Evaluarea Si Controlul Simptomelor in Tratamentul Paliativ

8/20/2019 Evaluarea Si Controlul Simptomelor in Tratamentul Paliativ

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MINISTERUL EDUCAŢIEI ŞI CERCETĂRII ŞTIINŢIFICE

EVALUAREA SI CONTROLUL SIMPTOMELOR IN TRATAMENTUL PALIATIV

DOMENIUL: SĂNĂTATE ŞI ASISTENŢĂ PEDAGOGICĂCALIFICAREA: ASISTENT MEDICAL GENERALIST

2015



CUPRINSI. ARGUMENT ................................................................................................... PAGINA.... 3II. CONŢINUT ...................................................................................................... PAGINA.... 4 II. Sco !" .............................................................................................................. PAGINA.... 4 II. 2. O#$%c&$'%........................................................................................................ PAGINA.... 4 II.O#. 1. A (o)!*+,(%, co*c% &!"!$ +% -* ($/$($ ,"$,&$'% .................................... PAGINA.... 5 II.O#. 2. P(% %*&,(%, , 4 $ &o % )(%c'%*&% -* -* ($/$($"% P,"$,&$'% .................. PAGINA.... II. 2.1 D!(%(%, ..................................................................................................... PAGINA.... II. 2.2 S$ &o % +$ % &$'%: G(%, , $ V6( 6&!($"% ............................................... PAGINA.... 7 II. 2.3 T% ! %*&%"% ............................................................................................. PAGINA.... 10 II. 2.4 D$ *%%, ................................................................................................... PAGINA.... 11 II.O#. 3. Mo+,"$&6 $ +% %',"!,(% , $ &o %"o( -* -* ($/$($"% ,"$,&$'% ............... PAGINA.... 12

II. 3.1 E',"!,(%, D!(%($$ ........................................................................................ PAGINA.... 13

Co*&(o"!" D!(%($$ ......................................................................................... PAGINA.... 18 II. 3.2 E',"!,(%, S$ &o %"o( D$ % &$'%: G(% !($ $ V6( 6&!($ ............................. PAGINA.... 17 Co*&(o"!" (%&!($ $ ',( ,&!($ ....................................................................... PAGINA.... 21 II. 3.3 E',"!,(%, &% ! %*&%"o( .............................................................................. PAGINA.... 21 Co*&(o"!" E c,(%"o( ..................................................................................... PAGINA.... 22 II. 3.4 E',"!,(%, D$ *%%$ ..................................................................................... PAGINA.... 22 Co*&(o"!" D$ *%%$ ...................................................................................... PAGINA.... 23II.O#. 4. I "% %*&,(%, !*!$ G9$+ %*&(! -* ($/$($ P,"$,&$'% -* % c,(% ............. PAGINA.... 23 II. 4.1 C", $)$c,(%, c"$*$c6 , E c,(%"o( ................................................................... PAGINA.... 24

II. 4.2 C", $)$c,(%, c,! %"o( -* )o( ,(%, % c,(%"o( ................................................ PAGINA.... 24 II. 4.3 M6 !($"% +% (%'%* $% , % c,(%"o( ................................................................ PAGINA.... 2

II. 4.4 A"$ %*&, $, $ 9$+(,&,(%, ,c$%*&!"!$ c! % c,(% +% +%c!#$&.......................... PAGINA.... 2 II. 4.5 A "$c,(%, (!"o!($"o(;$*%"%"o( ....................................................................... PAGINA.... 28 II. 4.5 Sc9$ #,(%, o &!($$ ,c$%*&!"!$. Mo#$"$ ,(%, ............................................ PAGINA.... 2 II. 4. A "$c,(%, ,* , %*&!"!$ c! !* !%*& .......................................................... PAGINA.... 30 II. 4.8 P(%"!c(,(%, "6 $$ -* % c,(% ......................................................................... PAGINA.... 31 II. 5. P%( %c&$'6 %( o*,"6 , c,*+$+,&!"!$< O# %(',(%, $ 6 !(,(%, (% $(, $%$....... PAGINA.... 32 II. U&$"$&,&%, o"!&$$"o( , $&% ...................................................................................... PAGINA ... 34III. =I=LIOGRAFIE .............................................................................................. PAGINA.... 35 >E=GRAFIE ................................................................................................... PAGINA.... 3



