$*#? D&>$)(%* 5& $%'$&':

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    P'5)$'6%# *)$*#? L% '$&5# 5&%'&5#?

    D&>$)(%*5 5& 2 ' )': P'5)$'6%# *)$*#?

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    :embre

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    F## ('+$' &%*5&'? N)+&5 *)5)&%'? M'( $)+&5.

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    M 8'*5& ''$%, 6## &5, )$1*' ('+$&%' ;$ &+'5' &5+)$&'. N %1'1%'.

    $parat cardio+ascular: T.A: 00 ++4>. , A.V. 0 .+$., %+ '>5&%. )* &'@&$ (&/5 V $%'*)(%&5 (%, ' 5$& +')*5&8*5. b>)+)%' *&&*' $)+&5', 6## (65'.

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