3

Argument

?Ro"!" % %* $," ," , $ &%* %$ %+$c,"% co* &6 -* , ,/!&, %( o,*6 #o"*,'6 ,! 6*6&o, 6 6@ $ %* $*6

6*6&,&%, B ,! 6@" , $ &% -* !"&$ %"% c"$ % .V$( $*$, %*+%( o*

* ,c%, &6 "!c(,(% +o(% c 6 co& -* %'$+%* 6 (o"!" +%o %#$& +% $ o(&,*& c% "% (%'$*% c,+(%"o( %+$, $ &,(%, #o"*,'$"o( -* c,+(!" -* ($/$($"o( ,"$,&$'%. L!c(,(%, +% ), 6 co,&% -* %'$+%* 6 $ o(&,* , ,#o(+6($$ ,c$%* $"o( -* ,&$ ),c%(%, *%'o$"o( )!*+, %*&,"% $* *+ co*& +% , %c&%"% %c$)$c% ,"% )$%c6(%$ P($* &!+$%(%, ,c% &!$ !#$%c& , ,/!* ", o -* %"% %(% $ c!*o, &%(% , )$$* %$ ! ,*% $ , o+!"!$ -* c,-*&(% $*% (%", $$ $*&%( %( o*,"% coo %(,*&% #, ,&% % (% %c& -*&(% % #($$ %c9$ %$ +% -* ($/$



4

CONŢINUTUL

II. 1. Scopul

Sco !" ,c% &%$ "!c(6($ co* &, $* +% c($%(%, %',"!6($$ $ co*&(o"!"!$ !*o( $ &o % +% -*& "*$&% -* -*$ "% %*&,(%, !*!$ 9$+ +% -* ($/$($ ,"$,&$'% -* c, !" ,c$%* $"o( c% (% $*&6 % c,(%.

II. 2. Obiective

@ O#$%c&$'!" 1: A( ! %*&,(%, co*c% &!"!$ +% $* ($/$($ ,"$,&$'%.@ O#$%c&$'!" 2: P(% %*&,(%, , 4 $ &o % )(%c'%*&% $* $* ($/$($"% ,"$,&$'%.@ O#$%c&$'!" 3: Mo+,"$&,&$ +% %',"!,(% , $ &o %"o( $* $* ($/$($"% ,"$,&$'%.@ O#$%c&$'!" 4: I "% %*&,(%, !*!$ G9$+ %*&(! $* ($/$($ P,"$,&$'% $* % c,(%.



5

Evaluare si controlul Simptomelor in tratamentul Pileativ

Obiectivul 1.

Argumentarea conceptului de ingrijiri paliative

F!*+, $, +% -* ($/$(% ,"$,&$'6 B17 1 , +%)$*$& &(,&, %*&!" ,"$,&$' c,: ?o -* ($/$(% ,c&$'6 , #o"*,'$"o( ,)", $ț ț ț

c,(% #o,", *! ,$ (%,c $o*%, 6 ", &(,&, %*&!" &(,+$ $o*," c,(% ,(% c, co (%"!* $(%, '$% $$ $ -* $&!, $, -* cț ț ț ț

$ &o %"o( % &% %* $*!& ", !* *$'%" ($+$c,& .ț

* ($/$(%, ,"$,&$'6 (% (% $*&6 -* ($/$(%, co "%&6 , %( o,*%"o( c! #o,"6 $*c!(,#$"6< ! !( *+!@"% !)%($($/$* -* ,c% &% o %*&% +$)$c$"%.

Co*)o( ,c% &%$ +%)$*$ $$< -* ($/$(%, ,"$,&$'6 % , "$c6 % ,(c!( !" !"&$ %$ %($o,+% +% '$, 6 ,c$%*

+% ,"$,&$' -* %, *6 , %"$o(,*&< c," ,*&< %+,&$'.

* ($/$(%, ,"$,&$'6 ($/$*6 ,c$%* $$ c!:@ *%o ", %@ IV $ S$+,@ =o,"6 *%!(o"o $c6 (o (% $'6@ =o,"6 !" o*,(6 -* &,+$!" ,',* ,& $ &%( $*,"@ I* !)$c$%*&6 (%*,"6 ,! c,(+$,c6@A"&% #o"$ $*c!(,#$"% (o (% $'%

Co*)o( O( ,*$ , $%$ Mo*+$,"% +% S6*6&,&%< -* ($/$(%, ,"$,&$'6:ț

1 ,)$( 6 '$, , $ ($'% &% o,(&%, c, !* (oc% *o( ,"ț

2 co* $+%(6 o,(&%, c, o %H %($%* 6 ',"o(o, 6ț

3 *$c$ *! (6#% &%< +,( *$c$ *! -*c%&$*% &% o,(&%,4 c," %, 6 +!(%(%, $ ,"&% $ &o %5 $*&% (%, 6 -* ($/$(%, $9o"o $c6 $ $($&!,"6

o)%(6 ! $*%(% %*&(! , ,/!&, ,c$%* $$ 6 +!c6 o '$, 6 c & ,$ ,c&$'6 c! !&$* 6ț ț ț ț8 ,/!&6 ), $"$, 6 ),c6 ), 6 +!(%($$ț

% &% !"&$+$ c$ "$*,(6< $*c"! *+ %+$c$< , $ &%*&%< $9o"o $< $9$,&ț

I* $/$(%, ,"$,&$'6 ,#o(+%, , 9o"$ &$c !)%($* , ,c$%*&!"!$ț < *%(, o(& *+!@ % *! ,$ ", !)%($* 6 )$ $c6 c$ $ ", c%,$($&!,"6

* ($/$(%, ,"$,&$'6 (%c!*o, &% c6 o, %*$$ !*& ,$ !"& +%c & &(! !($ $*&%,< $($&!" $ % o $$"%



!*&% < (%c! !*& ), $"$$"% $ co !*$&,&$$"% +$* c,(% ),c% ,(&%.* ($/$(%, ,"$,&$'6 *! % (%)%(6 +o,( ", -* ($/$(%, +% ", ) ( $&!" '$%&$$ c$ o,&% 6 -*c%, 6 -* o %*&!"

#o,"6 $*c!(,#$"6.Sco !" ,c% &%$ -* ($/$($ ,"$,&$'% *! % &% (%"!* $(%, ,! c!(&,(%, '$% $$< c$ ,c%", +% , - #!*6&6 $ c,"$&$ !" c,(% , ,$ (6 , .

C,"$&,&%, '$% $$ % &% o &,(% +% #$*% +$* !*c& +% '%+%(% )$ $c $ % o $o*," *! ,# %* , #o"$$ c$ co,c% &%$,. Ac%, &, ', )$ +$)%($&6 %*&(! %( o,*% +$)%($&% @,( !&%, 6 % (%)%(% ", , )$ c, ,#$" 6 )c!(%*&%< , )$ c, ,#$" 6 'o(#%, c6 c! ($%&%*$$< ,! , )$ c, ,#$" 6 +% ! &% !* )%" +% *c,(%.

* ($/$(%, ,"$,&$'6 )!*c $o*%, 6 c! ,"&% (o (, %: N! -*"oc!$% &% ,"&% )o( % +% -* ($/$($. Po,&% )$ $*&% (,&6 -* (o (, !" +% -* ($/$($ +%/, %H$ &%*& +$* -* ($/$(%, )$%c6(%$ %( o,*% c! o #o,"6 c,(% "$ $&%, 6 '$, ,.

* ($/$(%, ,"$,&$'6 o,&% )$ $*&% (,&6 -* ,c% &% (o (, % c% o& o)%($ o -* ($/$(% 9o"$ &$c6.P,c$%* $$ ,! *%'o$% +% -* ($/$(% -* o+ +$)%($& -* )!*c $% +% $&!, $, )$%c6(!$, $ +% c & +% #o"*,'$ !*&C9$,( $ +! 6 o,(&%< -* ($/$(%, ,"$,&$'6 o,&% )$ co*&$*!,&6 o)%($*+ ! o(& -* %($o,+, +% +o"$! ), $"$

co $$"o(.Ac%, &, ', $ "$c, -* ($/$(% c,(% ', )$:@ F$ $c6 :, $ &%* 6< &(,&, %*&< (% c($%(%@ P $9$c6: , c!"&,(%< co* $"$%(%< , )$ (% %*&@ Soc$,"6: ,/!&o( )$*,*c$,(< c!(6 %*$%< ! o(& ), $"$,"@ S $($&!,"6: (! 6c$!*%< co* $"$%(%< %('$c$$ (%"$ $o, %

T$ !($ +% %('$c$$ +% -* ($/$(% P,"$,&$'6@ -* ($/$(% ,"$,&$'6 ", +o $c$"$!.@ A #!",&o($! +% -* ($/$(% ,"$,&$'6.@ C%*&(! +% $.@ Ec9$ , +% -* ($/$($ ,"%,&$'% +% $&,"@ U*$&,&% c! ,&!($

S%('$c$$"% +% -* ($/$($ ,"$,&$'% &(%#!$% 6 )$% ,co(+,&% +% o %c9$ 6 $*&%(+$ c$ "$*,(6 )o( ,&6 +$* , , $ !(, %('$c$$ +% c,"$&,&%. M!*c, -* %c9$ 6 % &% % %* $,"6 -* -* ($/$(%, ,"$,&$'6.EC IPA DE =AJĂ: * ($/$(%, ", +o $c$"$!:@ M%+$c@ A $ &%*& %+$c,"@ A $ &%*& oc$,"

Po"$c"$*$c6;A #!",&o($!:@ M%+$c

@ A $ &%*& %+$c,"



8

U*$&,&% c! ,&!($:@ M%+$c@ A $ &%*& %+$c,"@ I*)$( $%(,

@A $ &%*& oc$,"@ P $9o"o@ C"%($cAc% &% -* ($/$($ ,"$,&$'% %( $&% ,c$%* $"o( 6 &(6$, c6 $ 6 % $ &6 ',"o($ , $ *6 ", ) ( $&!"

“ Decesul unui om tulbura mersul vietii dar nu-l opre ș te, munca trebuie dusă mai departe in

interesul omenirii”

C,(o" Mo % B1784 <ș T%9*$c, I* ($/$($$ =o"*,'!"!$ 'o"! !" 2< E+$&!(, M%+$c,",

Obiectivul 2

Prezentarea a 4 simptome frecvente in ingrijirile Paliative

!urerea

E &% co* $+%(,&6 o %* , $% c,! ,&6 +% !* &$ !" )$ $c ,! +% o +$ )!*c $% o( ,*$c6. E &% (o#"% , c%-* (,c&$c, %+$c,"6.

D!(%(%, % &% %(c% !&6 !#$%c&$' +% $*+$'$+ $ o,&% )$ +% c($ 6 +o,( +% ,c%, &,. EH %($%* , +!(%(% &% !* )%*o %* $*+$'$+!," $*)"!%* ,& +% )o*+!" c!"&!(,"< $9o@ oc$," $ %co*o $c.

C", $)$c,(%, +!(%($$ +! 6 &(!c&!(, ,*,&o $c6 ,)%c&,&6:

Durerea nociceptivă somatică : C,(,c&%($ &$c$: % +,&o(%, 6 +$ &(!c $%$ % !&!($"o( o ,& #$*% "oc,"$ ,&6< ! %()$c$," ,! , (o, % +% ! (,), , co( !"!$. Durerea nociceptivă viscerală : C,(,c&%($ &$c$: % +,&o(%, 6 ,)%c&6($$ '$ c%(,"%< o# &(!c $%



c,'$&,(%< $ c9% $%$ $ % &% (o)!*+6< (o & "oc,"$ ,&6< c! c,(,c&%( +% ? (% $!*% . Durerea neuropată : C,(,c&%($ &$c$: % &% (o+! 6 ($* ,)%c&,(%, ,! +$ &(!c $, % !&!"!$ * (% %*&6 !# )o( 6 +% ?,( !(6 < ? oc %"%c&($c < ?)!(*$c6&!($ < , oc$,&6 c! ,(% &% $ D!(%(%, *%!(o ,&6 (% (% $*&6 o (o'oc,(% %*&(! c"$*$c$,*< )$$*+ !* $ &o (%! co*&

co* $+%(,&6< *6 -* (% %*&< o +!(%(% (% $ &%*&6 ", &(,&, %*&!" c! o $o$+%.D! 6 +%#!&< +!(%(%, % &% c", $)$c,&6 -*: ,c!&6< c(o*$c6 $ % $ o+$c6:

Durerea acută : C,(,c&%($ &$c$: #$*% "oc,"$ ,&6< +$ c($ $*,&$'6< +!(%, 6 *6 ", -*+% 6(&&$ !"!"!$ +!(%(o < % -* o % &% +% &$ !",(%, $ &% !"!$ *%('o ,!&o*o B $+($, 6

&,9$ *%%< &(,* $(, $$< ', oco* &($c $%< (%, 6< 9$ %( "$c% $% < (6 !* $9o"oB)($c6< ,*H$%&,&%

Durerea cronică : C,(,c&%($ &$c$: +!(%(% c! +!(,&6 +% c%" ! $* 2 "!*$< c! +%#!& $* $+$o <

o+$)$c6($ % *$)$c,&$'% co o(&, %*&,"% $ $9o"o $c% B+% (% $%< %*&$ %*&$* o *$%< &%*+$* 6 +% *% ,(%

Durerea episodică : C,(,c&%($ &$c$: , ,(% )(%c'%*& % !* % $ o+ +% +!(%(% c(o*$c6< %* $c,(,c&%($ &$c$"% !*%$ +!(%($ ,c!&%.O $ o(&,* 6 +%o %#$&6 -* ,&o"o $, *%o ", $c6 % ,co(+6 +!(%($$ +% &$„breakthrough” < c,(%*%c% $&6 !* +$, *o &$c co(%c& $ &(,&, %*& %c$)$c.

Clasificare dupa evenimentul care o produce: D!(%(%, c% , ,(% )6(6 o c,! 6 %c$)$c6< *%, &% &,&6 % &% +!(%(%, $+$o ,&$c6; o*&,*6D!(%(%, c% ,(% o c,! 6 %c$)$c6 % &% +!(%(%, $*c$+%*&6; (%c$ $&,&6 $ % &% !#c", $)$c,&6 -*:@ D!(%(%, +%&%( $*,&6 +% !* ,c& 'o"!*&,(< % &% +!(%(%, $*c$+%*&6 'o"!*&,(6@ D!(%(%, +%&%( $*,&6 +% !* ,c& $*'o"!*&,( % &% +!(%(%, $*c$+%*&6 $*'o"!*&,(6.@ D!(%(%, +%&%( $*,&6 +% o (oc%+!(6 &%(, %!&$c6 % &% +!(%(%, (oc%+!(,"6.

Simptome digestive

"reata si varsaturi

1. G(%, , % &% o %* , $% *% "6c!&6 , oc$,&6 c! ,'%( $!*% %*&(! ,"$ %*&% $ c! %* , $, $ $*%*&6 +,$ ! 6(6&o,(% +%c & 'o ,< !" $ ,c$%* $ ,cc% & *+ o 'o 6 oc, $o*,"6< +,c6 +! 6 ,c%%, *! ,$ (% $*&6

2. V6( 6&!($"% (% (% $*&6 %H !" $, co* $*!&!"!$ , &($c % !(6< )$$*+ (%c%+,&6 ,! *! +% %* , $, +V6( 6&!(, % &% !* ,c& (%)"%H< c! c%*&(!" -* #!"#!" (,9$+$,*< (% (% %*& *+ o o+,"$&,&% +% , 6(,(% ), 6

&o ,c," +6!*6&o( o( ,*$ !"!$.* o %*&!" '6( 6&!($$< ! c!",&!(, %(% $"o( &o ,c,"$< ! c9$$ ,#+o $*,"$ $ +$,)(, !" % co*&(,c&6 $

,c%,", $ &$ < $"o(!" % -*c9$+%< $,( co* $*!&!" &o ,c," ,/!* %< !# (% $!*%< $,( c,(+$, -* ,c%, & o %*

* !( , (% $!*$$ $*&(, &o ,c,"%< co* $*!&!" , &($c &(%c% -* % o), < , o$ -* ),($* %< "$ #, % &% &(, 6



7

$ ),($* %"% % -*c9$+< $,( co* $*!&!" &o ,c!"!" % &% ,(!*c,& % !(6.

Factorii etiologici ai greţurilor şi vărsăturilor sunt : &! o($ ,"$ *% "oc," ,',* ,&% Bc,*c%( , &($c<," ,*c(%, !"!$< o(o),($* $,* < %&, &, % 9% ,&$c%< c,(c$*o ,&o 6 %($&o*%,"6< , c$&

co (% $% , % o), !"!$< o# &(!c $% $*&% &$*,"6 B %c,*$c6 ,! $* !)$c$%* 6 %($ &,"%&, &, % c%(%#(,"% c! 9$ %(&%* $!*% $*&(,c(,*$,*6< &! o($ '% &$#!",(%< *%!(o ,&$%

B $*+(o, % ,(,*%o ", $c%< +$,#%&< ,"coo"$ < $* !)$c$%* 6 (%*,"6 ,! 9% ,&$c6< 9$9$ o*,&($% $%< , &(o ,(% 6 B*%!(o ,&$, ,(,*%o ", $c6 '$ c%(,"6 < %+$c, %*&% Bo,*&$co"$*%( $c%< c9$ $o&%(, $%< AINS< )$%(< c,(#, , % $*,< #(o*9o+$",&,&o,(%< % &(,+$o&%(, $%.

#egumentele

D,&o($&6 ,"c6&!$($$ ,"% ',($,&%< $%"%, -*+% "$*% &% o %($% +% )!*c $$< $ ,*! %:@ , 6(6 o( ,*$ !" - o&($', , %* $"o( ,&o %*$< - $%+$c *+ 6&(!*+%(%, ,c% &o(,@ -" , 6(, - o&($', !*o( (,+$, $$B!"&(,'$o"%&% ($* $ %* $$ % c,(% -$ co* $*%.@ (%c% $o*%, 6 %Hc$&, $$"% &%( $c%< &,c&$"% $ +!(%(o, %.@ ,(&$c$ 6 ", %Hc(% $, !# &,* %"o( (% !"&,&% +$* %&,#o"$ : ($* ",*+%"% !+o($ ,(%< %"$ $*6 ,!(%%< "!co 6< co( $ c%&o*$c$.@ ,(&$c$ 6 ", &%( o(% ",(% ,& & ($* &%( o"$ 6 c & $ ($* %* $*%(%, &% %(,&!($$ ($* &(,&!" ,+&%( $c.@ ,(&$c$ 6 ", ,# o(# $%.@ ,(&$c$ 6 ", (% $(, $%< o c,*&$&,&% $c6 +% O2 o,&% $*&(, ($* $%"%< ", )%"< % %"$ $*6 o c,*&$Po& , 6(%, !( 6&o,(%"% (o#"% % &% ! %*&,(%:@ % c,(%: "% $!*% ! %()$c$,"6 ,! (o)!*+6 , % !&!($"o( co ($ ,&% -*&(% (o% $*%* %"% o o, % $ !c,! ,&% +% &!"#!(6($ +% c$(c!", $% $ ,"% ,"$ %*&, $%$ "oc,"% c! * % -* % !&!($"% co ($ ,&%@ %($&% : S&,(% ,&o"o $c6 ,*$)% &,&6 ($* , ,($ $, %&%"o( (o $$ % $%"%ț ș

@ % co($, $$: D$ &(! %(% , &(,&!"!$ ! %()$c$," ," $%"$$ /!"$&!(6< ($%&!(6@ c(! &%@ "6 $ : "% $!*$ &(,! ,&$c%< c,(,c&%($ ,&% ($* -*&(%(! %(%, co*&$*!$&6 $$ &% ! %*&%"o( ,! , !co,co*&$*!$&,&% "% $!*%, $%"$$ ,! , !co, %$ o,&% )$ c! ,! )6(6 "% $!*$ &$ !",(% +% (o)!* $ %@ '% $c!"%: '% $c!", % &% !* #! !*,( c! "$c9$+ ", *$'%"!" &(,&!"!$ ! %($o( ," &% ! %*&!"!$@ ! &!"%:L% $!*% , $%"$$ c,(% % (% $*&6 c, o '% $c!"6 "$*6 +% !(o$.@ %+% %: Ac! !",(% %Hc% $'6 +% "$c9$+ %(o -* , $$"% $*&%(c%"!",(% ,"% o( ,*%"o( $ % !&!($"o(.ț ș ț

@ "% $!*$ +% (,&,/: ($%&!(6@ %&% $$: P,&6 +% c!"o,(% (o $%@'$ $*$%< +% +$ %* $!*$ (%+! %< c,(% , ,(% % $%"% +,&o($&6 !*%$ș ș

@ %c9$ o %: * %(,(% !#c!&,*,&6 , 6(!&6 c, !( ,(% , "% 6($$ !*!$ ', +% * % c! %H&(,', ,(%, * %"!$.



1

@ ,"$+$&,&%: co"o(, $, -* ,"# , &% ! %*&%"o(.@ c$,*o ,: co"o(, $, -* ,"#, &(! , &% ! %*&%"o(.@ $c&%(: co"o(,& -* ,"#%* , &% ! %*&%"o(

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,

Obiectivul 4

Implementarea unui "*id pentru Ingrijiri Paliative in escare

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Anexele ), *, 1+, 11

(lasificarea cauzelor in formarea escarelor

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1.1 +,suri de prevenire a escarelor

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1.2 A"$ %*&, $, si *idratarea pacientului cu escare de decubit

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1. =o +,* C.< S&,$*o'$c$ S.< G9$+ +% N!( $* %($,&($c<< E+$&!(, J%c, $*< 1778.

2. D(. D,*$%", Mo o$! $ D(. Z,*% $* 9,Y B2010 < M,*!,"!" Fo( ,&o(!"!$ $* $* ($/$(%, P,"$,&$',< G(,)$c,: R,T,!&!< PDF.

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4. I*+(% &,( %*&(! , $ &%*&% %+$c,"%< c, . III< , .41@5 .

5. Z!(*," ?N!( $* co !*$&,(< < *(. 2 *(. 8; < 2007.

. ,(" %$* ($ &%" B177 < I* ($/$(%, =o"*,'!"!$< =!c!(% &$: E+$&!(, A"".

8. L!c(%&$, T$&$(c,< T%9*$c$ +% %',"!,(% $ $* ($/$($ ,co(+,&% +% , $ &%*&$$ %+$c,"$< =!c!(% &$ 177

. L!c(%&$, T$&$(c, B200 < G9$+ +% *!( $* Vo"! !" 1< =!c!(% &$: E+$&!(, '$,&, %+$c,", Ro ,*%, c,.

7. S9%$", P,K*%< Z,*% S%K o!( $ C9($ &$*% I* "%&o*< 2012< T(,&,& +% $* ($/$($ ,"$,&$'% %*&(! ,P($*c$ $$ $ +o'% $ %*&(! (,c&$c, c"$*$c,< &(,+!c%(% F!*+,&$, o $c% C, , S %(,*&%$< =(, o'.

10. S&,*+,(+% +% I* ($/$($ N!( $* < A oc$,&$, +% *!( $* < C9$ $*,! 2018.

11. S%&!" LEMON< c, $&o("!" @ P(,c&$c, c"$*$c, +% N!( $* .

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http://www.boli-medicina.com/

http://www.doctoracasa.ro/

http://www.tehnoplus.ro/docs

http://www.medicultau.com/

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https://www.scribd.com/doc/201120335/Aspecte-de-Teorie-Si-Practica-in-Ingrijirea-Paleativa

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http://dexonline.ro/

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